Polycystic ovary syndrome (PCOS) is a common condition that affects 4-20% of women of childbearing age worldwide, and its incidence appears to be increasing over time. In addition to menstrual problems and other physical symptoms, it is a leading cause of infertility. Fortunately, there is a potentially effective lifestyle treatment: a low-carb diet (keto diet).
What is PCOS?
Polycystic ovary syndrome is a common hormonal disorder that is thought to affect 1 in 10 women in their reproductive 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.
The exact cause of polycystic ovary syndrome is unknown, but it is thought that a number of factors may contribute to the condition.
These factors include low-grade inflammation and hormonal imbalances, such as insulin and testosterone. Although women naturally create and require testosterone, women with polycystic ovary syndrome may have higher than expected levels.
Some symptoms of PCOS include :
- 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
Polycystic ovary syndrome is usually managed through a combination of medications and lifestyle changes. In general, a weight loss program is recommended for women with polycystic ovary syndrome and obesity because it can help improve insulin resistance and promote hormonal balance.
Why Keto Diet for PCOS
Keto diet is an effective treatment for PCOS because it targets the underlying causes of polycystic ovary syndrome, not just the symptoms. Keto means eating high fat and super low carbohydrates. By reducing carbohydrates, you can greatly reduce the amount of glucose in your blood.
High glucose levels in the blood may be the underlying cause of polycystic ovary syndrome. Glucose can cause polycystic ovary syndrome in two main ways: (1) By creating chronic hormonal disturbances. (2) By causing chronic oxidative stress – what we commonly call inflammation.
Glucose raises insulin levels. There is strong evidence that high insulin levels, known as hyperinsulinemia, is a major factor in the development of PCOS. Hyperinsulinemia contributes to polycystic ovary syndrome by inhibiting the synthesis of sex hormone binding globulin (SHBG), which in turn increases the levels of male sex hormones (androgens) in women.
High levels of testosterone and other male sex hormones interfere with normal ovulation by suppressing the production of progesterone, while keeping estrogen levels elevated. These hormonal imbalances cause follicles that should mature and be released from the ovary to remain attached and continue to grow or leave a sac. The remaining sac can reseal and fill with fluid, resulting in a cyst. Over time, you can see the buildup of these cysts with an ultrasound.
Other hormonal symptoms associated with polycystic ovary syndrome include excessive hair growth, weight gain and decreased sex drive.
In numerous studies, carbohydrate depletion has been shown to cause inflammation and oxidative stress. And since polycystic ovary syndrome is an inflammatory disease, it is not surprising that carbohydrate consumption is a key factor in polycystic ovary syndrome. Studies have shown that for women with polycystic ovary syndrome, eating a diet high in carbohydrates can lead to oxidative stress and a cellular inflammatory response.
Excess androgens in women with polycystic ovary syndrome can exacerbate inflammatory cells, even if you don’t eat carbohydrates. Those cells that are first activated by eating carbohydrates, and then further emphasized by testosterone, become more susceptible to the inflammatory effects of carbohydrates (glucose).
Studies have shown that women with polycystic ovary syndrome have a higher percentage of abdominal fat than women without polycystic ovary syndrome. This finding was true even for women who were not overweight. For women with polycystic ovary syndrome, this abdominal fat is a site of chronic inflammation. And, even if you take medication to treat the hormonal imbalances associated with polycystic ovary syndrome, you are still vulnerable to inflammation, even in women of normal weight.
Side Effects of Keto for PCOS
The keto diet for PCOS may have some drawbacks or challenges.
In some studies, researchers have found that following a keto diet can increase cholesterol levels. This may be a concern for some people, especially those who already have high cholesterol levels.
In addition, the keto diet has proven to be restrictive, so it may be difficult for many people to stick to. On a keto diet, you need to avoid bread, pasta, rice, cereals, potatoes, most fruits and other foods high in sugar or carbohydrates.
If you decide to try keto to manage your polycystic ovary syndrome, be sure to work closely with your healthcare provider so they can monitor your progress closely.
A less restrictive low-carb diet may offer similar benefits for polycystic ovary syndrome, while being easier to adopt long-term than a strict keto diet. In fact, similar results have been observed using less restrictive dietary patterns, such as a low-carb Mediterranean diet.
The Bottom Line
Because polycystic ovary syndrome is characterized by insulin resistance, a keto diet may help in the management of polycystic ovary syndrome because it can improve your insulin sensitivity.
In addition, researchers have found that the keto diet helps women with polycystic ovary syndrome lose weight, improves their sex hormone balance, lowers triglyceride and cholesterol levels, normalizes their menstrual cycle, and improves their fertility.
However, keto is still a very restrictive diet for most lifestyles, so cycling on and off keto may actually make your body more sensitive to high-carb foods.
In addition, more research is needed on the effects of keto on polycystic ovary syndrome.
In any case, adopting a low-carb eating pattern that you can stick to for life may provide some benefits in the management of polycystic ovary syndrome.