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A new study suggests the keto diet may improve symptoms associated with polycystic ovary syndrome (PCOS). Abraham Gonzalez Fernandez/Getty Images
  • New research shows the ketogenic diet may reduce testosterone levels in women with PCOS, which could improve fertility outcomes.
  • There is an established link between PCOS and insulin resistance, which helps explain why the condition may lead to obesity and type 2 diabetes.
  • PCOS symptoms can be managed by following a low carb and low-sugar diet, maintaining a healthy weight, and exercising regularly.

Polycystic ovary syndrome is a leading cause of female infertility, impacting as many as 5 million women of reproductive age in the United States.

A new study published September 7 in the Journal of the Endocrine Societyreveals a potential connection betweenthe ketogenic diet and fertility in women with polycystic ovary syndrome (PCOS). The findings suggest the keto diet may decrease testosterone levels in females with PCOS.

The keto diet protocol emphasizes low carb and high fat foods. Significantly decreasing carbohydrate consumption puts the body into a metabolic state called ketosis.

“Our study provided tangible evidence from pooled clinical data on the association between ketogenic diet and improvement in reproductive hormones levels (which influence fertility) in women with PCOS,” study author Dr.Karniza Khalid, medical officer for the Ministry of Health Malaysia in Kuala Lumpur, Malaysia, told Healthline.

“These findings carry substantial clinical importance, particularly for endocrinologists, gynecologists, and dietitians, as it underscores the necessity of personalized dietary recommendations based on individual unique clinical profiles among women with PCOS,” Khalid added.

Prior research has shown that ketogenic diets can help lower blood sugar and insulin levels.

“[The] ketogenic diet can lead to weight loss and improved insulin sensitivity, which decrease insulin spikes,” Dr. Adi Katz, the director of gynecology at Northwell Lenox Hill Hospital, told Healthline.

“The ketogenic diet may help regulate these hormonal imbalances, potentially leading to more regular menstrual cycles and reduced symptoms like hirsutism (excess hair growth) and acne,” Katz explained.

Some people with PCOS will have insulin resistance, which may put them at risk for developing type 2 diabetes, explained Dr. Hugh Taylor, chair of obstetrics, gynecology, and reproductive sciences at Yale School of Medicine.

Higher levels of testosterone also play a role in the development of PCOS.

“The elevated insulin level associated with insulin resistance also triggers the ovaries to make more testosterone and hence promotes PCOS,” Taylor explained.

In some cases, testosterone is the major driver of the acne and hair growth associated with PCOS, Taylor added. Higher insulin levels and testosterone levels may also interfere with ovulation and lead to irregular or absent menstruation and infertility.

“PCOS is an important leading metabolic disorder,” Katz said.

“Around 50–90% of individuals with PCOS will have insulin resistance. Insulin resistance can contribute to PCOS, and PCOS can exacerbate insulin resistance. Elevated androgen can worsen the resistance. Individuals [who have obesity] with insulin resistance are at increased risk for PCOS but also the other way around,” Katz added.

To diagnose PCOS, doctors will check to see if at least two of these three symptoms are present:

  1. irregular periods or no periods
  2. increased levels of male hormones including testosterone
  3. numerous small cysts on the ovaries

“PCOS is a condition where individuals do not ovulate (mature an egg in the ovary) on regular intervals (every 21-35 days) and have difficulties getting pregnant,” Katz said.

“Many individuals with PCOS are not aware.”

Treating PCOS may involve several lifestyle changes.

Follow a low carb and low-sugar diet

“Diets low in carbs and sugars (Keto included) reduce the need for insulin, lower insulin production, and thereby reduce testosterone and some of the most bothersome symptoms of PCOS,” Taylor said.

Lifestyle modification is of major importance in controlling PCOS and decreasing insulin spikes. This can occur through increasing intake of fruits and vegetables and less processed foods, Katz noted.

Engage in regular physical activity

Taylor explained that adequate exercise, maintaining a healthy body weight, and controlling insulin levels can vastly improve PCOS.

“Regular exercise is also a major factor in regulating hormone levels,” Katz said.

Additionally, if treatment is needed, some supplements can help with tissue insulin sensitivity and medication or use a hormonal treatment to prevent the overproduction of androgens, Katz added.

Track your menstrual cycle

Taylor noted the absence of menses or infertility for more than one year requires medical attention.

“If your menses are irregular skipping months more than once a year go see a provider and discuss the issue,” said Katz.

According to a new study, the keto diet may lower testosterone levels in women with PCOS.

There is a link between PCOS and insulin resistance. Higher levels of insulin result in an increased production of testosterone which is a contributing factor for PCOS.

PCOS symptoms can be managed by following a low carb and low-sugar diet, maintaining enough weight, and getting regular exercise.