Building Muscle with PCOS: Is It Easier or Harder?

womens-muscle

Polycystic Ovary Syndrome (PCOS) affects approximately 1 in 10 women of reproductive age and is associated with hormonal imbalances, insulin resistance, and metabolic complications. While PCOS is commonly linked to challenges like weight gain and difficulty losing fat, less often discussed is how PCOS influences muscle-building — and whether it’s easier or harder for women with the condition to gain lean muscle mass.

Let’s explore what current research says and how women with PCOS can optimize their strength-training efforts.

PCOS Hormones

PCOS is marked by elevated levels of androgens, particularly testosterone. While this can lead to unwanted symptoms such as acne, hirsutism, and menstrual irregularities, higher testosterone levels may also play a role in enhancing muscle development. Testosterone is a well-known driver of muscle protein synthesis — the biological process responsible for muscle growth following resistance training.

So, is it easier for women with PCOS to build muscle?

Potentially, yes.
Scientific studies suggest that women with PCOS may have an advantage when it comes to developing lean mass and muscular strength due to higher circulating androgen levels (Enea et al., 2009; Ibáñez et al., 2000).

One study published in the European Journal of Endocrinology found that women with PCOS had significantly higher lean body mass and strength compared to women without the condition, despite similar activity levels (Enea et al., 2009).

The Challenges of Muscle Gain with PCOS

Despite the possible anabolic advantage conferred by elevated testosterone, other PCOS-related factors can complicate the muscle-building process:

  • Insulin resistance may impair recovery and alter nutrient partitioning.
  • Fatigue and mood disorders are common and can impact training consistency.
  • Chronic inflammation and elevated cortisol may interfere with anabolic signaling.
  • Body image concerns or exercise stigma can hinder motivation or self-efficacy.

In other words, having the hormonal potential for muscle gain does not necessarily make the journey straightforward.

Building Muscle with PCOS

To build lean muscle effectively, it’s important to tailor both training and nutrition to work with your body’s needs:

1. Focus on progressive resistance training

Engage in strength-based workouts 3–4 times per week, incorporating multi-joint compound movements like squats, deadlifts, presses, and rows. Aim to gradually increase resistance over time.

2. Prioritize dietary protein

Consuming 1.6–2.2 grams of protein per kilogram of body weight per day can help support muscle recovery and growth. Protein also plays a role in stabilizing blood glucose levels.

3. Manage carbohydrate intake strategically

Carbohydrates support training performance, but insulin sensitivity can vary. Emphasize complex carbohydrates, fiber, and consistent meal timing to stabilize blood sugar.

4. Optimize recovery and manage stress

Poor sleep and elevated cortisol levels can inhibit muscle gain. Aim for 7–9 hours of sleep per night and incorporate stress reduction techniques such as breathwork, mindfulness, or low-impact movement.

5. Track progress beyond body weight

Muscle gain may not always show up on the scale. Consider tracking strength metrics, progress photos, how clothing fits, and subjective energy levels to assess improvements.

Final Thoughts

Contrary to outdated narratives, women with PCOS are not inherently “at war” with their bodies. While PCOS presents unique challenges, it may also provide a biological advantage in developing lean mass, thanks to elevated androgen levels. With a thoughtful approach to training, nutrition, and recovery, building muscle with PCOS is not only possible — it can be a powerful tool in improving metabolic health, body composition, and self-confidence.

References

  • Enea, C. et al. (2009). Circulating Androgens Are Related to Muscle Strength in Female Athletes. European Journal of Endocrinology, 160(5), 905–913. https://doi.org/10.1530/EJE-08-0751
  • Ibáñez, L. et al. (2000). Increased Androgen Receptors and Enhanced Androgen Sensitivity in Young Women with PCOS. The Journal of Clinical Endocrinology & Metabolism, 85(7), 2610–2616. https://doi.org/10.1210/jcem.85.7.6651

Disclaimer

This blog is intended for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider, such as your GP, endocrinologist, or registered dietitian, before beginning any new exercise or nutrition program, especially if you have PCOS or other medical conditions.