You had acne as a teenager, but that's not unusual. You saw a dermatologist, and they prescribed medications to help. You noticed excessive hair growth, but some women grow more than others. Your periods have been irregular for years. You saw a gynecologist for help. Weight control may have been an issue, so you've tried different diets. Now you want to get pregnant, but you can't. What's going on?
Millions of women live with polycystic ovary syndrome (PCOS) and don't know they have it. It's estimated that as many as 10% of American women in their reproductive years have PCOS. The most common point of discovery of PCOS is when they try to get pregnant and can't. An ultrasound shows cysts on the ovary. That's when a doctor can piece together the ultrasound with the other symptoms to determine that you have PCOS.
The keto diet is a low-carb diet that keeps daily carbohydrate intake below 50 grams. It also involves intermittent fasting, where you may only eat for 8 hours daily while fasting for 16 hours every day. The goal is to start a ketosis process, where your body uses fat for fuel instead of carbs.
So how does the keto diet help people with PCOS? That's what the remainder of this article is about! We will explore how a keto diet can reduce PCOS symptoms and prevent or reverse PCOS complications by attacking the underlying causes of PCOS. Read on to learn what keto can do for you.
The Bottom Line
- Why keto diets are best for managing PCOS: PCOS patients often have insulin resistance. As a result, a particular ultra-low-carb diet has the most success with treating PCOS symptoms — the ketogenic diet.
- Top 12 ways keto diets help with PCOS symptoms: A keto diet can reduce excess weight and body fat, remove the cause of the underlying inflammation, reduce insulin resistance, reduce excess androgens, reverse infertility, and prevent diabetes, among other things
- How Top Nutrition Coaching can help: Registered dietitians can help you find the right foods, stick with your diet, and assess whether your keto diet works or needs to be adjusted.
Why a Keto Diet is Best for Managing PCOS
The Mayo Clinic defines PCOS as a "problem with hormones during the reproductive years." That's the tip of the iceberg. The Centers for Disease Control and Prevention (CDC) says, "it's a lifelong condition that continues far beyond the child-bearing years."
Like diabetes, PCOS patients often have insulin resistance. More than half of women with PCOS develop type 2 diabetes by age 40. In the past several years, scientists have become more aware of the patterns involved with PCOS, and while we still don't know the cause, considerable evidence points to the following:
- Insulin resistance
- Low-grade inflammation
- High androgen levels
- A combination of these causes
Now that we're zeroing in on the likely causes, we can focus on treating the cause and not just the symptoms. And one choice of care that's emerging is a low-carb diet. A particular ultra-low-carb diet has the most success with PCOS—the ketogenic diet.
The keto diet starts weight and fat loss in PCOS patients. Some of this fat is the dangerous fat in the lower abdomen that is especially hard for other diets to reach. Keto is more effective in visceral fat because it burns fat for energy instead of carbs. You aren't just losing weight—you're losing weight in the most dangerous places.
Since the keto diet is ultra-low-carb, it reduces glucose in your blood. It's the glucose that causes low-grade inflammation. Why are you having problems with glucose? Because you're experiencing insulin resistance. Your pancreas produces the hormone insulin to regulate glucose—blood sugar. If you are insulin resistant, your body needs more insulin to regulate blood sugar.
When your body can't keep up with the insulin demand, it loses the ability to regulate your blood sugar. But your body needs carbs to create blood sugar. By cutting out these carbs, a keto diet can bring your blood sugar back to a healthy level.
Read on to learn how these features of the keto diet start a domino effect that can prevent PCOS from damaging your organs and restore at least some of your body's normal function—including reversing infertility.
Top 12 Ways Keto Diets Help With PCOS Symptoms
PCOS leads to many medical issues beyond the ovaries. These complications include:
- High blood pressure
- High cholesterol and triglycerides
- Heart disease
- Anxiety and depression
- Sleep apnea
- Non-alcoholic fatty liver disease (NAFLD)
- Gestational diabetes
- Type 2 diabetes
If we don't target the underlying causes, your PCOS will progress into type 2 diabetes. That only adds to your PCOS complications since diabetes can lead to:
- Nerve damage
- Chronic kidney disease (CKD) and dialysis
- Amputation of legs, feet, toes, or other extremities
In the following sections, we'll talk about how the keto diet stops or lessens most of these risks and how it gets your ovaries to work the way they should. We strive to make these roundups as comprehensive as possible to include individuals with all sorts of dietary restrictions. Thankfully, it is possible to eat a low-carb diet as a vegan or vegetarian.
1. Reduces Excess Weight and Body Fat
Being overweight is familiar to PCOS patients. The keto diet is a great way to lose weight and keep your body mass index (BMI) healthy. But many women with PCOS aren't overweight.
Even in women who aren't overweight, there's a pattern of excessive lower abdominal fat. Insulin resistance and inflammation may cause this abdominal fat, but this visceral fat also causes more inflammation. It's like we're going in a loop here. We're experiencing a snowball effect.
So how can a keto diet stop this chain reaction? First, we bring the culprit in the initial inflammation under control: glucose. Second, the keto diet reduces this abdominal fat better than other diets because ketosis causes your body to burn fat for energy instead of carbs. In essence, the keto diet attacks these underlying causes of PCOS in two ways.
- It helps you lose weight
- Reduce inflammation
- Many PCOS patients may not need to lose weight
- It can be challenging to maintain a healthy weight
Bottom Line: A ketogenic diet can help people with PCOS lose weight and reduce inflammation that can be harmful. But you need to talk to a doctor about how to stay at a healthy weight while on this diet.
2. Keto Removes the Cause of the Underlying Inflammation
If inflammation is a cause of PCOS, what causes the inflammation? Could it be a dietary trigger such as glucose? That's what studies suggest. What does glucose need to form?
Carbohydrates. What eliminates carbs? The keto diet. Do you see the logic? By cutting back on carbs, your blood glucose levels should go down, and the low-grade inflammation thought to cause your PCOS symptoms should also go down.
- Can eliminate inflammation
- It makes PCOS less uncomfortable during the day
- Patients may not know how to meal plan
- This could potentially lead to a lack of essential nutrients and vitamins
Bottom Line: A ketogenic diet can help PCOS patients eliminate the root cause of their inflammation. Patients could miss out on important vitamins and nutrients, though, if they don't know how to plan their meals well and don't get the help they need.
3. Keto Reduces Insulin Resistance
Studies show that low-carb diets like the keto diet can reduce insulin resistance by as much as 75%. We're trying to understand why this happens. The idea seems to be that giving your pancreas a break from carbs can help it become more sensitive to insulin again. That means your blood sugar levels are much better regulated.
It's the excess sugar in the blood that causes the inflammation. So here we are again. The keto diet addresses one cause of PCOS symptoms while also addressing others. It's like playing pool and hitting one ball, which knocks the others into the holes.
By now, you may be wondering what all this has to do with your ovaries. A little patience, please. Looking past the underlying causes of the symptoms is why medical researchers have had difficulty finding effective treatments for PCOS.
We know you probably received your PCOS diagnosis after unsuccessfully trying to get pregnant. That's why, out of the many complications from PCOS, we will start with the reproductive system in the next section.
- Regulates blood sugar
- Can lower the risk of diabetes
- It may cause an insulin imbalance
- This could lead to other health problems if not properly monitored
Bottom Line: A keto diet can reduce insulin resistance, so your blood sugar levels become more regulated. But if you don't pay attention to what you eat, this could cause an insulin imbalance.
4. Keto Reduces Excess Androgens
Insulin resistance is most likely why your ovaries produce androgens, which are male sex hormones. Your ovaries have insulin receptors. Abnormally high insulin levels cause your ovaries to make too much androgen. It's a condition called androgen excess disorder (AEDs). But there's more. AED leads to more insulin resistance. It's a snowball effect again.
AED leads to the following issues for women:
- Excessive hair growth — sometimes on the face
- Irregular periods
- Ovarian cysts
Now we're getting to the heart of the problem. If you can reduce insulin resistance, you can reduce the number of androgens produced and restore them to normal levels. That, in turn, also helps reduce insulin resistance. What reduces insulin resistance? The keto diet!
If you go on a ketogenic diet, you might be able to stop this snowball effect and set off a chain of events that gets your ovaries back to normal. Now, we're going farther into reproductive issues.
- Can return ovaries to normal function
- Can make PCOS women fertile again
- Can increase the chance of pregnancy
- Can make AEDs worsen
- It can take a lot of time until you see the results
Bottom Line: Since a keto diet can reduce insulin resistance, it can also help fertility and encourage standard ovary functionality. However, this isn't a guarantee, and it's crucial to consult with a doctor to see how a keto diet will affect your insulin levels since everyone is different.
5. Keto Can Reverse Infertility
Women have successfully reversed infertility by following a low-carb diet. By solving the excess androgen issue, periods return to normal. Excess androgen leads to dysfunctional follicle development in the ovaries. The follicles are fluid sacs that contain immature eggs.
If these follicles don't develop correctly, they won't optimally release the egg. Most follicles don't mature to the point of releasing an egg. The problem is when no follicle releases the egg. Now you have infertility.
Some androgens assist ovulation, while others don't. The key is to have the right androgen balance. Now, let's go back to the cause of the androgen imbalance: insulin resistance. Keto reverses insulin resistance, restoring androgen balance. With androgen balance, we can have successful ovulation, leading to pregnancy.
Now that there's a care plan for the problem that led to your initial PCOS diagnosis, let's look at the other reasons to be concerned about PCOS.
- Women with PCOS can get standard ovary functionality back
- Women can become fertile again
- Regular periods can start again
- Different PCOS diagnoses can affect infertility and insulin levels, so this might not work for you
Bottom Line: While a keto diet has the potential to reverse infertility in women, it isn't a 100% guarantee. However, it could still be worth a try as long as you maintain healthy eating habits.
6. Keto Prevents Diabetes
The last thing you want is for your PCOS to progress into type 2 diabetes or, even worse, gestational diabetes. Gestational diabetes puts your baby's health and your own at risk.
The keto diet can help prevent diabetes by making the body less resistant to insulin, reducing chronic inflammation, keeping the body at a healthy weight, and getting rid of excess belly fat. But there's still more: keto helps with cardiovascular issues related to PCOS and diabetes.
- Can prevent diabetes
- Decreases chronic inflammation
- Removes excess abdominal fat
- This can lead to more health issues if a proper diet isn't maintained
Bottom Line: A ketogenic diet can balance insulin, preventing diabetes. This can only be done if a patient has no other underlying health conditions and maintains healthy eating habits tailored to their body.
7. Keto Reduces High Blood Pressure
Unregulated blood glucose levels damage the blood vessels and kidneys. This damage increases your risk of high blood pressure. Women with PCOS have three times the risk of high blood pressure as other women.
The keto diet lowers blood pressure in three ways: it reduces glucose by eliminating carbs from your diet, it reduces inflammation, and it increases insulin sensitivity.
- Can lower blood pressure
- Decreases high glucose levels
- Blood pressure should be constantly monitored to protect blood vessels and kidneys
Bottom Line: Because PCOS causes women to have a much higher blood pressure than usual, a keto diet can be extremely beneficial in lowering your blood pressure and preventing the development of other severe health conditions.
8. Keto Lowers Cholesterol and Triglycerides
The keto diet significantly reduces high cholesterol and triglyceride levels in women with PCOS. Is there anything this diet can't do?
- Can reduce cholesterol levels
- Won't see results unless monitored by a professional
Bottom Line: A keto diet can help women with PCOS lower their cholesterol and triglyceride levels, but only if their diet is closely watched and they talk to a nutritionist.
9. Keto Prevents Heart Disease and Strokes
Your heart and blood vessels will be healthier if your blood pressure, cholesterol, and triglyceride levels are good. The keto diet helps keep these measures in line.
It also reduces inflammation, as C-reactive proteins decrease for people on the keto diet. Chronic inflammation is another cause of cardiovascular disease. You're far less likely to have a PCOS-related heart attack or stroke with a healthy cardiovascular system.
- This can lead to a healthier cardiovascular system
- Reduces chronic inflammation
- Reduces chances of heart disease
- Since PCOS causes high blood pressure, the chances of having a heart attack or stroke are still highly high if healthy eating habits aren't maintained
Bottom Line: A keto diet can be an excellent option for those with PCOS who are at high risk of heart disease. By following the diet's rules and keeping up healthy eating habits, blood pressure could decrease, and the chance of getting heart disease could decrease.
10. Keto Can Help With Anxiety and Depression
There's a pattern of PCOS patients having anxiety and depression. Studies have not proven that PCOS is part of the cause. But there's some evidence that chronic inflammation contributes to these mental issues. Low-grade chronic inflammation is one cause of PCOS. What relieves chronic inflammation? The keto diet.
- Can help manage depression
- Can reduce anxiety levels
- It can help with inflammation and other digestive issues
- Other factors can cause depression and anxiety, so a diet may not solve these issues
- Consulting with a medical or mental health professional may still be necessary
Bottom Line: PCOS or any chronic illness can lead to elevated levels of depression and anxiety in patients. A keto diet can help people with PCOS feel better about themselves and control their symptoms, which can greatly affect their mental health.
11. Keto Helps With Sleep Apnea
The evidence links sleep apnea to inflammation. Evidence also links sleep apnea to obesity. And a disproportionate number of PCOS patients have sleep apnea. Again, this is a symptom of PCOS, where a keto diet may be the right care plan.
- This can lead to better quality sleep
- Can reduce inflammation and obesity
- Not a direct cure
Bottom Line: Starting a keto diet has the potential to help you sleep better at night, although it isn't guaranteed. Check-in with a doctor to see if a keto diet can drastically improve sleep apnea symptoms.
12. Keto Protects Your Liver
Non-alcoholic fatty liver disease (NAFLD) is associated with PCOS. It's thought that excess androgen production and insulin resistance with PCOS contribute to NAFLD. A ketogenic diet can fix insulin resistance and has been shown to stop the body from making too much of the hormone androgen.
- Can prevent NAFLD
- This can lead to a healthier liver
- It may not be a cure if you already suffer from a liver disease
Bottom Line: A keto diet can protect your liver and other vital organs. While this isn't guaranteed, it can be worth a shot when considering switching to a keto diet.
How Top Nutrition Coaching Can Help
A keto diet is much more challenging than most diets. Not only do you have to reduce your carb intake to ultra-low levels, but you also need to adopt intermittent fasting to get the most out of your keto diet. You'll need to replace a large portion of your diet with your low-carb diet. You want to do this without losing vital nutrients. You need a university-trained nutrition scientist to get you through all that!
Fortunately for you, such professionals exist and are registered dietitian nutritionists (RDNs). There are many benefits of working with a PCOS nutritionist. At Top Nutrition Coaching, we match you with the right RD for your condition and your goals. They can help you find the right foods, stick with your diet, and assess whether your keto diet works or needs to be adjusted. They can also help you decide if the keto diet is or isn't the best care plan for you.
The RDs at Top Nutrition Coaching are here to help you transition to the keto diet. Take the online quiz today to get matched with a nutrition expert and begin your journey toward better health while managing PCOS.
The keto diet is excellent, but you can make it even better by consulting a nutrition expert. Working with a registered dietitian can help you maintain healthy eating habits by making a personalized meal plan to help you start feeling better.
Frequently Asked Questions
Still unsure about how a ketogenic diet can help with your PCOS? Below are some frequently asked questions about keto diets and PCOS management.
How does the keto diet help with PCOS-induced infertility?
Reducing insulin resistance prevents excess insulin from interfering with hormone production by your ovaries. Your ovaries have insulin receptors. When overloaded, they confuse the ovaries into producing excessive male hormones—androgens. Too much androgen disrupts ovulation. That can lead to infertility. Without the excess insulin, your ovaries begin to function normally again. This process can reverse infertility caused by PCOS.
What can I eat on the keto diet?
Anything that's extremely low in carbohydrates. That usually means you'll be eating a lot of high-fat foods. But that doesn't mean you'll gain weight. The ketosis process causes you to lose weight. This is true even for people who have a tough time losing weight because of the hormonal issues caused by PCOS.
How long does it take for ketosis to start?
Eating less than 50 grams of carbohydrates daily usually takes 2-4 days to reach ketosis. Still, some people may need more time depending on how active they are, their age, their metabolism, and how much carbohydrate, fat, and protein they eat.