The ketogenic diet has gained popularity over the years thanks to its health benefits of promoting weight loss, lowering blood pressure, and enhancing brain and cognitive function. When we talk keto diet, our main focus is on its effects on insulin resistance. The ketogenic diet’s benefit of improving insulin resistance is what has attracted attention to eating a keto diet as a preventive treatment for chronic and other diseases.
Today, we will focus on keto PCOS to answer the questions in many people’s minds: which is the best diet to manage PCOS symptoms? Is keto good for PCOS? What is the mechanism of action of restricting carbohydrates associated with managing PCOS symptoms?
Let’s start from the beginning, shall we?
What Is PCOS?
Polycystic ovarian syndrome, popularly known as PCOS is a hormonal disorder that affects women of childbearing age, altering the functions of the ovary and ovulation. According to the U.S Department of Health and Human Services, Office on Women’s Health (OHW) one in 10 women of childbearing age suffer from polycystic ovary syndrome (PCOS).
The underlying causes of PCOS are yet to be known but several factors can contribute to its development. These include inflammation and hormone imbalance of insulin and the male hormones or androgens. Increased insulin levels increase the production of androgens in the body. Overweight women and obese women are at a higher risk of insulin resistance, further worsening PCOS symptoms.
Women normally produce and use a little testosterone, but in women with PCOS, there is an overproduction of testosterone.
What Are The Symptoms of PCOS?
The main symptoms of PCOS are:
- Abnormally high levels of male hormones
- Irregular periods or lack of menstrual cycle
- Development of ovarian cysts
Other symptoms of PCOS are weight gain or obesity, excess hair growth, skin changes like skin tags and acne, and male-pattern baldness or thinning hair.
What Are The Risk Factors of PCOS?
If you have any of the following, you are at a higher risk of polycystic ovary syndrome:
- Insulin resistance
- Diabetes Mellitus
- Overweight and obesity
- Increased androgen levels
- Poor dietary habits
- Previous infertility problems
- Sedentary lifestyle
PCOS is one of the causes of infertility, but the good news is there are ways of treating PCOS. Because of hormonal imbalance, you can’t ovulate, and if you can’t ovulate you can’t get pregnant.
How Can You Diagnose PCOS?
The presence of symptoms of PCOS doesn’t necessarily mean you have PCOS. On the other hand, not every woman with PCOS has an irregular flow or unwanted hair growth. Most of these symptoms can be brought about by other health conditions. If you are a woman of reproductive age, and you have elevated insulin levels or insulin resistance, or a combination of all these symptoms, you should visit a gynecologist or reproductive endocrinologist.
PCOS is a syndrome that cannot be diagnosed by a single test. The Rotterdam criteria is the criterion used for the diagnosis of PCOS. For it to be said that you are suffering from PCOS, you have to have two out of three of the following findings:
- Hyperandrogenism: through clinical diagnosis by the presence of acne or male-pattern baldness or through blood tests to check testosterone levels
- Ovulatory dysfunction: through clinical diagnosis by oligomenorrhea characterized by menstrual cycles more than 35 days, but less than 6 months apart. It can also be diagnosed by amenorrhea which is the absence of menstruation for 6 to 12 months.
- Polycystic ovaries: diagnosed through an ultrasound.
How Do You Treat PCOS?
PCOS is treatable but the method of treating polycystic ovary syndrome depends on if you want to get pregnant in the future, the severity of your symptoms, and your overall health.
For Women with PCOS Who Want To Get Pregnant In Future
Clomifene is prescribed to women with PCOS to help with ovulation that is inhibited by hormonal imbalances. Your healthcare provider will prescribe clomifene as the primary drug for infertility caused by polycystic ovary syndrome.
For Women with PCOS Who Don’t Plan to Get Pregnant
Birth Control Pills
If you have no plans of starting a family in the future, your healthcare provider may prescribe birth control pills to help with PCOS management. Birth control pills can lower androgen levels, reduce skin changes like acne, and control menstrual cycles
Your healthcare provider can prescribe Metformin diabetes medication to help lower insulin resistance in polycystic ovary syndrome. It can help reduce circulating insulin levels and lower androgen levels in the body, assisting with symptoms of PCOS management.
Diet changes are a method of treating PCOS and PCOS management for both women who want and those who don’t want to start families in the future. A healthy diet that promotes weight loss can help reduce the risk of being overweight and obese, risk factors of polycystic ovary syndrome. In addition, eating healthy foods can assist you in regulating blood sugar, reduce insulin resistance and increase cell insulin sensitivity.
Other lifestyle changes like increasing physical activity can help improve hormone imbalances in PCOS.
When referring to dietary changes, I would recommend keto PCOS management. The question you will through at me is, why? Is keto good for PCOS? You’re about to find out.
Keto PCOS: Is Keto Good for PCOS?
The keto diet has basic rules: low carbohydrate intake, high fat, and moderate protein consumption. Carb intake increases inflammation and contributes to hormonal imbalances. Your eating of high-carbohydrate foods may be contributing to polycystic ovary syndrome.
Low-carb diets and high fat intake control glucose levels and improve insulin resistance by improving lipid and glucose metabolism. Metabolic parameters are altered by a low-carb diet which improves the hormonal imbalance of blood insulin
Can Keto Help With PCOS?
The keto diet for PCOS is an effective low-carb diet for treating PCOS. This is because it removes the root cause of polycystic ovary syndrome, carbs, that cause inflammations in the body. Let’s look at how a keto diet affects contributing factors of PCOS to increase insulin sensitivity and restore normal hormonal function.
Is Keto Good For Insulin Resistance With PCOS?
Insulin is involved in the regulation of blood sugar in the body by increasing the absorption of glucose by the cells. When you have insulin resistance, your body’s response to the elevated blood sugar levels due to reduced cell sensitivity is to produce more insulin increasing blood insulin levels.
Excess glucose is stored in glycogen stores and it can also be stored as lipids in the adipose and fat tissue. The deposition of lipids into fat storage is what causes overweight and obesity. These are risk factors for type 2 diabetes.
A keto diet restricts carb intake, which lowers blood glucose levels in the body. When there’s inadequate glucose, glycogen, and proteins are converted to glucose to fuel the body. Once these are depleted the body is forced to use its secondary fuel source, fat, as fuel. This switch from glucose metabolism to fat metabolism is what improves insulin resistance.
Is keto good for PCOS? Yes, because it increases cell insulin sensitivity by switching the body’s fuel from glucose to ketones. Ketosis triggers weight loss which also further improves insulin sensitivity and reduces insulin resistance.
A study on overweight and obese women with PCOS to assess the effects of a ketogenic Mediterranean diet showed that a keto diet reduced blood glucose and insulin levels and significant improvements in insulin resistance.
Another study on overweight and obese women with PCOS on the effects of a mixed keto diet reported a reduction in insulin concentration attributed to the depletion of muscle and liver glycogen stores and a reduction in glycemia.
Keto PCOS Weight Loss
As mentioned, nutrition ketosis is triggered when glycogen stores are depleted and no more glucose can be made through gluconeogenesis. Reduced insulin levels lead to fat oxidation from adipose tissue, glucagon-induced lipolysis, and the production of ketones to be used as metabolic fuel.
What you need to know is nutrition ketosis reduces the need for endogenous glucose and provides the body with fuel for metabolic function. It also spares the use of amino acids from lean muscle mass and instead uses fat mass in storage as a fuel source which helps you to lose weight.
Further consuming a high-fat diet is to burn fat even as your body is in ketosis. Eating a low-carb diet will trigger ketosis but pumping your body with healthy fats will provide more fuel in form of dietary lipids to maintain ketosis. This is what prevents further weight gain and helps you to continuously lose weight.
The 14 women mentioned in this study experienced a significant reduction in body weight, losing weight of about 20 pounds in 12 weeks. They also experienced a reduction in body mass index (BMI).
In another study, 17 obese women with PCOS consuming 10g to 20g of carbs per day experienced a reduction in body weight and body mass index (BMI). Ketosis improves body weight and body composition by reducing fat mass.
Keto Diet for Improving Liver Function in PCOS
A study on women with PCOS and liver dysfunction who were obese was done to assess the effects of a keto diet on liver function. Consumption of a keto diet reduced liver function markers. There was a drop in total cholesterol and LDL cholesterol and an increase in HDL cholesterol.
The 14 women also experienced an improvement in lipid profile. Their total cholesterol, bad cholesterol, and triglyceride levels dropped while the good cholesterol increased.
It is safe to say that eating keto improves endocrine parameters. To answer your question again of, is keto good for PCOS, yes it is.
Keto Diet For Menstruation and Pregnancy In PCOS
Reduced insulin levels lower androgen levels in the body. Moreover, weight loss improves fertility. The Keto diet for PCOS improves insulin resistance and promotes weight loss helping to restore normal hormonal balance, ovulation, and menstrual cycle and increasing pregnancy rates.
Lower insulin levels decrease androgen secretion and increase circulation of sex hormone binding globulin (SHB) which limits the circulation of androgens in the blood. Moreover, the keto diet reduces the luteinizing hormone (LH) and follicle-stimulating hormone (FSH) ratio resulting in the balance of endocrine parameters.
In this study, two women got pregnant despite previous infertility problems, 5 women had their period return after several years and 12 women reported that the regularity of their flow had improved.
There was also an improvement in symptoms of PCOS like skin tags and acne and thinning hair due to the restoration of normal hormonal levels.
Keto Pcos has shown promising results in the management of PCOS but more research is needed to ascertain the long-term effects of a low-carb, high-fat diet on polycystic ovary syndrome.
Now that we know the keto diet for PCOS is effective, let me give you a few tips, and guidelines if you may, on how to keto the right way with PCOS.
Tips for Keto Dieting With PCOS
Your healthcare provider will agree with me when I say that there are guidelines to follow to increase the efficiency of your keto diet in PCOS management.
Eat A High Fat, But Very Low Carb Diet
Carb intake is restricted to 20g to 50g of carbohydrates when eating keto. This is another reason for answering yes to is keto good for PCOS. You should be getting 70% to 80% of your total calories from fats. Pay attention to what you are and are not allowed to eat on keto. This will make sure that the keto foods you eat enable you to stay in ketosis and avoid those that will kick you out of ketosis.
Aerobic exercise for 30 minutes, plus strength training twice a week can help you lose weight and manage your insulin levels. Physical activity plus a keto diet are the right ingredients for weight management.
If you suffer from PCOS, your healthcare provider may have prescribed some natural supplements for you to use to manage insulin resistance and increase fertility.
Inositol or myo-inotisol is a sugar we can make in our body or get from citrus fruits and vegetables. Inotisol balances hormones by increasing cell insulin sensitivity further reducing exposure of the ovaries to insulin. It is a second messenger for insulin and it can modulate hormones like androgen and those that regulate ovulation like FSH.
A clinical trial on poor ovarian respondent women to investigate the effects of inotisol on fertility concluded that supplementation with myo-inotisol improved assisted reproductive techniques.
Supplementation of vitamin B9, magnesium, vitamin D, zinc, and folic acid is necessary to improve fertility among obese women with PCOS and normal-weight women. Zinc can improve hormonal imbalance and symptoms of PCOS like unwanted hair growth.
You may suffer from magnesium deficiency because many magnesium-rich foods like legumes and fruits are not allowed because they are high-carb food. For this reason, you may need to supplement magnesium because its deficiency causes increased nerve excitability which could worsen symptoms of PCOS.
Vitamin B9 or folic acid is necessary for women with PCOS because they improve fertility and increase pregnancy rates. Your healthcare provider will prescribe for you 0.4 mg of folic if you have a healthy weight and 5 mg if you are overweight or obese. You don’t have to be worried about folic acid deficiency when eating keto, because green leafy vegetables are rich sources of vitamin B9.
Your chances of having vitamin D deficiency on a keto diet are also high because magnesium increases absorption of vitamin D. Calcium and vitamin D can improve symptoms of PCOS like irregular periods. Supplement magnesium together with vitamin D to lower your risks of micronutrient deficiency.
Intermittent fasting creates a calorie deficit triggering the body to enter a fasting state. Weight loss on IF may be difficult because of the large intake of high-carb meals during the eating window. But, intermittent fasting while on a keto diet introduces autophagy into the picture. Autophagy is the body’s cleaning system. Your body breaks down damaged proteins and uses these components to make new healthier proteins. This prevents the breakdown of lean mass in the body.
You can consider fast keto or speed keto dieting if you want to introduce intermittent fasting to your keto diet. Speak to your healthcare provider before you start fasting to get the go-ahead to do so.
Hormones need water to be transported around our bodies. It also helps with cleansing and detoxification. Furthermore, ketosis brings about dehydration because of ketones fluid and electrolyte excretion through urine. Carbs hold water, so restricting them from your diet means you can easily lose water through sweat.
Is Keto or Paleo Better For PCOS?
Other low-carbohydrate diets like paleo may restrict eating carbohydrate foods but allow for the consumption of high-starch foods from other food groups. Fruits may not be carbs, but they are high in sugar which could spike insulin levels and worsen insulin resistance. Paleo is not good for PCOS because it allows for the consumption of high-carb and high-glycemic-index foods that increase insulin resistance.
Is keto good for PCOS? A ketogenic diet is a low-carb, high-fat diet. It is recommended because it fat in storage triggers ketosis while dietary fat maintains ketosis. It also advocates for whole foods rather than processed foods.
It also emphasizes on consumption of healthy fats rich in monounsaturated and polyunsaturated fatty acids (MUFAs and PUFAs) and monounsaturated triglycerides that increase implantation and pregnancy rates.
Can Keto Make PCOS Worse?
If you restrict carbohydrates too much below the recommended intake, you may stress your body making the adrenal gland produce more cortisol stress hormone. This could worsen the symptoms of PCOS. The keto diet restricts but does not eliminate carb intake.
Speak to a nutritionist or a health coach to find out how much carbs you should eat on keto.
Although the exact cause of PCOS is unknown, inflammation and insulin are contributing factors to this syndrome. Restricting carbs reduce these factors. So, is keto good for PCOS? Yes, the ketogenic diet is the best diet for the job of PCOS management.
Tell me in the comment section if you or anyone you know has used the keto diet for PCOS management. Has it improved your situation? Share your experience in the comment section.