The ketogenic diet is a popular very low carb, high fat diet favored by many people for its ability to promote quick weight loss.

There are other benefits related to the keto diet as well, including improved blood sugar regulation and other markers of metabolic health.

However, you may wonder whether the ketogenic diet is equally effective for all populations, including women. 

This article reviews how the ketogenic diet affects women’s health. 

Is the keto diet effective for women?

The ketogenic diet shows promise when used therapeutically to improve certain factors of health.

Studies have shown that it can be used as a way to reduce body fat and improve blood sugar, and even as a complementary treatment for certain cancers (1, 2). 

Although much of the research focuses on how well the keto diet works in men, a decent number of studies have included women or focused exclusively on the effects of the keto diet on women. 

Keto and weight loss for women

One of the main reasons why women turn to the keto diet is to lose excess body fat.

Some research suggests the keto diet may be an effective way to encourage fat loss in the female population. 

Studies have shown that following a keto diet may aid weight loss by increasing fat burning and decreasing calorie intake and hunger-promoting hormones like insulin — all of which may help encourage fat loss (3).

For example, one study in 45 women with ovarian or endometrial cancer found that women who followed a ketogenic diet for 12 weeks had significantly less total body fat and lost 16% more belly fat than women assigned to a low fat, high fiber diet (4).

Another study in adults with obesity that included 12 women demonstrated that following a very low calorie ketogenic diet for 14 weeks significantly reduced body fat, decreased food cravings, and improved female sexual function (5).

Additionally, a review of 13 randomized controlled trials — the gold standard in research — that included a population comprised of 61% women found that participants who followed ketogenic diets lost 2 pounds (0.9 kg) more than those on low fat diets after 1 to 2 years (6).

Although research supports the use of this very low carb way of eating to enhance fat loss in the short term, keep in mind that there’s currently a lack of studies exploring the long-term effects of the keto diet on weight loss. 

Plus, some evidence suggests that the weight-loss-promoting benefits of the keto diet drop off around the 5-month mark, which may be due to its restrictive nature (7). 

What’s more, some research shows that less restrictive low carb diets may result in comparable effects and are easier to sustain long term.

For example, a study that included 52 women found that low and moderate carb diets that contained 15% and 25% carbs, respectively, reduced body fat and waist circumference over 12 weeks similar to a ketogenic diet that contained 5% carbs (8).

Plus, the higher carb diets were easier for the women to stick to.

Keto and blood sugar control for women

The ketogenic diet typically limits carb intake to less than 10% of total calories. For this reason, the diet is favored by women with high blood sugar, including those with type 2 diabetes.

A 4-month study that included 58 women with obesity and type 2 diabetes found that a very low calorie keto diet caused significantly greater weight loss and reductions in fasting blood sugar and hemoglobin A1c (HbA1c) than a standard low calorie diet (9).

HbA1c is a marker of long-term blood sugar control.

A 2019 case study in a 65-year-old woman with a 26-year history of type 2 diabetes and depression demonstrated that after following a ketogenic diet for 12 weeks, along with psychotherapy and high intensity exercise, her HbA1c dropped out of diabetic range.

Her fasting blood sugar and her markers for clinical depression normalized. Essentially, this case study showed that the ketogenic diet reversed this woman’s type 2 diabetes (10). 

A study in 25 people that included 15 women showed similar results. After 34 weeks of following a keto diet, approximately 55% of the study population had HbA1c levels below the diabetic level, compared with 0% who followed a low fat diet (11).

However, it’s important to note that currently, studies on the long-term adherence, safety, and efficacy of the ketogenic diet on blood sugar control are lacking. 

Plus, many other less restrictive diets, including the Mediterranean diet, have been researched for decades and are well known for their safety and beneficial effects on blood sugar control and overall health (12).

Keto and cancer treatment for women

The ketogenic diet has been shown to be beneficial when used as a complementary treatment method for certain types of cancer alongside traditional medications. 

One study in 45 women with endometrial or ovarian cancer found that following a ketogenic diet increased blood levels of ketone bodies and lowered levels of insulin-like growth factor 1 (IGF-I), a hormone that may promote the spread of cancer cells.

The researchers acknowledged that this change, along with the decrease in blood sugar seen in those following ketogenic diets, creates an inhospitable environment for cancer cells that may suppress their growth and spread (4).

Plus, research also shows that the ketogenic diet may improve physical function, increase energy levels, and decrease food cravings in women with endometrial and ovarian cancer (13).

The ketogenic diet has also shown promise when used as a treatment alongside standard treatments like chemotherapy for other cancers that affect women including glioblastoma multiforme, an aggressive cancer that affects the brain (14, 15, 16).

However, it’s important to note that because of the highly restrictive nature of the ketogenic diet and the current lack of high quality research, this diet isn’t recommended as a treatment for most cancers. 

summary

Some research has shown that the ketogenic diet may be effective at promoting weight loss and improving blood sugar regulation in women. Plus, it may be beneficial when used as a complementary therapy in women with certain types of cancers.

Does the ketogenic diet pose any risks for women? 

One of the largest concerns over following a very high fat, low carb diet is its potential negative effects on heart health.

Interestingly, while some evidence shows that the ketogenic diet may increase certain heart disease risk factors including LDL (bad) cholesterol, other studies have found that the diet may benefit heart health. 

A small study that included 3 female Crossfit athletes found that after 12 weeks of following a ketogenic diet, LDL cholesterol was increased by around 35% in the ketogenic diet, compared with the athletes who followed a control diet (17).

However, a study in women with endometrial and ovarian cancer demonstrated that following a ketogenic diet for 12 weeks had no adverse effects on blood lipids when compared with a low fat, high fiber diet (18).

Likewise, other studies have shown conflicting results.

Some findings indicate that the ketogenic diet raises heart-protective HDL cholesterol and reduces total and LDL cholesterol, while others have found the ketogenic diet to significantly raise LDL (19, 20, 21).

It’s important to note that depending on the composition of the diet, ketogenic diets are likely to affect heart health risk factors differently.

For example, a ketogenic diet high in saturated fat is more likely to raise LDL cholesterol than a keto diet primarily composed of unsaturated fats (20).

Plus, although it’s been shown that the keto diet may increase certain risk factors for heart disease, more research is needed to determine how this high fat diet may increase or decrease the risk of heart disease itself and to better understand its effect on overall health.

May not be appropriate for some women 

Due to its restrictive and hard to maintain macronutrient ratio, the ketogenic diet isn’t appropriate for many people.

For example, it’s not recommended for the following populations (22, 23):

  • women who are pregnant or breastfeeding
  • people who have liver or kidney failure
  • those with alcohol or drug use disorders
  • people with type 1 diabetes
  • people who have pancreatitis
  • people who have disorders that affect fat metabolism 
  • people who have certain deficiencies including carnitine deficiency
  • those who have a blood disorder known as porphyria 
  • people who can’t maintain adequate nutritional intake 

In addition to the contraindications listed above, there are other factors to consider when thinking about trying the ketogenic diet. 

For example, the ketogenic diet can cause unpleasant symptoms known collectively as the keto flu during the adaptation phase of the diet.

Symptoms include irritability, nausea, constipation, fatigue, muscle aches, and more.

Although these symptoms typically subside after a week or so, these effects should still be considered when thinking about trying the keto diet (24).

summary

The long-term effect of the ketogenic diet on heart health and overall health is unknown due to the current lack of high quality research. The keto diet isn’t appropriate for many populations and can cause unpleasant side effects like irritability.

Should you try the keto diet?

Whether you should try the keto diet depends on many factors.

Before you start any significant dietary changes, it’s important to consider the positives and negatives of the diet, as well as its appropriateness based on your current health status.

For example, the ketogenic diet may be an appropriate choice for a woman with obesity, diabetes, or who’s unable to lose weight or manage her blood sugar using other dietary modifications.

Additionally, this diet may also be effective for women who have overweight or obesity and have polycystic ovarian syndrome (PCOS). Studies show that the keto diet may help women with PCOS lose weight, improve hormonal imbalance, and enhance fertility (25).

However, being that the ketogenic diet is restrictive in nature and lacks long-term, high quality studies backing its safety and efficacy, less restrictive dietary patterns may be the best choice for most women.

Depending on your health and dietary needs, it’s always suggested to adopt a dietary pattern that’s rich in whole, nutritionally dense foods that can be maintained for life. 

Before trying out the keto diet, it’s a smart choice to explore other, less restrictive options to improve your health and reach your wellness goals. 

Since the keto diet is highly restrictive and its efficacy depends on maintaining ketosis, it’s recommended that this diet only be followed while working with a qualified health professional.

Speak to your medical provider or a registered dietitian if you’re interested in trying out the ketogenic diet.

summary

Although the ketogenic diet may result in positive health changes in some women, it’s a highly restrictive diet. Most women will likely find long-term success by adopting a less restrictive, nutrient-dense diet for long-term health. 

The bottom line

The ketogenic diet has shown promise when used therapeutically to improve certain aspects of health in women including body weight and blood sugar control.

However, there are some caveats that come along with the keto diet, including the lack of studies investigating the diet’s long-term effect on overall health and its restrictive macronutrient composition. 

Plus, this diet isn’t safe for certain female populations, including women who are pregnant or breastfeeding. 

Although some women may find success when following a ketogenic dietary pattern, choosing a less restrictive, nutritious diet that can be followed for life is likely more beneficial for the majority of women.