Can a Ketogenic Diet Conquer Polycystic Ovarian Syndrome (PCOS)?

ketogenic diet for pcos

What Is Polycystic Ovarian Syndrome (PCOS)?

PCOS, also known as Stein-Leventhal Syndrome, affects one in every ten women of childbearing age worldwide. It's one of the most prevalent metabolic (endocrine) disorders affecting women. Unfortunately, 70% of the women who live with PCOS remain undiagnosed1.

There are three key hormones associated with PCOS. Insulin and androgen are overproduced. Low levels of progesterone are the main culprits for many of the complications associated with PCOS.

How Is Androgen Related to PCOS

Women with PCOS don't produce enough follicle-stimulating hormones (FSH). Your body needs FSH for the eggs in your ovaries to mature and complete its cycle.  With low FSH, the eggs continue to grow but they don’t get to the point where they break out of the follicle.

The follicles are unable to mature. They remain in the ovaries and eventually turn into cysts. The cysts produce excessive amounts of the male hormone androgen.

Insulin Resistance Contributes to PCOS

Research also suggests two causes for resistance to insulin in the body in women with PCOS. One is a defect in the signaling receptors for insulin. Because the receptor for insulin isn't working normally, insulin levels in the blood rise. Avoiding insulin trigger foods (carbohydrate and sugar) will improve this condition. High insulin causes imbalances in hormones. One of these is testosterone. The more insulin the more testosterone produced. It's this hormone that makes it difficult for the follicles to ovulate2.

The second is the enzyme that controls the insulin signaling receptor. Currently, the specific enzyme has not been identified. Yet this enzyme is responsible for the links between PCOS and genetics and fertility.

Low Progesterone, Infertility, and PCOS

Insulin resistance along with an excessive amount of male hormones in the woman's body leads to a drop in progesterone levels. The body needs progesterone to complete the ovulation cycle. With low progesterone levels,  the ovary increases the production of FSH and LH. This prompts the ovaries to increase production of the hormones, estrogen, and androgen3.

Symptoms of PCOS

You may not realize that you're affected by PCOS. You may be thin. However, more commonly women are overweight or obese. This is a result of insulin resistance or higher estrogen (a female fat storing hormone that may be high when levels of progesterone are low).

Women with high levels of androgen can develop masculine features. These include male-pattern baldness, a deep masculine voice, and hirsutism (excessive amounts of stiff hair on the face, chest, and back).

Low levels of progesterone give way to irregular or absent menstruation. This makes it difficult for the body to become pregnant3, increases the risk of miscarriage or causes infertility. If pregnancy occurs, there is a high risk of developing gestational diabetes, delivering a premature baby, or having high blood pressure. This is very dangerous for the undelivered baby.

Additional hormone-related symptoms include:

  • Acne
  • Skin Tags
  • Decreased Breast Size
  • Depression

PCOS Risks

PCOS can also increase risk factors for serious medical conditions:

  1. Affecting your heart4: high levels of ‘bad’ LDL cholesterol, low levels of ‘good’ HDL cholesterol and high triglycerides can lead to a heart attack.
  2. Relating to high blood pressure and high blood sugar; high fasting levels of blood sugar and higher BMI 5     influence women's health.  Those with PCOS are 6.8 times more likely to develop Type 2 diabetes6 and high blood pressure.
  3. Including endocrine and metabolic abnormalities leading to Obstructive Sleep Apnea.7
  4. Raising the risk for cancer as an irregular menstrual flow can thicken the uterus wall and lead to uterine cancer.

A Ketogenic Diet For PCOS Targets Hormones For Weight Loss & Health

Several studies reflect the benefits of a ketogenic diet for PCOS7,8. Minimizing carbohydrates and eating more fat provides an advantage. This is because the body doesn't produce insulin. Eating higher amounts of carbohydrates negatively affect hormones that influence PCOS.

In one study9, five obese women with PCOS followed a keto diet (20 grams of carbs a day for 6 months).

The diet allowed unlimited amounts of protein including eggs, fish, chicken, and meat. Salad and non-starchy vegetables were limited to 3 cups a day. A maximum of 4 oz of cheese was included too.

Exercise helps lower insulin levels so the women were advised to partake in exercise at least 3 times a week.

Results were important in that it showed:

  1. a significant reduction in ovarian androgen production;
  2. an overall improvement in insulin resistance (insulin was lowered from 23.5 μIU/ml to  8.2 μIU/ml);
  3. body weight was reduced by 12.1%.
  4. two of these eleven women managed to get pregnant despite having earlier difficulties in getting pregnant

The authors explain that avoiding carbohydrates helps normalize the endocrine system. It does this by lowering fasting insulin levels, circulating male hormones (androgen and testosterone), and improve follicle stimulating hormone (FSH)10.

How To Keto With PCOS

So, you’ve read how the ketogenic diet for PCOS helps improve the underlying dysfunctions of the condition. But there are many other uses of living a keto lifestyle. Whether you have PCOS or just want to eat healthier, you may want to learn how to Keto correctly.  

It may take a few days to get into ketosis. If you are hungry, don't deprive yourself. But don't overeat. Enjoy the foods you choose. In general, you can eat healthy natural fats and proteins, herbs and spices, non-starchy vegetables, avocado, olives, and cheese. The table below shows a list of allowable foods.

Keto Friendly Foods

Fats Oil from olives, coconut, palm, olive, macadamia nut and avocado

Butter, ghee, lard, full-fat mayonnaise  

Proteins Animal protein or nut butters - Fish and shellfish, poultry (duck, turkey, quail, goose, pheasant), beef,  lamb, goat, veal, venison and other game meats, Jerky (no added sugar and variety) eggs, protein powder, bone broth, peanut, almond or any nut/seed butter.
Non-Starchy Vegetables All leafy greens (Spinach, kale, romaine, collard greens, bok choy, endive, arugula, escarole, fennel, radicchio, dandelion)

Mushrooms celery, cucumber, pickles, broccoli, tomatoes, zucchini, cabbage, green beans, asparagus, Brussels sprouts, peppers

Fruits Lemon, lime, avocado, olives, coconut, berries
Nuts and Seeds Macadamia nuts, almonds, peanuts, walnuts, cashews, pistachios, chestnuts, pumpkin, sunflower, flax and chia seeds
Full- Fat Dairy Goat cheese, farmer cheese, cottage cheese, parmesan cream cheese and any hard cheese; sour cream
Beverages Water (with lemon or lime), tea, V-8 (original, in moderation), flavored seltzer, unsweetened coffee (black/cream/half and half), unsweetened coconut or almond milk
Add-ons Salsa, guacamole, Braggs Aminos, soy sauce, mustard, hot sauce, horseradish, caponata, Worcestershire sauce, apple cider vinegar, herbs/spices, full-fat salad dressings (blue cheese, ranch, olive oil & vinegar)

Living On A Ketogenic Diet For PCOS

Many people with PCOS live a healthy keto life without deprivation. There's hope. Maria Emmerich is just one example. You may want to see her personal transformation and read about her journey.

Once you begin a ketogenic diet for PCOS, you have an opportunity to regain your life. You lose weight. You overcome the physical and emotional barriers of PCOS.

Ketogenic Diet for PCOS Wrap Up

A Ketogenic Diet heals the underlying hormonal causes of PCOS.  Excess carbohydrates and sugars contribute to the hormonal disruption associated with this medical condition. When you make a therapeutic ketogenic nutrition plan part of your life, you will regain health, lose weight and improve fertility issues.


  5. Parker, Louise, 2006, Understanding and Treating PCOS. SGC Health.


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