Nahima Shaffer
Fitness Trainer
FMS, NASM-CNC, NASM-CPT
Hormones, digestion, and bone health are closely linked, yet many women find themselves managing conditions like Polycystic Ovary Syndrome (PCOS), irritable bowel syndrome (IBS), osteoporosis, and other hormonal imbalances separately.
While medical treatments play a central role, movement is often recommended as part of a well-rounded approach to care. When done with intention, exercise can support hormone regulation, enhance gut health, strengthen bones, and help ease or prevent worsening symptoms.
The goal isn’t necessarily to do more, but to choose the type of movement that best supports your body’s needs.
Why Exercise Matters for Women’s Health
Exercise plays a fundamental role in supporting long-term health. For women in particular, research suggests that regular physical activity is associated with a significantly lower risk of death from any cause—by as much as 24 percent (1)<.sup>. Beyond longevity, movement supports better energy levels, improved mood, and reduced risk of chronic disease (2).
However, when it comes to hormones, the relationship is more complex. Exercise influences many hormonal systems in the body, meaning the type, intensity, and frequency of movement can either support balance or, in some cases, add stress.
At a broader level, key hormones such as insulin, cortisol, estrogen, and thyroid hormones—all essential to women’s health—are directly affected by physical activity.
Insulin: Produced by the pancreas, insulin plays a primary role in regulating blood sugar (glucose) levels by allowing cells to absorb glucose from the bloodstream for energy. Regular physical activity can improve insulin sensitivity, allowing the body to manage blood sugar more efficiently (3).
Cortisol: Produced by the adrenal glands, cortisol is the body’s primary stress hormone helping regulate metabolism, blood pressure, blood sugar and immune function. It follows a circadian rhythm, typically peaking in the morning and gradually declining throughout the day.
Moderate exercise can help regulate cortisol, while excessive or intense training without adequate recovery may elevate it (4). In women especially, chronically elevated cortisol has been linked to weight gain, fatigue, anxiety, and high blood pressure (5).
Estrogen: Produced mainly in the ovaries, estrogen is a group of hormones that regulate reproduction, sexual development, and the menstrual cycle. It also plays an important role in bone strength, heart health, and mood (6).
Levels naturally fluctuate throughout life, particularly during menopause. Research suggests that a combination of aerobic and anerobic resistance training can help support estradiol, one of the key forms of estrogen (7).
Thyroid Hormones: Produced by the thyroid gland, thyroxine (T4) and triiodothyronine (T3) regulate metabolism, heart rate, body temperature, and development (8). They are essential for maintaining the body’s overall energy balance. In conditions such as hyperthyroidism and hypothyroidism, exercise can be beneficial, but selecting the right type and intensity is important, as certain forms of activity may worsen symptoms (9).
Exercise and PCOS
Polycystic Ovary Syndrome (PCOS) is the most common hormonal disorder among women of reproductive age, affecting an estimated 5-6 million women in the United States (10). It is characterized by irregular menstrual cycles, elevated androgen levels (male hormones), and ovaries that may develop multiple small cysts. PCOS is also one of the leading causes of infertility and it can affect metabolic health, energy levels and overall hormonal balance (11).
Exercise is often recommended as a part of managing PCOS because of its wide-ranging effects on metabolic and hormonal health:
Improves insulin sensitivity: Women with PCOS experience higher rates of insulin levels causing the ovaries to release male hormones which suppress ovulation and contribute to other symptoms (12). Regular physical activity helps the body respond to insulin more effectively, which supports steadier blood sugar levels and may help reduce this key underlying driver of symptoms.
Supports weight management: Between 40 to 80 percent of people with PCOS live with obesity or have trouble maintaining a healthy weight (13). While movement along with a balanced diet can support weight management and improve body composition, the benefits of exercise in PCOS go far beyond weight alone. Regular physical activity also contributes to better energy levels, improved mood, and enhanced metabolic health.
Helps regulate menstrual cycles: Anovulation, or irregular ovulation, can contribute to fertility challenges. In examining the relationship between exercise and PCOS, research has shown that moderate-intensity physical activity can improve ovulation. These benefits appear to occur regardless of the specific type of exercise, as well as the frequency or duration of individual workout sessions (14).
What type of exercise is best?
Overall, research shows there is no single “best” type of exercise for women with PCOS. A review published in Sports Medicine found that both resistance and aerobic training, including activities like cycling, walking, jogging, and strength work—can all be beneficial (15).
Whether exercise is moderate or vigorous, indoors or outdoors, the key takeaway is that a wide range of movement styles can support healthier outcomes for women with PCOS.
The most important factor is consistency, and the best exercise form is ultimately the one you can maintain long-term and enjoy doing.
Exercise and IBS
Irritable bowel syndrome (IBS) is a chronic functional condition that affects the stomach and intestines (gastrointestinal tract), with symptoms including cramping, abdominal pain, bloating, gas, diarrhea, and constipation. IBS disproportionately affects women, with an estimated 25 to 45 million people in the U.S. living with the condition, and about two in three sufferers being female (16).
While only a small number of people with IBS have severe symptoms, many must be careful to control their symptoms by managing diet, lifestyle and stress. Understandably exercise can be tricky to navigate, especially when aiming to avoid aggravating symptoms.
Two main ways exercise helps IBS is by stimulating digestion and reducing stress.
Stimulating Digestion: Exercise supports digestion by stimulating peristalsis and increasing blood flow to the digestive tract, which can help reduce constipation and bloating. Both aerobic exercises, such as running, swimming, and cycling, along with resistance training have been shown to have positive effects on the gut microbiota. In people with IBS specifically, participating in a structured exercise program has been linked to both improvements in gut microbiota as well as reductions in abdominal pain and bloating (17).
Reducing Stress: The mental health benefits of exercise are well established, and they can be especially valuable for women with IBS. This is largely due to the gut–brain axis, the bidirectional communication system between the central nervous system (brain) and the enteric nervous system (gut), which means IBS is often linked with conditions such as anxiety and depression. By improving mood and reducing stress, exercise can help positively regulate this gut–brain connection (18).
What type of exercise is best?
Combining aerobic and resistance training may provide added benefits for gut microbiota health and function. However, as with other conditions—and particularly given the physical nature of IBS—excessive or inappropriate exercise can worsen symptoms.
Therefore, even with the proven benefits of exercise, it’s important to begin with low to moderate intensity, increasing gradually and seeking medical guidance as needed.
Exercise and Osteoporosis
Osteoporosis is a condition that gradually weakens bones, making them more prone to fractures from minor falls or everyday activities. Often called a “silent” disease, it typically has no symptoms until a fracture occurs. It primarily affects women, who make up roughly 80 percent of the 10 million people in the U.S. living with the condition. It is also estimated that 1 in 2 women over the age of 50 will experience an osteoporotic fracture (19).
Fortunately, exercise is one of the most effective ways to stimulate bone formation and slow bone loss. However, because of the fragile nature of the condition, selecting the right type of movement is essential. In more advanced cases of osteoporosis, where fracture risk is higher, certain exercises may need to be modified or avoided to reduce the chance of injury.
The types of activity most recommended for people with osteoporosis include:
Strength Training: Using free weights, resistance machines, bands, or body weight, strength training places controlled stress on bones. This mechanical load—through pulling and pushing—stimulates bone-forming cells and supports bone strength. It is especially beneficial for areas commonly affected by fractures, such as the hips, spine, and wrists (20).
Weight-bearing Aerobic Exercise: Includes activities like walking, dancing, light aerobics, stair climbing, or gardening where weight is borne on the feet. These types of movement work directly on the bones in the legs, hips, and lower spine (21).
Stability and Balance Exercises: These exercises are especially important in the effort to prevent falls and potential fractures, helping muscles work together and improving overall coordination.
Exercise and Hormonal Imbalances
Exercise can influence hormonal balance beyond conditions like PCOS, particularly through its effects on stress hormones, thyroid function, and menstrual cycle health.
Physical activity helps regulate cortisol, but when training becomes excessive or recovery is insufficient, stress levels can remain elevated, disrupting overall hormonal stability.
Thyroid function, which governs metabolism and energy production, can also be sensitive to both under- and over-exercising, making balance essential.
Women’s menstrual cycle health is closely tied to overall energy availability and recovery. While regular movement can support hormonal regulation, excessive exercise without adequate rest or nutrition may lead to irregular cycles or missed periods as the body prioritizes essential functions.
This is particularly important as many women seeking to live healthier lives may be over-training or under-fueling without realizing it, which can sometimes worsen hormonal imbalances rather than improve them. Recovery, sleep, and adequate nutrition are essential for restoring balance, allowing the body to respond positively to exercise and maintain stable hormonal function over time.
Bringing It Together: Finding the Right Balance
More exercise does not automatically mean better outcomes. In many cases, the quality, timing, and consistency of movement matter far more than intensity or volume. Learning to notice how the body responds—energy levels, recovery, and symptom changes—can help guide a more supportive and sustainable routine.
Because conditions like PCOS, IBS, osteoporosis, and hormonal imbalances affect each person differently, exercise should be personalized rather than rigid. What feels helpful during one phase may need adjusting during another, especially when symptoms or stress levels change.
A simple weekly framework can look like this:
- 2–3 strength training sessions
- 2–3 low-impact cardio days (such as walking or cycling)
- Daily light movement, such as stretching or casual walking
The SunnyFit app has hundreds of trainer-led workouts to help support you on your journey.
The goal is not perfection or strict adherence, but a flexible routine that supports the body without overwhelming it.
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