Fuel, Train, Thrive: Tips for Athletes Managing PCOS

Athletes with Polycystic Ovarian Syndrome (PCOS) may experience struggles with training, competing and recovering due to the hormonal and metabolic challenges associated with the condition. 

This is why it's essential to have a well-structured training programme that strategically incorporates efficient rest and recovery, along with nutritional adjustments designed to optimise both health and performance.

If you're working with a coach, it's essential they understand your unique needs and have the flexibility to adapt when necessary.

While performance is the goal, long-term health is the priority.

Managing the variables that can impact and disrupt your hormones is the key to unlocking your full potential, so you are able to compete to the best of your ability.

STRUCTURE AND REST

Following a properly structured training programme with attentive coaching ensures that the training intensity and volume align with your body's needs, especially during times when hormonal fluctuations may make recovery harder, but also allow for progression and success.

Implementing structured rest into your training programme isn’t optional — it’s essential. Overtraining without adequate recovery increases systemic inflammation, which can exacerbate PCOS symptoms, leading to energy crashes, hormonal dysregulation, and underperformance.

Here’s how to build smarter, recovery-focused training:

• Prioritise Full Rest Days

  Aim for 1–2 full rest days per week, minimum. This allows your muscles, nervous system, and hormones the time they need to reset and repair.
  

• Structure Your Sessions for Optimal Recovery

  Avoid stacking similar muscle group sessions (like two lower body days) back-to-back. Instead, space your sessions to give each muscle group adequate time to recover and adapt.
  

• Build in Adaptability

  Listen to your body. With PCOS, symptoms and stress levels can fluctuate daily. If you wake up feeling fatigued, highly stressed, or after a poor night’s sleep, it’s wise to adjust your plan where possible — swapping a demanding HIIT or heavy lifting session for a lower-intensity run, mobility work, or a relaxed strength session.

  That said, this kind of flexibility isn’t always possible for every athlete, especially in competitive environments. In those cases, it becomes even more important to focus on optimising the controllable factors — prioritising recovery, quality sleep, balanced nutrition, and practicing self-awareness to manage overall stress and support long-term performance.
  

• Schedule Deload Weeks

  Plan a deload week every 4–6 weeks, adjusting based on your cycle regularity, competition schedule, and overall nervous system state. Use this time to drop training intensity and volume to allow full physical and hormonal recovery.
  

• Utilise Recovery Tools

  Support your recovery with additional tools like:

  • Saunas

  • Cold therapy

  • Infrared light

  • Massage

  • Mobility and breathwork

  Find what works best for your body and nervous system, and make it part of your weekly routine.

  
  

• Optimise and Protect Your Sleep

  Prioritise 7–9 hours of quality, consistent sleep. Recovery starts here — poor sleep increases cortisol, insulin resistance, and inflammation, all of which worsen PCOS symptoms.

CARBOHYDRATE CYCLING

The concept of carb cycling involves adjusting your carbohydrate intake based on your activity level — eating more carbs on days when your body needs extra energy (like intense training days) and reducing them on rest or lower-intensity days.

A simple, effective approach is to time the bulk of your carbohydrates around your workouts — using them strategically as pre- and post-training meals to fuel performance and support recovery. Carb cycling isn’t about restriction — it’s about strategic fuelling. Adjusting your intake based on your training demands can help regulate insulin, improve performance, and support better overall health in athletes with PCOS.

How Carb Cycling Benefits PCOS Athletes

Helps Manage Insulin Resistance

Up to 80% of women with PCOS experience some degree of insulin resistance, which leads to higher circulating insulin levels, increased fat storage, and difficulty using carbohydrates efficiently for energy.

By training the body to utilise carbs when they’re most needed — like during and after workouts — you can improve insulin sensitivity over time, making it easier for your body to process carbohydrates effectively.

Supports Muscle Recovery and Blood Sugar Stability

• Replenishing glycogen stores post-workout is essential for muscle recovery, reducing fatigue, and maintaining performance in subsequent sessions.

• Proper carb timing helps stabilise blood sugar levels, preventing energy crashes and reducing cravings throughout the day — which is especially important for managing PCOS symptoms and supporting consistent energy levels.

MANAGING STRESS

Stress triggers physiological responses that can worsen the hormonal imbalances already present in PCOS, creating a negative feedback loop that affects both overall health and athletic performance.

It’s important to remember that stress isn’t just mental — it can be physical, emotional, environmental, or even hidden in poor recovery habits. Everyone experiences and responds to stress differently, so identifying your personal triggers and developing effective coping strategies is essential for managing both PCOS and training demands.

What Elevated Cortisol Can Do:

• Disrupt Hormonal Balance

  Increased cortisol levels can stimulate androgen production, worsening symptoms like acne, hair growth, and irregular cycles, while also amplifying insulin resistance.

• Impede Recovery

  High cortisol interferes with protein synthesis, slows down muscle repair, and increases systemic inflammation, which collectively impairs recovery and can lead to overtraining symptoms.

• Increase Fatigue and Burnout

  Chronically elevated stress can contribute to adrenal dysfunction, resulting in persistent tiredness, irritability, sleep issues, and reduced stamina during workouts.

• Cause Digestive Issues and Cravings

  Stress affects the gut-brain axis, potentially leading to bloating, discomfort, and increased cravings — especially for high-sugar, high-carb foods — which can further destabilise blood sugar and hormonal balance.

Why Self-Awareness Matters:

Without self-awareness, it’s easy to ignore or push through signs of imbalance — whether that’s fatigue, irritability, disrupted sleep, increased cravings, or mood swings. Over time, this leads to:

• Worsening hormonal symptoms

• Decreased training performance

• Poor recovery

• Higher injury and burnout risk

The sooner you recognise and respond to these signals, the better you can manage your stress, adjust your training, and support your overall health. Self-awareness isn’t a luxury — it’s a vital performance and health skill for athletes with PCOS.