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Keto Diet For PCOS In 2023: Pros And Cons To Consider

Polycystic Ovary Syndrome or PCOS, is a hormonal condition that can affect females: a condition in which ovaries can become enlarged and develop cysts. PCOS can also cause weight gain and infertility.
Though the cause of PCOS is not definitively known, keeping hormones balanced is a key factor in helping manage and treat the condition. The ketogenic diet, being high in fat and low in carbs, can prove beneficial to hormone balance and is one way to lose weight with PCOS.
Diet is an excellent way to balance hormones, especially when focusing on foods that increase fertility in females.
However, the keto diet for PCOS can also be restrictive, which for some people, can lead to different types of eating disorders, so it’s essential to understand the pros, as well as the cons, of eating keto for PCOS.
Keto Diet For PCOS
Low-carbohydrate diets like the keto diet may be especially helpful in reducing insulin resistance[1] and rebalancing hormones, which makes it a useful tool for treating PCOS. Additionally, this eating approach can reduce testosterone levels in women and help reduce weight, as well.
How Does Keto Affect PCOS
Weight Loss
Women with PCOS tend to struggle with weight gain due in part to insulin resistance[2], in which insulin cannot work as effectively to move sugar into cells for energy. Instead, excess sugar ends up in the bloodstream and can build up in fat storage.
Keto can help improve insulin sensitivity, which in turn can help with weight loss. And because keto is a low-carb diet, it offers additional weight loss mechanisms through lower-calorie foods.
Improved Insulin Resistance
Insulin resistance is not just associated with weight gain but is implicated in type 2 diabetes[3]. The healthy fats in a keto diet, such as avocados and fish, nourish hormones, helping them to rebalance, while the reduction of carbs helps limit the amount of insulin produced in the body.
Combined, these mechanisms help the keto diet improve insulin sensitivity, which can prevent obesity, type 2 diabetes, and other health complications associated with PCOS.
Reduces Inflammation
PCOS does not just have a hormonal base, it is also rooted in low-grade inflammation. In fact, studies have shown that women with PCOS have high inflammation markers, even in their genes[4].
A keto diet can help reduce inflammation via being low-carb (carbs can be inflammatory, especially processed carbs) as well as high-fat. Note that high levels of omega-3 healthy fats[5], specifically, are anti-inflammatory, as opposed to saturated fats, which can increase inflammation.
Omega-3 fats have been used to improve inflammation in PCOS as well as autoimmune disease.
What Is PCOS?
PCOS stands for Polycystic Ovary Syndrome, or sometimes “Ovarian” syndrome. It is a hormonal condition that affects women of reproductive age, causing ovarian cysts, weight gain, irregular menstrual cycles, and higher levels of androgens, such as testosterone, which can lead to excess body and facial hair.
Reducing carbohydrate intake is one method that can benefit this condition.
Cons Of Keto Diet For PCOS
May Raise Cholesterol

Some studies show a correlation between the keto diet and elevated cholesterol[6]. For women with PCOS who are already struggling with weight gain, insulin resistance, or obesity, their cholesterol may already be high, in which case, a keto diet could potentially be harmful.
Other studies demonstrate unfavorable implications for the liver[7], as well, such as non-alcoholic fatty liver disease.
May Be Too Restrictive
The keto diet is not the most lenient of diets; it’s restrictive, particularly around carbohydrates. Keto suggests limiting carbs to roughly 10% of the diet while increasing fats to upwards of 70%.
This is a drastic method to follow and can be difficult to stick to for long enough periods to see results. As a result, women who try keto for PCOS may struggle with feelings of deprivation or cravings and may even develop eating disorders.
For these women, a similar but more lenient eating approach, such as the Mediterranean diet[8], may also prove helpful for PCOS management. The Mediterranean diet emphasizes healthy fats and reduced carbs, but not to the extent that the keto diet does.
Nutritional Deficiencies
Any restrictive diet can pose the potential to miss out on important nutrients. The ketogenic diet mainly limits carbs, which can help the body go into ketosis.
However, whole grains and starches have a lot of nutrients like fiber and B vitamins, not just calories, so restricting them can cause a person to lose out on those nutrients.
Women with PCOS should work with a qualified nutrition specialist who can monitor their nutrient levels to ensure they’re supplementing as needed.
Keto Diet For PCOS: Precautions
When combining a keto diet and PCOS, women must take certain precautions and prioritize healthy, sustainable practices.
Professional Oversight
First and foremost, consult your doctor or nutritionist before embarking on the ketogenic diet to ensure it’s suitable for your unique body and to secure a professional eye over the process. You’ll want to monitor not just how you’re feeling but your medical labs as well.
Prioritize Nutrition
A keto diet can just as easily be done “dirty” as it can be done healthfully. Rather than increasing fats with just any sources of fat, be sure to choose high-quality, whole food sources, such as wild-caught fish, avocados, olives, coconut, MCT oil, nuts, seeds, and eggs.
Likewise, when choosing your protein, opt for healthy, natural, unprocessed sources, such as eggs, soy, lean meats, and legumes.
Watch Your Carbs
While carbohydrate intake should be reduced on keto (usually around 10%), this may not work for everyone.
Be sure to work with a nutritionist who can advise you on how to reduce your carbs slowly and safely and to a level that feels right for your body (this may mean a little more than 10%). Try not to be too dogmatic about the eating approach, and instead, listen to what your body needs.
Tips To Follow Keto Diet Polycystic Ovary Syndrome
PCOS is heavily rooted in hormone imbalance[9] and is intertwined with insulin resistance and weight gain. As such, a high-fat, low-carb diet can help to untangle these issues and, in turn, reduce symptoms of PCOS. Here are some tips to follow on keto PCOS for women:
Focus On Non-starchy Vegetables
You can’t go wrong with veggies on a keto diet. Think asparagus, leafy greens, tomatoes, cucumbers, artichokes, mushrooms, radishes, rutabagas, peppers, zucchini, broccoli, cauliflower, string beans, etc.
These foods add a ton of nutrients, yet very few calories, so they will not add too much to your carb load.
Lower Your Sugar
Reduce sugar and other forms of carbs, including fruit. Some fruits, such as berries, have a lower glycemic index, which means they are lower in sugar. Otherwise, a keto diet works best when starches such as potatoes, grains such as rice and oats, and sugars are reduced.
Increase Fat
The hallmark of a keto diet is high fat. Be sure to stock up on sardines, wild-caught salmon and mackerel, avocados, olive oil, nuts, and seeds. You’ll want to aim for roughly 70% of your daily calories to come from healthy sources of fat.
Choose Healthy Sources
PCOS is complicated and multifaceted. In order to get hormones back into balance and reduce inflammation, inflammatory foods need to be reduced.
This means less processed, artificial foods which contain excess sugar, additives, and other chemicals, and more whole, unprocessed foods. For fats, specifically, choose sources of omega-3 fats, not saturated fats.
Conclusion
The ketogenic diet has been used to treat a variety of health conditions, one of them being PCOS or polycystic ovary syndrome. This condition affects many women in their reproductive years.
Women with PCOS can experience weight gain, insulin resistance, facial and body hair, ovarian cysts, and infertility. Through various chemical mechanisms, the keto diet may be particularly beneficial in balancing hormones and reducing inflammation, which can reduce PCOS symptoms and help with significant weight loss.
However, keto is not for everyone, and those who are considering the diet should consult with their healthcare provider.
Frequently Asked Questions
PCOS cannot be cured[10]; however, the symptoms can be managed successfully with attention to diet and lifestyle. In some cases, hormonal birth control may be prescribed for treating PCOS, but it’s always good to try a natural approach first.
There is no specific conclusive test for PCOS; rather, a doctor can draw blood to check hormone levels and see if your androgens are high. Additionally, a doctor may perform a sonogram to check for ovarian cysts.
The keto diet can improve PCOS symptoms in a number of ways – by reducing inflammation, improving insulin resistance, balancing hormone levels, and helping with weight loss.
PCOS stands for polycystic ovary syndrome, though it is also referred to as polycystic ovarian syndrome.
+ 10 sources
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- Mavropoulos, J.C., Yancy, W.S., Hepburn, J. and Westman, E. (2005). The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: A pilot study. [online] 2(1). doi:https://doi.org/10.1186/1743-7075-2-35.
- Xu, Y. and Qiao, J. (2022). Association of Insulin Resistance and Elevated Androgen Levels with Polycystic Ovarian Syndrome (PCOS): A Review of Literature. [online] 2022, pp.1–13. doi:https://doi.org/10.1155/2022/9240569.
- Yuan, X., Wang, J.-D., Yang, S., Mei Hua Gao, Cao, L., Li, X., Hong, D., Tian, S. and Sun, C. (2020). Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis. [online] 10(1). doi:https://doi.org/10.1038/s41387-020-00142-z.
- Rudnicka, E., Katarzyna Suchta, Grymowicz, M., Calik-Ksepka, A., Katarzyna Smolarczyk, Duszewska, A.M., Smolarczyk, R. and Blazej Meczekalski (2021). Chronic Low Grade Inflammation in Pathogenesis of PCOS. [online] 22(7), pp.3789–3789. doi:https://doi.org/10.3390/ijms22073789.
- Simopoulos, A.P. (2002). Omega-3 Fatty Acids in Inflammation and Autoimmune Diseases. [online] 21(6), pp.495–505. doi:https://doi.org/10.1080/07315724.2002.10719248.
- Lee, D. and Lee, J.-A. (2021). Influences of Ketogenic Diet on Body Fat Percentage, Respiratory Exchange Rate, and Total Cholesterol in Athletes: A Systematic Review and Meta-Analysis. [online] 18(6), pp.2912–2912. doi:https://doi.org/10.3390/ijerph18062912.
- Anekwe, C.V., Chandrasekaran, P. and Fatima Cody Stanford (2020). Ketogenic Diet-induced Elevated Cholesterol, Elevated Liver Enzymes and Potential Non-alcoholic Fatty Liver Disease. [online] doi:https://doi.org/10.7759/cureus.6605.
- Mei, S., Ding, J., Wang, K.-L., Ni, Z. and Yu, J. (2022). Mediterranean Diet Combined With a Low-Carbohydrate Dietary Pattern in the Treatment of Overweight Polycystic Ovary Syndrome Patients. [online] 9. doi:https://doi.org/10.3389/fnut.2022.876620.
- NHS Choices (2023). Causes – Polycystic ovary syndrome. [online] Available at: https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/causes/
- NHS Choices (2023). Treatment – Polycystic ovary syndrome. [online] Available at: https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/treatment/#:~:text=Polycystic%20ovary%20syndrome%20(PCOS)%20cannot,of%20symptoms%2C%20or%20just%201.