Adrenal PCOS is one of the lesser-known but increasingly recognised types of polycystic ovary syndrome. Unlike the more common insulin-resistant type, adrenal PCOS is driven by an overproduction of DHEA-S (dehydroepiandrosterone sulfate), a type of androgen produced by the adrenal glands, not the ovaries.
This overproduction is usually a response to chronic stress — physical, emotional, or even from overexercising. It’s not about poor diet or insulin spikes. Instead, it’s often seen in women who are very active, high-achieving, or under constant mental load. Think: busy professionals, students, or mums juggling it all.
According to a 2023 review in Frontiers in Endocrinology, around 20–30% of PCOS cases may have an adrenal component. And many of these women have normal insulin and testosterone levels — which is why adrenal PCOS often goes undiagnosed or misdiagnosed.
Understanding the root cause — stress and the HPA (hypothalamic-pituitary-adrenal) axis — is key to managing adrenal PCOS. It’s not about doing more. It’s about doing what works with your body, not against it.
Why Adrenal PCOS Is Often Missed
One of the biggest challenges with adrenal PCOS is that it’s easy to overlook — both by individuals and healthcare professionals. That’s because adrenal PCOS doesn’t always come with the typical red flags like high testosterone or insulin resistance.
Instead, the standout marker is elevated DHEA-S, and unless a doctor specifically tests for it, this type can be missed. Many standard PCOS panels don’t include DHEA-S, especially if the patient appears lean, active, and otherwise “healthy.”
The symptoms also mimic modern life stress:
- Feeling wired but tired
- Anxiety or irritability
- Trouble falling or staying asleep
- Irregular periods despite healthy diet and regular exercise
- A tendency to overtrain and under-recover
If you’ve ever felt like you’re “doing everything right” — eating well, working out hard — but your body isn’t responding or is actually getting worse, adrenal PCOS might be part of the picture.
Recent studies, including a 2022 analysis in The Journal of Clinical Endocrinology & Metabolism, have called for more attention to adrenal markers in diagnosing and managing PCOS, especially in younger women or those without classic symptoms.
Exercise & Adrenal PCOS: What Works (and What Doesn’t)
When it comes to adrenal PCOS, not all workouts are helpful — and some can even make symptoms worse. That’s because this type is driven by chronic stress, and the body is already producing too much cortisol and DHEA-S.
High-intensity workouts like HIIT, bootcamps, spinning, or long-distance running can spike those stress hormones even more. While they might feel like you’re “working hard,” they often lead to inflammation, fatigue, and stubborn weight retention — especially around the belly.
From my experience working with women with adrenal PCOS for over 12 years, this is the most complicated and delicate PCOS type. It requires a full lifestyle review — not just a shift in exercise. Everything needs to follow a “not draining” approach:
- Your training
- Your work environment
- The atmosphere at home
- Your sleeping habits
- Even the way you eat
Here’s what works best when it comes to movement:
- 2–3 sessions of strength training per week
(Focus on full-body workouts, moderate weights, low to moderate intensity)
- Daily walking
(At least 3 x 10 minutes is a great start, especially spread out across the day)
- 1–2 restorative sessions per week
(Gentle yoga, Pilates, swimming, mobility work, or nature hikes — anything calming)
- Plenty of rest and recovery
(Sleep and down-time are key to balancing adrenal function)
The aim isn’t to burn out — it’s to rebuild a healthy stress response and allow your body to shift out of survival mode.
Sample Weekly Training Plan for Adrenal PCOS
This plan supports your hormones and nervous system while helping you stay active, strong, and balanced.
Monday
- Full-body strength workout (30–40 mins, slow controlled pace)
- 10–15 minute walk after lunch or dinner
Tuesday
- Restorative yoga or gentle Pilates (20–30 mins)
- 2 x 10-minute walks during the day
Wednesday
- Strength training (focus on lower body & core)
- Short evening walk
Thursday
- Swimming, mobility work, or a rest day
- Light stretching or breathwork before bed
Friday
- Full-body strength workout
- Walk outdoors — aim for daylight and fresh air
Saturday
- Nature walk or easy hike
- Mindful recovery activity: journaling, reading, creative hobbies
Sunday
- Full rest or gentle yoga/stretch session
Training Tips for Adrenal PCOS
- You can follow this plan as is or adapt it based on your current physical ability, energy levels, and time availability.
- The goal is not intensity, but consistency and recovery.
- Track how you feel after each session — if you’re more tired, bloated, irritable, or anxious, it’s a sign to reduce the load.
- Don’t compare your plan to others — adrenal PCOS needs a tailored, compassionate approach.
- Use your training to regulate, not drain — think of your workouts as adding energy, not burning it.
Nutrition for Adrenal PCOS
When you’re dealing with adrenal PCOS, your body is often in a state of chronic stress. This affects your blood sugar, sleep, mood, and even digestion. So your nutrition needs to focus on stabilising energy, reducing inflammation, and supporting your nervous system.
1. Balance Your Blood Sugar
- Eat every 3–4 hours — don’t skip meals.
- Combine protein, fats, and complex carbs in every meal.
- Example: eggs + avocado on rye toast or chicken + quinoa + olive oil-dressed salad.
- Avoid relying on caffeine or sugary snacks to keep going — these spike cortisol.
2. Prioritise Protein
- Protein supports hormone production and stabilises mood.
- Aim for 20–30g per meal — this could be meat, fish, eggs, tofu, or Greek yoghurt.
- Add a small protein snack mid-afternoon if energy drops.
3. Include Magnesium-Rich Foods
- Magnesium calms the nervous system and supports sleep.
- Include foods like pumpkin seeds, spinach, dark chocolate, almonds, and black beans.
4. Eat Warming, Nourishing Meals
- From my experience, adrenal PCOS clients do well with warm, cooked meals over raw salads.
- Soups, stews, roasted vegetables, and slow-cooked proteins support digestion and reduce stress load.
5. Gluten and Dairy — Yes or No?
- Often with PCOS, you’re told to completely cut out gluten and dairy. But in my experience, this only makes sense if those foods actually cause issues for you.
- Here’s how to figure that out:
- Exclude dairy for 5–7 days, then reintroduce it.
- If you notice bloating, fatigue, or digestive issues, it may be best to avoid it longer term.
- Do the same with gluten.
- If there’s no reaction, there’s no need to restrict it from your diet.
6. Hydration + Salt
- If you feel dizzy or lightheaded when standing up, you may need electrolytes.
- Add a pinch of quality sea salt to your water once a day, especially if you’re sweating or under pressure.
Lifestyle & Recovery for Adrenal PCOS
When it comes to managing adrenal PCOS, training and nutrition are just two parts of the puzzle. The way you live, work, and rest plays a massive role in how well your body responds — especially when cortisol is involved.
From my experience, adrenal PCOS is the most complex type. It’s not just about what kind of exercise you do — it’s about your whole environment: your workload, sleep, relationships, emotional pressure, and even your thoughts.
Here’s what to focus on:
1. Sleep Is Medicine
- You need consistent, quality sleep to lower cortisol and support your recovery.
- Aim for 7.5–9 hours.
- Go to bed and wake up at similar times — even on weekends.
2. Stress Awareness
- Stress isn’t just “feeling anxious.” It can be working long hours, rushing, negative self-talk, or even intense workouts.
- Learn to identify your stress signals: fatigue, irritability, low motivation, digestive issues, poor recovery.
- Build a few daily rituals to help you reset: meditation, journaling, baths, tech-free walks.
3. Nervous System Support
- Include activities that activate the parasympathetic nervous system (“rest and digest”):
- Deep belly breathing
- Slow walks in nature
- Stretching or mobility work
- Listening to music or a calming podcast
4. Time Off Is Part of the Plan
- Don’t overload your schedule. It’s okay to say no.
- Build in real rest days, even from social obligations, if needed.
5. Emotional Health
- Track your mood and energy throughout your cycle.
- If needed, work with a therapist or coach to manage emotional stress and mental load — especially for high-achieving women who “push through everything.”
Want Help Creating Your PCOS Plan?
Every woman is different. That’s why I offer free consultations to help you figure out what will work for your body and your lifestyle.
You can book your free consult here:
www.justinatraining.com
Also, check out my YouTube channel where I post PCOS-safe workouts, beginner routines, and strength sessions tailored for women with hormonal imbalances.
Conclusion: Take the Gentle, Smart Road
Adrenal PCOS can be frustrating, especially if you’ve tried everything and nothing seems to help. But trust me — I’ve helped hundreds of women shift from exhaustion and overwhelm to clarity and strength.
Start small. Choose movement that supports your energy, not drains it. Focus on your lifestyle as a whole — your sleep, your environment, your nervous system.
You don’t need to push harder. You need to work smarter. Your body is not broken — it just needs the right support.
