Is the Keto Diet Good for People with PCOS?

Polycystic ovary syndrome (PCOS) is a widespread hormonal problem that affects women of reproductive age (15-49 years). Its main symptoms include irregular periods, acne, excess hair growth, elevated androgens (male hormones), and polycystic ovaries. 

According to the World Health Organization

• There is no cure for PCOS. However, one can manage the symptoms and associated health risks. 
• It is estimated that about 8–13% of women worldwide suffer from polycystic syndrome (PCOS). 
• Women with PCOS following a ketogenic (keto) diet are likely to have improved fertility, weight loss, and lower testosterone levels. 

A woman with PCOS often faces issues like unwanted weight gain and impaired insulin sensitivity and is at higher risk of developing type 2 diabetes and cardiovascular diseases. One can manage these symptoms through diet, lifestyle changes, and the ketogenic (keto) diet, which is gaining considerable attention as a potential solution. 

This blog underlines whether the keto diet is beneficial for people with PCOS. What is the science behind the keto diet and its impact on PCOS symptoms? 

What is the Keto Diet?

The ketogenic diet, or keto diet, is high in fat and low in carbohydrates, and it aims to facilitate weight loss. It is characterized by getting more calories from protein and fat and less from carbohydrates. It encourages the body to enter a state of ketosis in which it burns fat for energy instead of carbohydrates. 

Below is a targeted keto diet macro ratio that may look like this: 

Fat	65-75%
Protein	20-25%
Carbohydrates	5-10%

4 Main Effects of Keto Diet on PCOS

In PCOS, the body’s cells don’t respond properly to insulin, resulting in higher blood sugar levels and an overproduction of insulin. PCOS is linked with elevated insulin levels and too much androgen production. This contributes to weight gain and disrupts menstrual cycles. 

The ketogenic (keto) diet is a potential way to manage symptoms of polycystic ovary syndrome (PCOS). Here are some of the key effects of the keto diet on PCOS:

1. Improves insulin sensitivity

To manage PCOS symptoms, improved insulin sensitivity is crucial. Insulin resistance is one of the primary causes of hormonal imbalances and metabolic problems with PCOS. 

The keto diet benefits women with PCOS due to its positive effects on insulin sensitivity. It reduces carbohydrate intake, and the body produces less insulin, improving insulin sensitivity. 

The current research, published in the Journal of Translational Medicine, on women with PCOS who followed a keto diet revealed a significant improvement in insulin sensitivity and weight reduction. Besides, their testosterone levels are reduced, improving reproductive hormone levels. 

2. Helps in weight loss

Women with PCOS usually struggle with weight gain. Too much weight is associated with irregular periods, infertility, and excess hair growth (hirsutism). The ketogenic diet mainly focuses on getting more from fat and some from protein, thus curbing hunger, reducing cravings, and promoting fat loss. 

It says small things make a big difference. Similarly, losing weight can help women with PCOS improve their menstrual regularity, lower their insulin levels, and alleviate other symptoms related to the disease. 

Females with metabolic disorders like PCOS should eat a low-carb diet rather than low-fat dishes for weight loss, such as egg whites, lean meats and fish, and part-skim cheese, to achieve the desired results. 

3. Reduces androgens in females

Androgens, or male hormones, in women with PCOS, contribute to symptoms like acne, hirsutism, and male-pattern hair loss. Studies reveal that the keto diet reduces androgen levels, which may help alleviate these symptoms. 

The ketogenic diet helps improve insulin sensitivity and reduce insulin levels, indirectly helping lower androgen production in the ovaries.

Reduced androgen levels can help manage the negative symptoms of PCOS, such as anxiety, depression, or a negative body image. It may even increase fertility by promoting ovulation. 

4. Restores menstrual cycle and ovulation

Problems such as irregular periods and anovulation are commonly linked with PCOS. Studies have shown that women with PCOS can successfully restore regular menstruation and ovulation. Besides, they can also lose weight and achieve improved insulin sensitivity. 

If a woman with PCOS tries to conceive, regulating her period and ovulation is important. The keto diet addresses insulin resistance and weight gain, which improves ovulation and fertility outcomes.

What are the side effects of the keto diet for PCOS?

PCOS affects women in their reproductive age and leads to irregular periods, high androgen levels, and weight gain. 

The ketogenic diet contains a high fat (75%), less protein (20%), and low carbohydrate (5%) diet that has significant effects in women with PCOS. 

The keto diet offers several health benefits to females with PCOS, but there may be some downsides, too. Let’s discover them in detail. 

1. It lacks nutrients. 

The keto diet lacks carbohydrate-rich foods, including fruits, vegetables, grains, and legumes. These foods are rich sources of vitamins, minerals, and fiber. Over time, if women with PCOS are eating a keto diet, it will lead to deficiencies of vitamins C, D, and E, as well as important minerals like magnesium and phosphorus. 

Avoiding a nutrient-rich diet is not a good idea. Women with PCOS should eat non-starchy vegetables, nuts and seeds, fatty fish, and avocados. This helps get enough essential nutrients. Consulting a healthcare professional is equally important to achieve the desired results. 

2. It is not good for long-term

It is challenging for some individuals to stick to a keto diet for the long run. Following a keto diet means avoiding bread, pasta, rice, cereals, and most fruits. This leads to a feeling of deprivation or even binge eating. Hence, sticking to a keto diet may not be a good idea for women with PCOS. 

Women with PCOS who want to follow a keto diet should consult with a healthcare provider or dietician to help tailor the diet to meet their needs. 

3. Hormonal imbalance. 

The keto diet is linked with improved insulin sensitivity. However, some women with PCOS may experience worsening hormonal imbalances in the diet. The keto diet may likely affect thyroid hormone levels and cause hypothyroidism. This can further exacerbate PCOS symptoms. 

If women with PCOS are following a keto diet, they need to monitor their thyroid hormone levels and overall health. If they see any hormonal imbalances, the diet needs to be adjusted or switched to a more balanced eating plan. 

4. Impact on Mental Health

The keto diet is low in carbohydrates. This can cause irritability, anxiety, and mood swings. Hormonal fluctuations are a common symptom of PCOS, making her more emotionally disturbed and can worsen overall well-being. 

Eating a nutrient-rich, low-carb diet and maintaining a balance of fats, proteins, and fiber can help alleviate the psychological effects of a strict keto diet. 

4 Best Substitutes to the Keto Diet for PCOS

No doubt, the keto diet is beneficial for women with PCOS, but there are other alternatives to managing symptoms. 

Below are diets that may help people with PCOS: 

1. Low-Glycemic Index (GI) Diet

This type of diet focuses on foods that minimally affect blood sugar levels. Consuming a low-GI diet can help improve insulin sensitivity and reduce PCOS symptoms. 

Whole grains, lentils and beans, nuts, seeds, fruits, and starchy vegetables are examples of a low-GI diet. 

2. Mediterranean Diet

Instead of a keto diet, women with PCOS can eat a Mediterranean diet. It contains anti-inflammatory properties that may help women manage weight and reduce insulin resistance, inflammation, and androgen levels. 

Mediterranean foods include fruits and vegetables, healthy fats (olive oil, unsalted nuts, and avocado), whole grains, and seafood. 

3. Anti-Inflammatory Diet

Switching to anti-inflammatory foods will help women with PCOS manage inflammation. These foods contain high fiber content and are rich in antioxidants and omega-3 fatty acids. 

Consuming an anti-inflammatory diet may help reduce inflammation and improve symptoms of hormonal imbalance, cardiovascular risk, high BP, and body composition. 

Anti-inflammatory foods include berries, oily fish, leafy greens, and extra virgin olive oil. 

4. The DASH Diet

Doctors focus on the Dietary Approaches to Stop Hypertension (DASH) diet to prevent and control hypertension. It may also prove beneficial for women with PCOS.

Based on a 2021 review, a DASH diet might reduce ovary size in PCOS patients and improve insulin resistance, glucose management, and fat deposits. 

Fish, poultry, fruits and vegetables, low-fat dairy products, and whole grains are examples of a DASH diet. 

Foods to Eat with PCOS: General Overview

A PCOS-friendly diet focuses on foods that help improve insulin sensitivity, reduce inflammation and blood sugar, and support hormonal balance. Some of them include: 

1. High-fiber foods include whole grains, vegetables, leafy greens, and legumes. These foods are rich in fiber, which can slow down digestion and reduce the impact of sugar on blood sugar levels. This makes them beneficial for insulin resistance. 
2. Lean protein foods such as chicken breast, fish such as fatty fish, salmon, sardines, eggs, and tofu can help stabilize blood sugar and maintain muscle maintenance and weight management. 
3. Healthy fats such as avocado, olive oil, nuts, seeds, and fatty fish can help reduce inflammation and improve insulin sensitivity. 
4. Dairy Alternatives: Some women with PCOS are sensitive to dairy products, which can aggravate insulin resistance or androgen levels. To manage symptoms, they can switch to almond milk, coconut yogurt, and cashew milk.
5. Herbs and spices such as cinnamon, turmeric, and garlic may help women with PCOS maintain low blood sugar and control inflammation. 

In short, a PCOS-friendly diet can successfully help manage symptoms and support overall health. 

When to See a Doctor?

Anyone experiencing symptoms related to PCOS must visit a professional to help improve symptoms and prevent complications, including: 

1. Acne
2. Thinning hair
3. Difficulty getting pregnant
4. Weight gain
5. Increase in facial or body hair
6. Irregular periods
7. Skin tags

Conclusion

The keto diet may help women with PCOS struggling with insulin resistance and weight gain. It is an effective tool that helps regulate menstrual cycles and improve fertility by improving insulin sensitivity, reducing androgen levels, and promoting weight loss. 

Researchers have revealed that KD helps women balance their sex hormones, reduce cholesterol and triglycerides, and regulate their periods. Still, it is not a one-size-fits-all solution, and it may have potential side effects that need to be addressed. 

Regular health check-ups are important for women with PCOS for early detection and timely intervention. They must consult with their healthcare provider before starting the keto diet to ensure it is the right approach for their health needs.