Expert Advice On Being A Personal Trainer For PCOS Clients

Whether you currently have a client with the condition or want to learn how to work with women with PCOS, our guide will help you be a successful personal trainer for PCOS clients!

We’ll cover:

• What A Personal Trainer Must Know About PCOS And Exercise
• 5 Tips For Training Clients With PCOS
• Top 3 Exercises Women For PCOS Clients

If you’re interested in specializing in a particular demographic or fitness niche, OriGym’s Level 4 Nutritionist qualification, can help you do just that! Enquire today, or browse our full range of fitness courses by downloading our free course prospectus here. 

What A Personal Trainer Must Know About PCOS And Exercise

Before we get into our tips for training clients with PCOS, let’s first establish exactly what PCOS is and some things you should know about the relationship between PCOS and exercise. 

What is PCOS?

PCOS stands for polycystic ovary syndrome, and is a hormonal condition in women that affects how their ovaries work.

For women with PCOS, their ovaries ovulate (release eggs) less often than normal. They also produce a higher than normal level of androgen, which is a hormone that’s typically higher in males. 

As the name suggests, they also develop ‘polycystic ovaries’, which is when the ovaries become enlarged and develop small fluid-filled sacs.

It is a very common condition, affecting around 1 in 10 women in the UK according to the NHS. 

It can happen at any age, but PCOS is most commonly developed in women of reproductive age, with symptoms usually becoming apparents in the late teens and early 20s. 

Many women with PCOS exhibit no symptoms. But some of the common symptoms of PCOS include:

• Irregular, infrequent or prolonged periods
• Excess facial hair (due to higher levels of androgen)
• Weight gain- particularly in the abdominal area 
• Insulin resistance 
• Difficulty getting pregnant 
• Hair thinning or loss
• Oily skin or acne

PCOS can also lead to other health complications as a result, such as an increased risk of getting Type 2 diabetes and high cholesterol levels.

The exact causes of PCOS are unknown, but some things that have been suggested to increase the risk of getting PCOS are:

• The body producing high levels of insulin, which can prevent normal ovulation and lead to weight gain
• Hormone imbalances
• Genetics 

Whilst there is no cure for PCOS itself, the symptoms can be treated, such as:

• Healthy lifestyle changes 
• Medication
• Surgery 

PCOS And Exercise: Things To Be Aware Of As A PCOS Personal Trainer

Now you know exactly what the condition is, you may now be wondering, what is the relationship between PCOS and exercise? And what should you be aware of as a PCOS personal trainer? 

In short, exercise is hugely beneficial for women with PCOS. As we mentioned above, one of the main symptoms of PCOS is weight gain. 

This is because for women with PCOS, the body produces insulin but struggles to use it correctly to absorb sugar from your blood. This is called ‘insulin resistance’. Since it isn’t being absorbed, this can lead to a build up of sugar in the blood, which can then lead to weight gain. 

Another effect of insulin resistance is that high levels of insulin can trigger the production of androgens (the ‘male hormones’). This causes symptoms such as excess hair growth, acne, irregular periods and weight gain- particularly in the abdomen. 

With this in mind, many women with PCOS will get a personal trainer to help them with the goal of losing weight.

As we will explore further in our tips section, including cardio in your exercise plan for clients with PCOS will help them achieve this goal.

However, as a PCOS personal trainer, you should be aware that it will likely be much harder for a client with PCOS to lose weight than your regular clients. It may therefore take longer for them to see results despite following your program. 

As a result of weight gain and higher blood sugar levels, women with PCOS are also at an increased risk of developing Type 2 diabetes. 

So, although many women may want to lose weight for aesthetic reasons, getting help from a PT can also help them reduce the risk of developing this condition. 

You should also be aware of this symptom when offering any nutrition advice to your clients with PCOS. We will discuss this in more detail later in this article, but in general, your training programme should encourage a low-sugar diet to further reduce the risk of developing Type 2 diabetes. 

Many women with PCOS suffer from mental health issues such as low mood or even depression. This can be a result of hormonal imbalances, as well as low self-esteem from weight gain.  

Given the many mental health benefits of exercise, it can therefore help with these psychological as well as physical symptoms of PCOS. 

However, you should remind your clients that exercise is by no means a ‘cure’ or ‘quick fix’ for PCOS- it can only help to alleviate the symptoms.

These 3 symptoms (weight gain, diabetes and mental health issues) are something you should be aware of as a PT when dealing with someone suffering from PCOS, and should inform what to include in your exercise programme. 

So, with the right PCOS exercise programme, a personal trainer can make a real difference to someone living with PCOS- both physically and mentally! 

5 Tips For Training Clients With PCOS

So, let’s get into our top tips to help you create an effective exercise plan for women with PCOS. 

#1- Allow Extra Time For Clients With PCOS To Reach Their Goals

A common goal for someone seeking a specialist PCOS personal trainer is wanting to lose weight. 

But as we mentioned above, a symptom of PCOS is that it is harder to lose weight. It may therefore be harder, or take longer for them to see results from your training programme. 

When training clients with PCOS, you will need to be aware of this and be patient. 

For example, you may have a weight loss programme you usually do with clients that takes 12 weeks. But when making a diet and exercise plan for PCOS clients, you may have to extend the program to 15 weeks. 

Instead of thinking that your client is not achieving their weight loss goals because of lack of effort or commitment to your programme, remember that a huge factor is simply due to their condition- which is out of their control. 

If this happens, make sure to reassure your client that they know they are working hard and that it is okay if it takes them a little longer to achieve their goals or complete the programme. 

Remember that it is likely that they will feel discouraged and unmotivated if they are struggling to meet their fitness goals. So as their personal trainer, you will need to be patient and keep them on track! 

#2- Focus On Cardio In Your Exercise Plan For Women With PCOS

Since a key goal for most clients with PCOS is weight loss, you should focus on cardiovascular exercises as part of any PCOS exercise programme. 

At its most basic level, in order to lose weight, you need to be in a calorie deficit. This means that you are burning more calories than you are consuming. 

One of the main benefits of cardio and aerobic exercise is that it burns calories. So, when combined with the right nutrition (which we will cover later in this article), this can contribute to a calorie deficit and therefore help your client lose weight.

As well as helping them lose weight, regular aerobic exercise can also help with other symptoms of PCOS. For example, it can help to regulate insulin levels, which can then reduce androgen levels (the male hormone that women with PCOS have an excess of).

Cardiovascular exercise also improves heart health, which can reduce the risk of high blood pressure and high cholesterol- all of which women with PCOS are at higher risk of. 

One of the best types of cardiovascular exercise to include in an exercise plan for PCOS clients is HIIT (high intensity interval training). 

HIIT training involves short, intense bursts of exercise, followed by rest. 

One of the main benefits of HIIT training- particularly when training clients with PCOS, is that it promotes weight loss, since it burns lots of calories in a short amount of time. 

Examples of HIIT exercises are:

• Running intervals on a treadmill- 30 seconds of running followed by 30 seconds of walking recovery. Repeat for 10 to 20 rounds. 
• Plyometric exercises such as jumping jacks, squat jumps and burpees.
• Encourage your client to attend a HIIT group exercise class, such as circuit training or an aerobics class. 

However, remember that cardiovascular exercise doesn’t always have to be intense HIIT workouts! Be sure to include lower-impact cardio exercises too, such as:

• Walking 
• Cycling 
• Swimming
• Dancing 

As a PCOS personal trainer, you should also remind your clients that making everyday lifestyle changes can also contribute towards weight loss. For example, encourage them to take the stairs instead of the lift instead of the stairs, or walk to work instead of driving. 

This is the case when training any client for weight loss, but particularly when training clients with PCOS. Since they may struggle more to lose weight, they may need to make extra efforts outside of your sessions to reach their goals. 

Including a variety of different types of cardiovascular exercises will also help keep clients engaged and motivated! 

#3- Adapt Your Usual Strength Training Exercises In Your PCOS Exercise Program 

As well as cardio, you should also include plenty of strength training when designing an exercise plan for women with PCOS. 

Whilst cardio will certainly help your client lose weight, strength training is equally important when training clients with PCOS. 

There are many benefits of strength training for everyone- but particularly clients with PCOS, including:

• Strength training can reduce insulin resistance. As we have mentioned, women with PCOS suffer from insulin resistance, where their body produces excess levels of glucose that aren’t absorbed by insulin.

Muscle cells are one of the main consumers of glucose in the body. So, by increasing muscle cells through strength training, more glucose is absorbed by the body, thus helping regulate blood sugar levels. 

• Strength training can reduce androgen levels. Women with PCOS have higher levels of androgen (the male hormone). This is what causes symptoms such as excess facial hair and acne. 

Studies such as this one have indicated that women with PCOS who took part in regular strength training for 16 weeks showed a reduction in their androgen levels! 

• Strength training can help women with PCOS lose weight. Many PCOS personal trainers will focus completely on cardio to help their clients lose weight. But in fact, strength training can do this too! 

Strength training increases muscle mass, which can help your body burn more calories at rest. 

This is because muscles require calories to function, even at rest. So, the larger the muscles you have, the more calories you burn at rest. This increases your metabolic rate, which will in turn help you lose weight!

Since women with PCOS can struggle to lose weight, strength training can therefore help them maintain weight loss. 

However, one thing to remember when it comes to strength training and PCOS, is that you may need to adapt the kind of strength training you may normally do with other clients. 

This is because extreme high intensity strength training can actually have an adverse effect on women with PCOS. Over-straining and ‘overdoing’ any kind of exercise can actually irregulate hormone levels by causing a spike in cortisol levels. 

On a long-term basis, this can cause hormonal imbalances, which will only worsen the symptoms of PCOS! 

To avoid this, when designing an exercise program for women with PCOS, try to focus on achieving muscular endurance, rather than hypertrophy. 

For example, keep weights low but reps high- rather than using heavy weights for fewer reps. 

You may also want to use resistance bands or even just bodyweight exercises to keep impact low. For example, instead of having your client do a heavy barbell back squat, try a bodyweight squat or have them hold a low weight kettlebell. 

This will still give them all the same benefits of strength training for PCOS, but without the risk of disturbing their hormones!

However, as always, you should treat each client individually. For example, if someone has been doing weight training already for many years, then you may be able to include higher intensity strength training exercises without adverse effects. 

Check out these signs of overtraining to look out for in your clients to avoid this.

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#4- Include Flexibility Training Into Your Exercise Plan For PCOS Clients

As well as cardio and strength training, you should also consider including flexibility training when training clients with PCOS. 

Flexibility training is simply about improving the flexibility, mobility and range of motion of your muscles. It can take many forms, from simply dynamic and static stretches before and after a workout, to disciplines such as yoga and pilates. 

There are many benefits of flexibility training for all types of clients, including for women with PCOS!

One particularly beneficial type of flexibility training to include in your exercise program for women with PCOS is yoga. 

The benefits of yoga for women with PCOS include:

• Reduce stress and anxiety. Due to hormonal imbalances, many women with PCOS suffer from mental health issues such as stress, anxiety and low mood. 

Since yoga helps to calm the mind by reducing cortisol levels (the stress hormone), it can therefore be hugely beneficial for women with PCOS. 

In fact, a study by the International Journal of Yoga found that young women with PCOS who completed 10-12 weeks of yoga considerably reduced their symptoms of anxiety. 

• Can help regulate hormones. Many studies have also indicated that yoga can help regulate hormonal imbalances in women with PCOS. 

For example, the same study by the International Journal of Yoga found that after 10-12 weeks of yoga, women with PCOS showed lower testosterone levels and even more regular menstrual cycles. 

• Can reduce blood sugar levels. Regular yoga has also been shown to reduce blood sugar levels- which is a major symptom of PCOS. 

This is because like other forms of exercise, yoga increases glucose uptake from the muscle cells, which in turn reduce blood sugar levels in the blood. 

With these benefits in mind, how do you incorporate elements of yoga into your PCOS exercise program?

Including just 5-10 minutes of stretching before and after the main body of your session with a PCOS client will help them see these benefits. 

However, if you want to really stand out as a PCOS personal trainer, taking a Level 3 yoga teaching qualification with OriGym will give you a strong foundation of knowledge and skills to help your clients reap the benefits of yoga for PCOS! 

#5- Help Your PCOS Clients With Nutrition And Diet

As a personal trainer for PCOS clients, you should know that diet and nutrition is just as important as physical exercise when it comes to helping your client get results.

 The right diet and nutrition is important for any type of client, but particularly clients with PCOS. This is because it can help them to lose weight and manage the symptoms of PCOS. 

Before we get into our tips, when it comes to giving nutrition advice as a PCOS personal trainer, it is important to be aware that you are only qualified to give nutrition ‘advice’, rather than prescribe meal plans. 

This is because only registered dieticians can officially write meal plans for clients. If you try to do this with just a personal training qualification, you would be technically acting outside of your professional capabilities.  

Instead, you should ensure that you use phrases such as ‘I advise’ or ‘I recommend’- rather than giving them a set meal plan to follow! 

By completing one of OriGym's online nutrition courses, you can acquire the knowledge needed to give expert nutritional advice to your clients!

Check out our guide to whether personal trainers can give nutritional advice here for more detail on exactly what you are qualified to include in your exercise and diet plan for PCOS clients. 

So, what kind of nutrition advice should you give to your clients with PCOS? 

• They need to be in a calorie deficit to lose weight. As we have mentioned, many clients with PCOS will come to you wanting to lose weight. Whilst exercise plays a key role in this, nutrition is equally important.

To lose weight, you need to be in a calorie deficit, which means burning more calories than you are consuming. It is no use giving your client lots of cardio exercises, if they are putting all the weight back on with the food they are eating!

Instead, you should advise your clients with PCOS to eat a healthy, balanced diet full of fruits, vegetables and whole foods. 

• Avoid sugar and refined carbohydrates. Foods high in sugar and refined carbohydrates can cause spikes in blood sugar, which is already high in clients with PCOS. Avoiding these kinds of foods can therefore help regulate blood sugar levels and reduce insulin resistance. 

Examples of these kinds of foods to avoid include:

• Processed ‘junk’ food
• White bread and pasta
• Sugary snacks and drinks
• Foods high in saturated fats such as cheese and red meat

• Avoid inflammatory foods. Foods such as processed meats, margarine and junk food can cause inflammation, particularly in women with PCOS. 

Instead, advise your client to eat more anti-inflammatory foods, such as green vegetables, nuts, olive oil and omega-3 rich foods such as oily fish. 

• Eat small amounts often. Instead of 3 large meals a day, PCOS clients will benefit more from 4 to 6 smaller meals. This will help avoid blood sugar spikes and regulate insulin levels. 

Check out these healthy eating tips for ideas of ways you can motivate and inspire your clients to eat well! 

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Top 3 Exercises Women For PCOS Clients

So, now that you have some tips for training women with PCOS, here are some examples of specific exercises you can include in your exercise plan for PCOS!

Abdominal exercises

As we have mentioned, a common symptom of PCOS is weight gain- particularly in the abdominal area.

As a PCOS personal trainer, you may therefore find that many clients come to you wanting to reduce ‘belly fat’. 

Whilst calorie-burning cardio and diet are huge contributors to this, abdominal strengthening exercises will of course also help your client achieve this goal! 

Some examples of ab exercises to include in your exercises plan for PCOS are:

• Planks
• Abdominal crunches 
• Bicycle crunches 
• Leg raises

However, a particularly beneficial ab exercise for PCOS is pelvic floor exercises. 

The pelvic floor muscles are simply the muscles that support the bladder, bowel and uterus (in women). In women with PCOS, the pelvic floor can become weak, due to hormonal imbalances and being overweight. 

Pelvic floor exercises can therefore not only tone the abdominal muscles, but also help strengthen their weakened pelvic floor muscles. 

To help your client find the pelvic floor muscles, tell them to imagine that they are trying to stop the flow of urine. This contraction is how to engage your pelvic floor.

Here is how to instruct a pelvic floor exercise:

• Sit down comfortably and squeeze these muscles.
• Do this quickly at first, then more slowly, holding for as long as you can before relaxing. 
• Remember to breathe deeply throughout the exercise. 
• If this is the first time that your client has done pelvic floor exercises, then have them do this just once or twice. Then over time, work up to 3 sets of 8 squeezes a day. 

You could include pelvic floor exercises at the start or end of your session, as part of a warm-up or cool-down. 

Squats 

Another great exercise for women with PCOS is squats. 

As we have mentioned, strength training is particularly beneficial for women with PCOS, and one of the best strength training exercises is the squat. 

This is because squats are a great all-round (or compound) exercise that work a whole range of muscles, from the lower body to the core.

It also burns calories, helping your PCOS clients achieve their weight loss goals too! 

Plus, many clients with PCOS may not have much experience in strength training. The squat is therefore an ideal exercise as it can be easily adapted to make it accessible for all levels. 

For example, a client who has never done strength training before could start off with a bodyweight squat, whereas someone with more strength may be able to add weights using a barbell or kettlebell. 

You could also make the squat a more cardio-based exercise by having your client do bodyweight jump squats- which again will help them burn more calories!

Check out our complete guide to squats here, including benefits, variations and how to instruct it. 

Butterfly yoga pose

As we have said, there are many benefits of yoga for women with PCOS. And one of the best yoga poses to incorporate into your exercise plan for women with PCOS is the butterfly pose (or badhakonasana). 

This is great for women with PCOS because it helps to open up the pelvic muscles and hips. This will not only help promote relaxation and reduce stress, but it is also a great pose for relieving menstrual cramps- which many women with PCOS suffer from.

You could include this pose in the cool-down of a session with a client with PCOS. As well as the specific benefits for PCOS, it is also a great stretch for the leg and hip muscles that they will have worked during your session- especially during squats! 

Here’s how to instruct your client to do butterfly pose:

1. Sit on a mat or soft surface with the spine upright.
2. Slowly bend your knees and pull the soles of the feet together, holding your feet together with your hands. The closer the feet to your body, the deeper the stretch. 
3. Lengthen your spine, face your chest forwards and allow your knees to fall out to the sides. Depending on hip flexibility, the knees may hover or they may touch the floor. For extra comfort, you could place yoga blocks under your knees.
4. Breathe deeply and hold for 15-30 seconds. 

Another benefit of this exercise for PCOS clients is that it can be adapted to any level of flexibility. 

For example, for a deeper stretch, you could see if your client wants to try a reclined butterfly pose. This is essentially the same pose, but instead of sitting upright, you are lying flat on your back.

Before you go!

So, we hope you now have a better idea of how to be an effective personal trainer for PCOS clients!

Feeling inspired? Why not get qualified to train a wider range of clients and become a Level 4 Nutritionist? Enquire today, or download our free course prospectus here to browse the full range of courses we offer.