Research Review: Keto For PCOS
The ketogenic diet has displayed strong evidence for its ability to promote weight loss and provide therapeutic impact for conditions like cardiovascular disease and type 2 diabetes. Additionally, there are many emerging areas of therapeutic value for keto such as cancer, Alzheimer’s disease, brain trauma, ALS, acne, and PCOS which I will be highlighting in this article (1).
What is PCOS?
PCOS is a condition that affects up to 10% of American women. Excess production of androgens (male sex hormones) and the presence of acne, menses, ovarian cyst and increased infertility are common characteristics of PCOS. One of the biggest problems with PCOS is that 50% of women go undiagnosed!
Interestingly, over half of the women who are diagnosed with PCOS are overweight or obese. Women with PCOS are also more likely to have altered blood lipids thus increasing the risk for metabolic disorders including coronary heart disease and metabolic syndrome.
What Causes PCOS?
While the exact cause of PCOS is not known, one of the leading theory’s is that its development is associated with the excessive release of luteinizing hormone (LH) and insulin resistance. The chronic elevation of insulin via insulin resistance may interrupt normal cell signaling pathways and result in increased androgen production (2). Additionally, insulin resistance can also promote inflammation, another common side effect of PCOS.
How is PCOS Treated?
Researchers are still looking for the optimal treatment to combat PCOS, however the current treatment recommends a “multi-factorial” approach centered around diet and lifestyle modifications as well as pharmaceuticals and in some cases surgery. Since most PCOS patients are insulin resistant and inflamed, strategies should aim to improve insulin sensitivity and reduce inflammation.
Why Keto Can Help
Since PCOS is characterized by insulin resistance, inflammation, obesity, impaired hormone levels, and damaged metabolism, the keto diet could offer some therapeutic value since transitioning to fat and ketones for fuel tends to lead to improved insulin levels, lower inflammation, weight loss, and improved metabolism.
One study in 2005 put this hypothesis to the test with one of the first pilot studies investigating the effects of a Ketogenic Diet on patients with PCOS (3).
11 obese women with PCOS were volunteers for this study. Participants were instructed to follow a Ketogenic Diet for 24 weeks. Participants returned to the clinic every two weeks for measurements and help sticking to the diet.
At the end of 24 weeks the results demonstrated that those who completed the study decreased body weight by an average of 12%, free testosterone by 22%, LH/FSH ration by 36% and fasting insulin by 54%. It’s also important to mention that the researchers also reported non-significant decreases in insulin, glucose, testosterone, HBA1c and perceived body hair also decreased.
What is even more incredible, two women became pregnant during the study despite previous infertility problems! If that doesn’t tell you there is something to look at then I don’t know what will.
As always, we need a lot more research before we can definitively say what the best approach to treating PCOS is but with some of the early studies and anecdotal stories producing these kind of results, I think it would be difficult to not consider keto a top option!
Paoli, A., Rubini, A., Volek, J. S., & Grimaldi, K. A. (2013). Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. European journal of clinical nutrition, 67(8), 789.
Liepa, G. U., Sengupta, A., & Karsies, D. (2008). Polycystic Ovary Syndrome (PCOS) and Other Androgen Excess–Related Conditions: Can Changes in Dietary Intake Make a Difference?. Nutrition in Clinical Practice, 23(1), 63-71.
Mavropoulos, J. C., Yancy, W. S., Hepburn, J., & Westman, E. C. (2005). The effects of a low-carbohydrate, Ketogenic Diet on the polycystic ovary syndrome: a pilot study. Nutrition & metabolism, 2(1), 35.