Low Energy in PCOS? Start With Hydration
Hydration is one of the basic foundations of health, yet in PCOS it is rarely given the attention it deserves. Conversations more often centre around carbs, supplements, weight, or lab results. Water is reduced to a passing comment. Drink more. Stay hydrated. Aim for two litres.
In practice, however, fluid balance is not a background detail. It is part of the physiological environment in which hormones are produced, transported, signalled and cleared. When hydration is inconsistent, the effects are rarely dramatic enough to trigger medical concern, but they are often significant enough to influence daily symptoms such as fatigue, cravings, headaches, bloating and low mood.
For women already navigating the metabolic and hormonal complexity of PCOS, these small physiological stresses can accumulate. Understanding hydration as part of the wider gut–hormone conversation helps move it from generic lifestyle advice into something clinically meaningful and genuinely supportive.
The Link Between Hydration and Hormone Signalling
Hormones travel through the bloodstream to reach their target tissues. This process depends on stable blood volume, balanced electrolytes and effective cellular communication, all of which are influenced by hydration status. Even mild dehydration can subtly alter cardiovascular function, thermoregulation and cognitive performance.
In PCOS, where insulin signalling and appetite regulation are often already under pressure, these subtle shifts may be felt more clearly. Research shows that hydration status can influence blood sugar regulation, perceived energy, mood and concentration. Hydration is not a cure or a treatment for hormonal imbalance, but inadequate intake may add an additional burden to systems that are already working harder.
Our digestive system provides another important connection. Adequate fluid intake supports good production of digestive juices, how well our gut moves, and stool formation. These processes shape the gut environment that interacts with inflammation, microbial balance and hormone metabolism, themes explored in our discussion of the gut–hormone axis in PCOS.
When hydration is low, constipation and bloating are more likely to occur. In turn, discomfort may reduce appetite for fibre-rich foods, gradually influencing microbiome diversity and digestive resilience. This illustrates how hydration, gut health and hormonal regulation rarely operate in isolation. They are overlapping pieces of the same physiological picture.
Dehydration, Fatigue and Cravings
One of the most useful things to consider regarding hydration in PCOS is energy regulation. Mild dehydration commonly shows up as tiredness, headaches, dizziness or reduced concentration. These sensations are easily interpreted as hunger, particularly in the mid-afternoon when energy naturally dips.
For women managing insulin resistance, this misinterpretation matters. Responding to dehydration-related fatigue with quick carbs can reinforce the cycle of blood glucose spikes and crashes that many of us are trying to stabilise. Something as simple as improving fluid intake earlier in the day can therefore support steadier energy and clearer appetite signals, even without changing overall food intake.
There is also a neurological component. Thirst and hunger signals arise from closely related regions in the brain, which helps explain why they are so easily confused. Chronic under-hydration can therefore shape eating patterns in subtle but meaningful ways, contributing to grazing, sugar cravings or the sense of never quite feeling satisfied after meals.
Behaviour and routine play a significant role here. Busy work environments, long clinic shifts, caring responsibilities, commuting and high caffeine intake all make regular hydration more difficult than guidelines suggest. Many women realise late in the day that they haven’t drunk much water. Addressing hydration in PCOS is therefore less about strict targets and more about creating consistent daily habits.
Practical Hydration Strategies for PCOS
Hydration does not need to be complicated to be effective. In fact, the most helpful strategies are usually the simplest and most consistent.
Beginning the day with a glass of water helps restore hydration after overnight fasting and may gently stimulate digestion. Keeping water visible on a desk can subtly increase intake without conscious effort.
For those who struggle with plain water, small sensory changes often help. Lemon, cucumber, mint or herbal infusions can make fluids more appealing without relying on sugary drinks. Warm drinks can feel easier to tolerate for those with sensitive digestion, while cooler fluids may feel more refreshing during exercise or warmer weather.
Electrolyte balance is another quiet but relevant factor. Women who exercise regularly, sweat heavily, consume a lot of caffeine or experience frequent loose stools may benefit from paying attention to mineral intake alongside fluids. This does not usually require specialist products. Regular inclusion of vegetables, leafy greens, seeds and balanced meals often provides meaningful support.
Importantly, hydration should feel calm rather than pressured. Very high fluid intake is not necessary for most people and can occasionally feel uncomfortable or disruptive. Listening to thirst, observing urine colour and noticing energy levels often provide more realistic guidance than rigid rules.
A Small Habit With Wide Effects
Hydration will never be the most dramatic part of PCOS care, but it can be one of the most quietly influential. When fluid intake becomes more consistent, women frequently report steadier energy, fewer headaches, improved digestion and clearer appetite cues. These changes may appear modest, yet they create a more stable internal environment in which broader nutrition and lifestyle strategies can work more effectively.
Alongside balanced eating patterns, adequate fibre intake and support for gut health, hydration forms part of the everyday physiology that underpins hormonal wellbeing. You can explore these wider foundations in our article on balanced eating for PCOS, where the focus shifts from isolated nutrients to sustainable daily patterns.
Sometimes the most meaningful shifts in PCOS do not begin with complex interventions, but with simple habits repeated consistently. Hydration is one of those habits. Easy to overlook, yet powerful when supported.
This article is for educational purposes only and is not intended to diagnose or treat medical conditions. Nutritional therapy does not replace medical care. If you experience persistent fatigue, excessive thirst, dizziness or other concerning symptoms, please consult your GP or qualified healthcare professional.
The Power of Small Changes
Many people begin January believing they need major changes to manage PCOS. It is easy to feel pressure to overhaul your whole lifestyle or follow restrictive plans that feel unsustainable. But the truth is that small, consistent actions often make the biggest difference. These gradual steps are easier to maintain and can support more stable energy, steadier appetite and an overall sense of greater control.
The following case studies help to show how simple changes helped three women begin to feel more balanced and confident in their routines. Each story reflects something I see often in practice: real progress begins with changes that fit the individual, rather than trying to force a perfect plan.
Why small changes make the biggest difference
PCOS can feel overwhelming because it touches so many areas of our life. When everything feels so intertwined, it is tempting to think you need a complete and utter reset. Yet research consistently shows that sustainable, moderate lifestyle adjustments can be more impactful than extreme diets or intense exercise plans.
Small changes work because:
These changes accumulate over time, creating momentum that feels manageable rather than stressful. For many women, this gentle approach makes PCOS feel far less intimidating.
Case study 1: Balancing blood sugar
Amira started the year feeling tired most mornings and often found herself searching for snacks by mid-afternoon. She had tried cutting out entire food groups in the past, but nothing seemed to stick. Instead of another strict plan, she chose one simple goal. She added protein to her breakfast each day.
She began making a balanced morning meal with oats, seeds, berries and a good source of protein. After a few weeks, she noticed she felt fuller for longer and more stable through the morning. Her energy was more consistent, and she felt more confident approaching the rest of her meals with the same balanced mindset.
A single daily habit had a ripple effect on her routine, making eating feel calmer and more predictable.
Case study 2: Adding movement gradually
Claire wanted to exercise more but felt overwhelmed by the idea of committing to long workouts. In the past, she would start an ambitious routine, stick with it for a week or two, then stop when life became busy or she didn’t have the energy to continue such a massive plan.
This time she focused on one achievable goal. She added a 10-minute walk after lunch on weekdays. It felt manageable and didn’t require any special planning. As her confidence grew, she extended a couple of walks and added gentle strength work twice a week.
Within a month, movement felt less like a chore and more like a positive part of her day. The steady routine supported her mood, energy and sense of wellbeing without the pressure of a strict programme.
Case study 3: Supporting gut health
Sofia had always struggled with digestive discomfort, which often left her feeling bloated and unsure about which foods worked best for her. Instead of cutting out several foods at once, she explored adding more fibre in a gentle, consistent way.
She began by including a portion of vegetables with lunch and dinner, then added ground flaxseed to her breakfast a few mornings a week. After a few weeks her digestion felt more regular, mealtimes felt easier and she had a clearer sense of what supported her body.
Supporting gut health did not require a major overhaul. Small additions created meaningful progress.
What you can take from these stories
Each of these women started with just one change. None of them relied on strict rules or dramatic plans. They each chose something realistic, repeatable and supportive of their goals.
You might begin by:
The most effective approach is the one that feels manageable for you. Progress with PCOS rarely comes from perfection. It comes from steady steps that you can keep returning to, even during busy or stressful times.
If you feel unsure about where to begin, you are not alone. A personalised plan that fits your lifestyle can make the process feel far more achievable and grounding. You don’t need drastic changes, just the right ones. Book a free call with us to see how you could start your own PCOS progress story.
Why movement matters in PCOS
Many of my clients with PCOS describe the same pattern: constant cravings, afternoon energy dips, and a sense that workouts don’t really make much of a difference. These can be common experiences when insulin resistance is part of the picture.
However, regular physical activity is one of the most effective ways to improve insulin sensitivity, support glucose control, and enhance overall metabolic health in PCOS. Exercise also benefits mood, sleep quality, and body confidence - all key areas that can be affected by PCOS.
The 2023 International Evidence-Based PCOS Guideline identifies movement as a first-line approach to managing PCOS symptoms and improving long-term health. UK guidance recommends at least 150 minutes of moderate activity per week (such as brisk walking or cycling) or 75 minutes of vigorous activity, along with strength training on two or more days each week. Breaking up long periods of sitting is equally important.
Strength training and insulin sensitivity
Resistance or strength training plays a central role in improving insulin sensitivity. It increases muscle mass, and muscle tissue is one of the main sites where glucose is stored and used for energy. The more efficiently muscles take up glucose, the less insulin the body needs to produce, reducing insulin resistance over time.
Several studies have shown that women with PCOS who include resistance training experience improvements in insulin sensitivity, body composition, and metabolic markers. This type of exercise also helps protect bone density and maintain healthy weight as we age.
If you’re new to it, begin with two sessions per week using your bodyweight, resistance bands, or light dumbbells. Focus on controlled movements that target major muscle groups - such as squats, lunges, presses, and rows. Over time, gradually increase the challenge by adding repetitions, sets, or resistance. But do check with your GP if you are new to exercise or have any other health conditions.
Cardio and blood sugar balance
Aerobic or cardiovascular exercise helps the body use glucose more efficiently during and after activity. For women with PCOS, both moderate-intensity and interval-based cardio have been shown to improve insulin resistance and cardiovascular fitness.
Moderate-intensity options include brisk walking, swimming, or cycling at a pace where you can still hold a conversation. If you enjoy shorter, more dynamic workouts, interval training, alternating periods of higher effort with active recovery can be highly effective for improving insulin sensitivity and energy levels.
Aim for activities you genuinely enjoy and can maintain consistently. The goal is regular movement, not perfection.
The role of daily activity (walking, stretching)
Exercise isn’t only about structured workouts. Small amounts of daily movement make a real difference to blood sugar control and energy levels.
Simple habits, like walking after meals, taking the stairs, standing during phone calls, or doing gentle stretches before bed, all help counter the effects of prolonged sitting.
Even 10 minutes of light activity after eating can support post-meal blood glucose regulation and help stabilise afternoon energy. Over time, these micro-movements build a foundation of consistent activity that supports metabolic and hormonal balance.
How to find the right exercise for you
The most effective movement plan is one that fits your current energy, preferences, and lifestyle. Consistency matters more than intensity.
A balanced weekly routine might include:
If you’re feeling tired, recovering from illness, or just getting started, gentle movement such as stretching, walking, or yoga is still beneficial. Gradually build up frequency and intensity as your energy and confidence grow.
For best results, pair regular movement with balanced nutrition, good sleep, and effective stress management - all of which further support insulin sensitivity and hormone balance.
For further information, check out our blog How to Fuel Exercise with PCOS or why not book a call?
This article is for educational purposes only and does not replace medical advice or diagnosis.
Are you saying I’m cranky?
Tackling Mood and PCOS
For many women with PCOS, irregular or absent periods are more than just a medical symptom. They can bring uncertainty, frustration, and even a sense of disconnection from your body. Some women I’ve worked with have described feeling “broken” or anxious about not knowing when their period will arrive, while others feel dismissed when their concerns are minimised by healthcare providers.
These emotional experiences are valid. Understanding the impact of irregular cycles is an important step in caring for both your physical and mental health.
Why irregular cycles affect emotions
Menstrual cycles are guided by a rhythm of hormonal changes that influence not only reproduction but also mood, energy, and mental wellbeing. In PCOS, irregular or absent ovulation means these hormones often do not follow their usual patterns. Instead of a predictable rise and fall of oestrogen and progesterone, women may experience fluctuating oestrogen with little or no progesterone to balance it.
This disruption can lead to:
Rather than being “all in your head,” these experiences are rooted in the biology of PCOS, which helps explain why mood changes are so common.
Research has shown that women with PCOS are significantly more likely to experience mood difficulties. One large UK survey reported that around 50% of women with PCOS met criteria for anxiety and nearly 14% experienced depression using standard screening tools. Other international studies have found that more than half of women with PCOS report depressive symptoms, with around a quarter experiencing anxiety symptoms. These rates are substantially higher than in women without PCOS, highlighting the very real emotional burden of the condition.
How hormonal changes influence mood
Alongside the unpredictability of cycles, hormonal imbalances themselves can affect emotional wellbeing.
These hormonal dynamics help explain why women with PCOS may experience more frequent or intense mood changes, beyond the emotional impact of irregular cycles alone.
PMS and PCOS
Premenstrual syndrome (PMS) describes the physical and emotional symptoms that occur in the days before a period. These may include mood swings, irritability, bloating, and breast tenderness. In PCOS, PMS can sometimes feel more severe.
Because cycles are often longer and ovulation less frequent, progesterone levels can remain low while oestrogen fluctuates. This imbalance contributes to symptoms such as heightened irritability, anxiety, and sleep disturbance. The unpredictability of cycles can also mean PMS arrives unexpectedly, adding to distress.
While PMS is very common, if symptoms are severe or interfere with daily life, it is important to discuss them with a healthcare professional.
When PMS becomes PMDD
For some women, premenstrual symptoms go beyond PMS and develop into premenstrual dysphoric disorder (PMDD), a recognised mood disorder. PMDD causes severe emotional symptoms such as intense mood swings, depression, irritability, or anxiety in the luteal phase of the cycle (the two weeks before menstruation).
Although research into PMDD in PCOS is still developing, the hormonal irregularities of PCOS may increase vulnerability in some women. If you suspect PMDD, it is important to speak to your GP. Diagnosis usually involves symptom charting across several cycles, and treatment options can include medical, psychological, and lifestyle approaches.
You do not need to suffer in silence. Support is available, and seeking help is an important step towards improving quality of life.
The impact of feeling dismissed
A common theme for many women with PCOS is feeling unheard when they raise concerns. Being told “it’s just irregular periods” or “come back when you’re trying for a baby” can feel incredibly invalidating. Over time, this can add to feelings of isolation and frustration.
Recognising that these concerns are legitimate – and that your emotional wellbeing matters as much as your physical symptoms – is an important part of managing PCOS.
Supportive ways to cope with cycle unpredictability
While irregular cycles cannot always be fully controlled, there are ways to feel more grounded and supported:
These strategies cannot change the underlying hormonal patterns alone, but they can restore a sense of control and self-compassion.
When to seek professional input
If irregular cycles, PMS, or possible PMDD are causing distress or interfering with daily life, it may help to seek support. A GP can investigate medical options, while a nutrition practitioner can help you explore evidence-based ways to support hormone balance.
It is important to remember that you deserve support not just for your physical health, but also for the emotional impact of living with PCOS. If you’d like to chat further, why not book a free call?
How to fuel exercise with PCOS
When you enter into a good, consistent exercise routine with PCOS, it can be incredibly effective in helping to manage symptoms (see blog). But it can be difficult to know how to fuel these workouts, particularly when following a lower carbohydrate diet and working to balance blood sugar.
Here are some top tips to follow to get the most from your workouts:
Don’t exercise when fasting
Probably the most important factor is not to exercise in a fasted state. While this can be beneficial for men, research shows that it is less helpful for female athletes. As stress can be a factor in driving symptoms of PCOS (see blog), exercising in a fasting state puts women’s bodies under undue pressure and therefore may increase PCOS symptoms. Women’s bodies respond better to exercise when fed than fasted, plus it helps with recovery. Therefore, adjust your workout to align with your eating schedules.
Ensure adequate protein intake
As a woman with PCOS, working on appropriate protein levels is key for blood sugar balance. But it’s also important for ensuring we get the most from our exercise plan. Prioritise protein, particularly after workouts, to ensure proper recovery and muscle repair. Aim for 15g of good quality protein before a workout and follow with 30-45g of protein with 3g of leucine after exercise for the best results.
Don’t exclude carbohydrates all together
Remember that we should focus on a low refined carbohydrate diet with PCOS, not a no carb diet. Aim to include some whole food, un-refined carbohydrates in your diet, such as legumes, starchy veg and low sugar fruits, like berries.
Listen to your body
Listen to how you feel, look at how you’re recovering from exercise, and how well you’re performing. You know your body better than anyone else, so learn to trust your instincts and fuel your body in the right way for you. Don’t forget the important of rest days, not overdoing it, and getting plenty of sleep to help ensure you continue to improve and feel good.
Exercise is essential for managing PCOS well – it helps with blood sugar balance, it helps with controlling inflammation, and it provides excellent mental health benefits. By fuelling your body well, you can continue to enjoy those benefits!
Disclaimer: The information provided by the health and wellness coach is not intended to be a substitute for professional medical advice, diagnosis, or treatment. You should always consult your doctor or other healthcare provider before changing your diet or starting an exercise programme.
How exercise can improve PCOS
Many of us with PCOS are told to ‘eat less and move more’ as a kind of panacea for our symptoms. It is not usually that helpful, as it is far too simplistic in dealing with a complex endocrine condition like PCOS. However, certain types of exercise can be helpful in managing symptoms and keeping PCOS under control. Let’s take a look at why.
High levels of insulin, or hyperinsulinaemia, leading to insulin resistance is one of the main driving factors behind PCOS symptoms. For more information on this, check out this blog. The improvement in insulin sensitivity that we gain from exercise is the main reason it can help with PCOS. Exercise improves insulin sensitivity by increasing the efficiency of how muscles respond to insulin, allowing them to take up more glucose from the bloodstream. Secondarily to that, exercise has also been seen to reduce oxidative stress and inflammation, both further drivers of PCOS (see this blog).
Research has shown us that women with PCOS who exercise regularly see improved menstrual regularity and improved ovulation. There are also further benefits in improved muscle tone, improved energy levels, and, possibly most importantly, improved mental health, particularly low mood and anxiety. So, what can we do to include exercise in our lives? And what types of exercise are best for those with PCOS?
If you’ve not exercised for a while, or if it’s not really ever been on your agenda, starting movement can be a daunting task. Adding in just one exercise session per week and doing it consistently is much more beneficial than trying to exercise every day and only managing it for a week. Start slowly, build the habit, and then layer on more types of movement. Gradually, over time, work up to the recommended 150 mins per week – or 30 minutes of exercise 5 days per week.
Additionally, if this is new to you, try out a variety of different activities. You might love the sounds of nature whizzing around on your bike in the countryside, or you may prefer pounding techno in a spin studio. The main thing is to find out what floats your boat.
Here are some simple ideas of how to incorporate movement easily into your day:
Incorporating stretching exercises into your daily routine can help improve flexibility and reduce muscle stiffness caused by prolonged sitting. Check out examples on YouTube or Google a local class.
Taking short breaks to stand up and walk around can help increase blood flow and reduce the negative effects of prolonged sitting on the body. Walking for 10 minutes after eating can also help to improve insulin sensitivity – win-win! Set an alarm on your phone to remind you to get up and move around, or if you have a smart watch enable the notification.
Incorporating strength training exercises, such as bodyweight exercises or light resistance training, is especially good for women with PCOS. Increased muscle mass helps to improve insulin sensitivity. Plus, the added androgens that we have from having PCOS can actually be of benefit here – we’re usually pretty good at weight training! Here it might be worth investing in some expertise – online programmes such as with Caroline Girvan or Joe Wicks are available or see if there are local classes or PTs you can work with.
Practicing yoga or Pilates can help improve posture, strengthen core muscles, and increase flexibility, all of which can help counteract the negative effects of sitting for long periods. There are heaps of online programmes, Yoga with Adriene being one of my faves. Or look online for local teachers and classes.
Incorporating cardiovascular exercise, such as walking, running, cycling, or swimming, into your routine can help improve circulation, increase energy levels, and reduce the risk of chronic diseases associated with prolonged sitting. What did you love as a child? Were you always out on your bike, or a familiar figure at the local pool. Tap into that. It’ll feel hard at first, but you’ll get into the swing of it.
Start small but be consistent. And before you know it, exercise will be part of your life!
What is the worst exercise for PCOS?
From initial research, there's no one 'worst' form of exercise, but studies have found that over-exercising and over-training can make periods irregular due to a spike in cortisol levels which can put your hormones into disarray.
The reason why a crazy sweat session (running, swimming, rowing, etc.) is typically not recommended for PCOS is because it can put your body under too much stress. This happens when you don’t give your body enough time to recover or if you’re exercising at a moderate pace for more than 60 minutes, causing your body to produce additional cortisol, a stress hormone.
Part of PCOS symptom management is stress reduction, so putting your body under additional stress can worsen your condition. I know how contradicting this all sounds, but below are the main points to remember if you are someone who loves heart pounding workouts and wants to continue those forms of exercises:
And if you'd like to chat further about movement and PCOS, why not get in touch?
Disclaimer: The information provided by the health and wellness coach is not intended to be a substitute for professional medical advice, diagnosis, or treatment. You should always consult your doctor or other healthcare provider before changing your diet or starting an exercise programme.
For any conditions other than PCOS, please feel free to be in touch with our sister clinic Alex Allan Nutrion
PCOS Clinics is part of the Green Leaf Company (London) Ltd, a limited company registered in England and Wales. Registered number: 10990293
Disclaimer: ‘Please note that nutritional therapy is not medical advice - this should always be sought from your doctor or other medical provider. We aim to work alongside your doctor or GP to provide nutritional and lifestyle advice to support any underlying imbalances.'
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