Exercise Can Improve PCOS Hormones Without Weight Loss

Exercise Was Linked To Lower Testosterone

Elevated testosterone is one of the hormonal features commonly associated with PCOS and can contribute to symptoms such as acne, excess facial or body hair, hair thinning and disrupted ovulation.

Across the studies, exercise produced a statistically significant reduction in testosterone.

The effect was not enormous, but it was consistent enough across the research for the authors to conclude that exercise has a favourable effect on testosterone levels in adults with PCOS.

This gives us another reason to think about movement as part of hormone support, rather than simply something we do to burn calories.

Aerobic Exercise Stood Out

When researchers separated the studies according to the type of exercise used, the aerobic exercise group showed a significant reduction in testosterone.

Interestingly, the anaerobic and mixed exercise groups did not individually reach statistical significance.

There is an important piece of context here though. The researchers did not find a statistically significant difference when they directly compared the different exercise categories with each other.

So, this study does not prove that aerobic exercise is superior to resistance or mixed training. What it does show is that the clearest evidence for reducing testosterone currently sits with aerobic exercise.

More Intense Exercise Was Not Necessarily Better

One of the most useful findings was that higher intensity exercise did not appear to produce a significantly greater effect on testosterone than moderate intensity exercise.

Neither the high-intensity nor moderate-intensity subgroup independently reached statistical significance, and there was no significant difference between the two.

This is a great reminder that supporting PCOS does not necessarily mean pushing your body through the hardest workout possible.

The research simply does not support the idea that harder exercise automatically creates a better hormonal response.

Exercise Helped Testosterone Without Significantly Changing BMI

This may be my favourite finding from the paper.

Across 18 studies involving 988 participants, exercise did not produce a statistically significant reduction in BMI.

Yet testosterone still improved.

In other words, the hormonal benefits of exercise cannot be judged purely by whether someone loses enough weight to change their BMI.

The authors also point out that BMI is a fairly blunt measurement. It cannot distinguish between changes in body fat and changes in muscle mass, so improvements in body composition can easily be missed when BMI is the only measurement used.

Your Body Can Be Responding Even When The Scale Is Not

For anyone who has been exercising consistently but feels discouraged because their weight has not changed dramatically, this finding is worth remembering.

The absence of a significant change in BMI did not mean the intervention was doing nothing.

Exercise was still associated with a measurable improvement in testosterone.

It reinforces the idea that progress with PCOS should not be measured by body weight alone. Hormonal, metabolic and body composition changes can tell us much more about what is happening internally.

Why Might Exercise Affect Testosterone?

The researchers discuss several possible pathways.

One centres around insulin.

Exercise can improve insulin signalling and reduce hyperinsulinaemia. Because higher insulin levels can stimulate the ovaries to produce more androgens, improving this pathway may help reduce testosterone production.

The researchers also discuss inflammation as another possible mechanism. Exercise can influence inflammatory pathways, which may then improve insulin function and indirectly reduce ovarian androgen production.

This gives us a useful picture of why exercise can influence reproductive hormones. Metabolic health, inflammation and androgen production are closely connected.

Some Groups Appeared To Respond More Strongly

The researchers also explored whether the testosterone response differed depending on age or BMI.

A significant reduction was seen in studies where the average BMI was between 25 and 29.9, and in studies where the average participant age was 26 to 30.

However, this needs to be interpreted carefully.

When the researchers directly compared the different BMI and age groups, the differences were not statistically significant. The authors themselves describe these subgroup findings as exploratory.

So this research should not be interpreted as meaning exercise only works for people of a particular age or body size.

Not Every Reproductive Hormone Changed

Testosterone was the clear finding, but exercise did not significantly change follicle-stimulating hormone, or FSH.

The researchers also looked for evidence relating to LH, oestradiol, AMH, progesterone and prolactin.

However, there were not enough data points available for these hormones to perform the same full statistical analysis.

This is important because it means we cannot take the testosterone finding and assume exercise improves every reproductive hormone in the same way.

There simply is not enough evidence yet to make that conclusion.

We Still Do Not Know The “Perfect” PCOS Workout

The studies included a range of exercise types, intensities and intervention lengths, generally lasting between 8 and 24 weeks.

The researchers specifically tried to determine whether factors such as exercise intensity and duration changed the hormonal response.

At this stage, there simply is not enough evidence to prescribe one exact exercise formula for PCOS.

In fact, the authors state that the current research is insufficient to establish practical guidelines for the ideal intensity or duration of exercise.

So rather than searching for the perfect workout, the evidence supports something much more realistic: regular exercise matters, and we are still learning exactly how to optimise it for different people with PCOS.

The Evidence Is Promising, But Not Perfect

This was a systematic review and meta-analysis of randomized controlled trials, which makes it a valuable addition to the research.

However, the researchers rated the overall certainty of the evidence for testosterone, FSH and BMI as low.

The studies varied considerably in their exercise protocols, and many had methodological limitations. There were also not enough studies to explore different PCOS phenotypes or many of the reproductive hormones in detail.

So the finding that exercise reduces testosterone is encouraging, but we still need larger and better controlled trials before we can confidently say exactly which type, intensity and duration of exercise produces the greatest hormonal benefit.

What this means for PCOS/PMOS

For PCOS/PMOS, this research reinforces that exercise is doing much more than helping with weight management.

Elevated testosterone is a key hormonal feature of PCOS/PMOS and is linked with symptoms such as acne, excess hair growth, hair thinning and disrupted ovulation. Across these trials, exercise significantly reduced testosterone, even though BMI did not significantly change.

Aerobic exercise showed the clearest benefit, while higher intensity exercise was not shown to be better than moderate intensity movement.

For PCOS/PMOS management, this is an important reminder that the goal of exercise does not have to be weight loss. Regular movement can support the hormonal and metabolic pathways underlying the condition, and meaningful changes may be happening even when the scale stays the same.