Is The Keto Diet An Effective Fertility Solution For Women with PCOS?

• Polycystic Ovary Syndrome (PCOS) affects 8–13% of women in their reproductive years globally.
  
  
• While there is no cure for PCOS, various treatments aim to manage symptoms and reduce health risks.
  
  
• A recent study suggests that women with PCOS adhering to the ketogenic diet may observe enhancements in fertility, weight management, and reduced testosterone levels.

The World Health Organization (WHO) estimates that 8–13% of women in their reproductive years globally are affected by polycystic ovary syndrome (PCOS), a chronic condition characterised by hormonal imbalances that can lead to infertility.

PCOS has no cure, but medical professionals employ various approaches, including medications, fertility treatments, surgical interventions, and lifestyle modifications, such as diet and exercise, to manage its symptoms.

In a recent study conducted by researchers from the Ministry of Health Malaysia in Kuala Lumpur and published in the Journal of the Endocrine Society, there is evidence suggesting that women with PCOS who adhere to the ketogenic diet may experience enhancements in fertility, weight reduction, and lower testosterone levels.

This research was recently featured in the Journal of the Endocrine Society.

How Does PCOS Impact Fertility?

PCOS occurs when the ovaries produce excessive testosterone and other male sex hormones known as androgens.

Individuals with PCOS have insufficient hormone levels necessary for ovulation, resulting in irregular menstrual cycles and potential infertility.

Approximately 70–80% of women in their reproductive years who have PCOS may also experience fertility problems.

Furthermore, some women with PCOS may develop small ovarian cysts, further contributing to hormonal imbalances.

In addition to ovarian cysts, elevated androgen levels, irregular periods, and infertility, other symptoms of PCOS can encompass:

• Pelvic pain
  
  
• Fatigue
  
  
• Low libido
  
  
• Oily, acne-prone skin
  
  
• Thinning hair and/or male-pattern baldness
  
  
• Skin tags
  
  
• Weight gain and/or trouble losing weight
  
  
• Excess body hair

How Does A Low-Carb Diet Affect Hormones?

Research has previously explored the effects of the keto diet on PCOS in clinical studies. However, no systematic review has investigated how the keto diet specifically impacts reproductive hormone levels.

For the study, researchers analysed data from seven clinical trials that assessed the effects of the keto diet in women with PCOS.

The findings revealed that women with PCOS who followed the keto diet for at least 45 days experienced significant weight loss, improved reproductive hormone levels, and reduced testosterone levels.

How Does The Keto Diet Improve PCOS Symptoms?

When an individual consumes carbohydrates, their digestive system breaks them down into sugar called glucose. As glucose enters the bloodstream, it increases blood sugar levels, prompting the pancreas to release insulin. Insulin's role is to facilitate the transfer of glucose from the bloodstream to the body's cells.

However, in the case of insulin resistance, when a person with this condition consumes carbohydrates, the insulin produced by the pancreas does not function effectively. Consequently, excess glucose remains in the bloodstream, and the cells do not receive the necessary energy.

Prior research has indicated that women with PCOS who adopt a low-carb diet may experience improvements in:

• Testosterone levels
  
  
• Weight loss and body mass index (BMI)
  
  
• Insulin resistance

A range of low-carb diets exists, with the keto diet being one of the most renowned.

The keto diet primarily emphasises consuming protein and healthy fats while significantly limiting carbohydrate intake. This approach leads to the depletion of the body's sugar reserves, ultimately prompting the breakdown of body fat for energy.

This is not the initial study to investigate the impact of the keto diet on PCOS. A study in February 2020 characterised the keto diet as a valuable non-pharmacological treatment for PCOS.

Furthermore, prior research suggests that low-carb diets may offer benefits for infertility issues related to PCOS. A study from November 2021 recognised a low-carb diet as an effective intervention for enhancing fertility health in women with PCOS.

In addition, a study conducted in October 2022 found that a very low-calorie keto diet may help women with PCOS improve their metabolic and ovulatory functions.

What’s The Link Between PCOS And Insulin Resistance?

Researchers have identified some potential risk factors that may contribute to the condition, which may include:

• Obesity
  
  
• Genetics
  
  
• Insulin resistance

Previous research indicates that a significant percentage of women with PCOS, ranging from 35% to 80%, experience insulin resistance. This condition means their bodies do not efficiently utilise insulin, the hormone responsible for regulating glucose levels.

Insulin resistance can affect fertility, primarily due to the increased inflammation levels it triggers. It can also result in elevated testosterone levels, disrupting regular ovulation.

Furthermore, since insulin plays a role in instructing the body when to store fat, heightened insulin levels contribute to weight gain, potentially causing fertility challenges.

It's essential to note that insulin resistance not only elevates the risk of PCOS but also increases the likelihood of developing diabetes, which can further impact fertility.

Should You Try The Keto Diet?

Insulin resistance is a common issue associated with PCOS, which aligns with the recent study's findings. Low-carb diets, such as the Mediterranean diet, have emerged as potential strategies to address PCOS, mainly due to their capacity to regulate insulin levels and mitigate the effects of hyperinsulinemia.

Nonetheless, it's essential to recognise that the keto diet, characterised by high fat, high protein, and minimal carbohydrates, may only be somewhat suitable.

Specific populations should approach it cautiously, including pregnant individuals, those with certain health conditions like hypothyroidism, or individuals with eating disorders. When contemplating dietary changes for managing PCOS, it's crucial to consider various factors, including age, baseline BMI, gender, overall health status, kidney and liver function, and gut health.

If you're uncertain about the appropriateness of the keto diet or any dietary modifications for PCOS management, consulting with a gynaecologist, endocrinologist, or dietitian is recommended.

Count on Mobi Doctor to be your trusted health partner! Our team is just a consultation away if you have questions or need expert advice. Your well-being matters to us, so let's connect and keep you on the path to good health!