Ketogenic Diet: Polycystic Ovary Syndrome (PCOS)

By recent ASU nutrition student Alysia Nelson

Part of an ongoing series of articles on the Ketogenic Diet

A ketogenic diet is noted to have many health benefits including neuroprotective and disease-modifying mechanisms. It is used to treat patients with type 2 diabetes, a blood sugar disease caused by decreased insulin sensitivity. Polycystic ovary syndrome (PCOS) is an illness affecting 1 in 10 women, thought to be like a cousin to diabetes. An estimated 5-10%, or 5 million, women in the United States have PCOS.1 Women with type 1 diabetes are at an increased risk for PCOS and women with PCOS are at an increased risk for developing type 2 diabetes.1 The common factor in all of this is? Insulin, indicating that insulin could be a key driver for PCOS.1 Living with PCOS can feel discouraging, but there is hope that it can be treated through nutrition.

What is PCOS?

  • One of the most common hormonal disorder
  • Can cause infrequent or prolonged menstrual periods
  • Can cause excess production of the male hormone (androgen)- causing excess facial/body hair
  • Can cause the ovaries to develop many collections of fluid (follicles)
  • Can cause failing to regularly release eggs- can lead to infertility

What causes PCOS?

  • The cause is unknown
  • Excess insulin could be a factor (increasing androgen production)
  • Low-grade inflammation (can stimulate androgens) that can lead to heart and blood vessel problems
  • It could be heredity (research suggests related genes)
  • Excess Androgen- ovaries produce abnormally high levels resulting in hirsutism (hair growth) and acne

How can a Ketogenic diet help?

  • Promotes weight loss
  • Increases insulin sensitivity, hormone involved in blood sugar (glucose) levels

Ketogenic Diet and PCOS

In a study published in the National Center for Biotechnology Information (NCBI) a ketogenic diet leads to significant improvement in weight, percent free testosterone, LH/FSH ratio, and fasting insulin in women with obesity and PCOS.2 In this pilot study a total of 11 women were instructed to limit their carbohydrate intake to less than 20g per day for 24 weeks. From here they returned to an outpatient research clinic for measurements and dietary instruction every 2 weeks. Two women who were previously infertile became pregnant during the trial.2 In addition, there was a significant improvement in infertility, regularity in terms of menstruation, and the decreased production of abnormal hair growth.2 The pilot study led researchers to believe that a ketogenic diet had the opposite effect on PCOS decreasing androgen secretion and increasing circulating a sex hormone binding globulin (SHBG).2 The combination limited the amount of free- androgens and reduced LH/FSH hormones.2

Benefits of following a Ketogenic Diet

  • Improved fertility and ovulation: American College of Obstetricians and Gynecologists agreed that women participating in IVF (In Vitro Fertilization) had better quality eggs and embryos when consuming low levels of carbs.3 The Nurse’s Health Study 9NHS II) also agrees that high carbohydrate diets lead to ovulatory infertility.3
  • Increases Insulin Sensitivity: Results in the body utilizing fat for energy instead of sugar (glucose). When carbohydrate restriction is in place, blood sugar and insulin levels are reduced.3
  • Improves glycemic control: patients have been noted to eliminate or reduce their medication for blood sugar control.
  • It leads to weight loss: Found to be more effective for weight loss than a low calorie or low-fat diet.
  • Increases HDL and decreases LDL levels: Increase in “good cholesterol” and decrease in “bad cholesterol” showing a benefit for overall cardiovascular health.

1 PCOS: The Cousin of Diabetes? (2012, September 11). Retrieved April 16, 2018, from

2 Mavropoulos, J. C., Yancy, W. S., Hepburn, J., & Westman, E. C. (2005). Retrieved April 16, 2018, from

3 Is a Ketogenic Diet Best for PCOS? (2018, March 20). Retrieved April 16, 2018, from

Editor’s Note: Fill Your Plate neither endorses or supports this type of diet, but encourages readers to always consult with your doctor regarding special diets. this series shares one nutrition student’s experiences with the diet.

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