Fertility

Keto for PCOS – weight loss updates & where the research is at, in 2024

Jessie Day  |   3 Jan 2024


In 2023, the Journal of the Endocrine Society published a study indicating that women with PCOS may see improvements in fertility, effective weight loss and hormone management, by following a ketogenic diet. 

We’re not into ‘diets’ per se – eating for fertility is so often all about the variety, nourishment and the rich web of nutrients we can get from our food – but, for specific conditions like PCOS, endometriosis, thyroid issues and more – it really helps to have a scientific directive for what and how to eat. 

What is ‘keto’?

The ketogenic – keto – diet involves eating a much lower ratio of carbohydrates to fat (you’ll also get a moderate amount of protein, in the standard keto diet). 

In a keto eating plan, fats become our dominant source of energy, rather than carbohydrates. You’re restricting carbohydrates and literally burning fat, with the aim of getting your body into a state of ‘ketosis’. This is where your fat reserves are being converted into ketones for energy, rather than glucose which comes from carbs. 

How can keto help with PCOS?

We’ve covered PCOS in depth previously – run through our knock-out PCOS fertility tool kit and the all-important Can I get pregnant with PCOS? 101 expert Q&A chat for more – but the keto point is relatively new. 

According to the Endocrine Society, PCOS is the most common hormone disorder in women, and affects 7-10 per cent of women of childbearing age. It can cause infertility, and/or obesity, diabetes and other metabolic health problems.

The keto diet is now widely-known for its effectiveness in supporting weight loss, but more recently, it’s coming into its own as a potential tool for women who have PCOS. 2023 research suggests that it may help to improve reproductive hormone levels in women with the condition. 

And, while further study is needed, the findings are clinically important, particularly for endocrinologists, gynecologists and dieticians, recommending careful diet planning and customisation for patients with PCOS. 

Crucial aspects of the keto for PCOS link include the diet’s impact on: 

  • weight loss
  • fertility 
  • optimized cholesterol levels  
  • normalized menstrual cycles

PCOS patients on the keto diet for at least 45 days saw significant weight loss and an improvement in their reproductive hormone levels. In terms of hormones, highlights from the research include: 

  • lower FSH (follicle-stimulating hormone) ratio, and a better chance of ovulation
  • lower testosterone levels

Sounds exciting. And it is, but there are certain side effects we need to be aware of when going for a ketogenic diet. Let’s take a look. 

ketogenic diet for PCOS weight loss

Side effects and challenges

There is some research to suggest that eating keto can raise cholesterol levels. If this is a concern for you, rather than going all-out keto, a lower-carb diet might be more suitable – for example a low-carb Mediterranean diet. Medical opinion on cholesterol management is divided, however, so do get a professional opinion before making any big changes. 

Keto, depending on how you go about it, can also be pretty restrictive. It doesn’t have to be – listen to this fantastic podcast from Naturally Nourished for a fresh take on keto, women’s hormones, PCOS and delicious meal-planning – but a keto rut can easily lead to inadequate intake of fiber and other key dietary components. And, often, falling off the wagon.  

Full disclosure, I don’t have PCOS. And I don’t currently eat keto. I do, however, naturally prefer a lower-carb diet, and the way I make this work is by going for options like a rich, umami-tasting bolognese sauce over greens or tenderstem broccoli, rather than pasta. Or, a bowl of mixed berries (being helpfully low-glycemic) and whipped cream (go for coconut cream if you’re not doing dairy) with a few drops of vanilla extract, rather than ice cream. 

Packed with flavor, easy to vary and deeply satisfying. I don’t feel restricted, but I do like how my body feels, eating lower carb. And yes, when I’m consistently eating this way, I do usually experience sustained weight loss, as a sort of by-product.

Keto for PCOS weight loss – what’s the bottom line? 

Speaking of weight loss, let’s look at this aspect in more detail. PCOS can absolutely impact your weight, and ACOG says that even a small amount of weight loss may help regulate your periods if you have PCOS. 

But what about keto weight loss, in particular? 

Weight loss, however we’re doing it, can help women with PCOS metabolize blood sugar more effectively. And this, in turn, can support ovulation. By losing weight, optimizing menstrual cycles and opting for a way of eating which really impacts blood sugar control, you’re potentially looking at a really dynamic combined effect.

keto for PCOS meal plan

Mini keto for PCOS meal plan

Looking for inspo? The web is packed with everything from 7-day kickstart plans to 12-week overhauls. Pick and choose from recipes you like the look of, and use our suggestions below to get you out of a rut, when you’re sick of the avo-bacon-lettuce combo. 

Bear in mind if you’re doing full, serious keto, you’ll need to keep a tight focus on nutritional info, especially the fats, carbs, protein and sugars you’re getting from each serving. 

Breakfast

Option 1 – Veggie omelet (using 2 eggs, olive oil and leftover veggies like bell peppers or swiss chard) 

Option 2 – Avocado green smoothie (using full fat coconut milk, greens, avo, a knob of ginger & small amount of fruit, such as peach or strawberries)

Lunch

Option 1 – Cobb egg salad (add bacon, romaine lettuce, avocado and tomatoes, ground pepper & a squeeze of lemon for a winning combo) 

Option 2 – Lettuce wraps (stuffed with chicken thigh, avocado, roasted peppers and sea salt)

Dinner

Option 1 – This yummy asparagus and salmon with garlic lemon & butter 

Option 2 – This peanut butter chicken curry – trust me, it’s unreal 

Snacks

We’d go for pork rinds with guacamole, mini skewers with a wedge of lettuce, avocado & chicken, or a mug of bone broth blended with coconut milk and cilantro for a satisfying pick-me-up. 

Sweet treats

Depending on how you’re doing keto, emphasizing savory tastes over sweet can be a crucial part of the eating mindset. 

For consistency and steady weight loss, we’d suggest using that breakfast smoothie suggestion above as an opportunity to indulge, or opting for low-glycemic fruits like berries, peaches and watermelon, topped with whipped cream (coconut, if you’re not doing dairy), and a sprinkle of vanilla for some natural sweetness. 

Cinnamon is great, too, and one of my favorites is a little stewed peach with cinnamon and heavy whipping cream, as a real treat. 

On your reading list – crack through these features, for a PCOS deep-dive: 

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