Does the Keto Diet Aid PCOS Symptoms?

PCOS is a common hormonal condition that is thought to affect one in ten women in their childbearing years. It affects hormone levels and metabolism and remains a major cause of infertility in women. However, the condition is treatable with proper medical care (3).

The exact cause of PCOS is unknown, but it’s thought that a number of factors may contribute.

These include low-grade inflammation and an imbalance of hormones such as insulin and testosterone. Although women naturally create and require testosterone, women with PCOS may have levels that are higher than expected (3, 4).

Some symptoms of PCOS include (3):

• obesity, weight gain, or difficulty losing weight
• excessive body hair, such as on the face or chin
• irregular periods or no period
• thinning hair
• skin changes, like acne, dark spots, or skin tags

PCOS is usually managed through a combination of medications and lifestyle changes. Generally, weight loss plans are recommended for women with PCOS and obesity, since they can help to improve insulin resistance and promote hormonal balance (5).

Research has also found that weight loss may help improve fertility in people with PCOS.

Summary

PCOS is a condition caused by hormonal imbalances in women. It may cause infertility, irregular periods, or weight gain. You can manage the condition through medications and lifestyle changes.

On the low carb, high fat keto diet, your carb intake is significantly decreased, which forces the body into a state of ketosis ⁠— where you burn fat rather than carbs for energy.

On a keto diet, most people reduce their carb intake to less than 50 grams of total carbs per day (6, 7).

Researchers have found that keto diets may improve insulin sensitivity, help balance hunger hormones, and promote weight loss in people with obesity and type 2 diabetes.

A handful of recent studies have investigated the effects of keto diets on PCOS, too (6).

Insulin resistance

Insulin resistance is thought to contribute to the development of PCOS. The hormone insulin helps regulate blood sugar levels by shuttling glucose from the blood into the cells, where it can be used for energy or stored for later use (8).

However, people with insulin resistance tend to have elevated blood sugar levels and elevated insulin levels because their body compensates for the insulin resistance by producing more insulin (9).

Insulin resistance occurs when your cells stop responding appropriately to insulin, which increases blood sugar levels and results in the pancreas making more insulin (10).

Because insulin is also responsible for fat storage, high insulin levels and insulin resistance are also associated with weight gain and obesity. When left unmanaged, insulin resistance may also lead to type 2 diabetes.

Since the keto diet may help to improve insulin sensitivity, it may be useful for PCOS management (9, 11).

In a 12-week study of 14 women with PCOS, a keto diet high in plant foods (like low carb veggies) resulted in significantly lower blood sugar and insulin levels, as well as better insulin resistance scores ⁠— indicating higher insulin sensitivity (12).

In another study of 18 women with PCOS, liver dysfunction, and obesity, participants received either conventional prescription medications or consumed a ketogenic diet for 12 weeks.

Researchers found that the keto group experienced significant improvements in blood sugar levels, which suggests an improvement in insulin sensitivity ⁠— although this study didn’t measure insulin or insulin resistance scores (13).

Finally, a 45-day study of 17 women with obesity and PCOS found that a keto diet reduced average blood sugar levels by 10 mg/dL and mean insulin levels by nearly 13 micro-IU/mL. Insulin resistance scores, which reflect increased insulin sensitivity, also improved (14).

In short, recent research confirms that a ketogenic diet may significantly improve PCOS symptoms through effective insulin regulation.

Other effects

These same studies also noted significant improvements in weight, hormone levels, liver function, blood lipids, menstrual regularity, and fertility.

In one of the 12-week studies on a plant-food-rich keto diet, participants lost an average of nearly 21 pounds (9 kg). Additionally, they experienced significant improvements in triglyceride and cholesterol levels, along with a reduction in testosterone (12).

In the 12-week study on PCOS and liver function in women with obesity, 6 of the 7 participants in the keto diet group had no signs of fatty liver disease by the end of the study. Furthermore, these participants experienced significant weight loss (13).

In a 45-day study, participants lost an average of 21 pounds (9 kg) and significantly reduced their fat mass and waist-hip ratio. Additionally, their testosterone, triglyceride, total cholesterol, and LDL (bad) cholesterol dropped while their HDL (good) cholesterol increased (14).

What’s more, over the course of this study, 5 of the 17 participants had their period return after not having had one for several years, 12 women reported improved regularity in their period, and 5 women became pregnant after many unsuccessful prior attempts (14).

However, larger studies with longer durations are needed to learn more about the long-term effects of keto on PCOS.

Summary

Some small studies indicate that the keto diet may help with PCOS by improving insulin resistance, promoting weight loss, balancing hormones, and promoting regular menstruation.

There may be some downsides or challenges to the keto diet for PCOS.

In some studies, researchers have found that following a keto diet increases cholesterol levels. This may be a concern for some people, especially those who already have high cholesterol levels (15, 16, 17).

Additionally, keto diets prove restrictive, so they may be difficult for many people to stick to. On keto, you’ll need to avoid bread, pasta, rice, cereals, potatoes, most fruits, and other foods high in sugar or carbs. Instead, you primarily eat animal products, vegetables, berries, and unsweetened beverages.

If you decide to try keto to manage your PCOS, be sure to work closely with a healthcare professional so they can closely monitor your progress.

A less restrictive low carb diet may offer similar benefits for PCOS while being easier to adopt long-term than a strict keto diet. In fact, similar outcomes have been observed using less restrictive dietary patterns, like a low carb Mediterranean diet (18).

Summary

The keto diet may significantly increase your cholesterol levels. It’s also extremely restrictive and may be difficult to follow long-term. A less restrictive low carb approach may offer similar benefits, though.

Because PCOS is characterized by insulin resistance, the keto diet may help with PCOS management because it can improve your insulin sensitivity.

Additionally, researchers have found that the keto diet helps women with PCOS lose weight, improve their balance of sex hormones, reduce triglyceride and cholesterol levels, normalize their menstrual cycles, and improve their fertility.

However, keto remains a very restrictive diet for most lifestyles, so cycling on and off keto may actually make your body more sensitive to high carb foods.

Additionally, more research on the effects of keto on PCOS is needed.

Regardless, adopting a lower-carb eating pattern that you can stick to for life may provide some benefits for PCOS management.