Low carb

Keto for PCOS: does it work?

Keto for PCOS: does it work?

If you live with polycystic ovary syndrome (PCOS), you may be wondering if diet changes can help relieve some of your symptoms.

Like type 2 diabetes, PCOS is characterized by insulin resistance⁠—where your body does not respond appropriately to the hormone insulin, which helps regulate blood sugar and fat storage (1).

Since the low-carb, high-fat keto diet is often touted as a way to improve insulin resistance in people with type 2 diabetes, it may also offer some benefits for people with PCOS (2).

This article reviews the pros and cons of a keto diet for PCOS symptoms.

PCOS is a common hormonal condition believed to affect one in ten women of childbearing age. It affects hormone levels and metabolism and remains a major cause of infertility in women. However, the condition is treatable with proper medical care (3).

The exact cause of PCOS is unknown, but it is thought that a number of factors may contribute to it.

These include low-grade inflammation and an imbalance of hormones such as insulin and testosterone. Although women naturally create and require testosterone, women with PCOS may have higher than expected levels (3, 4).

Some symptoms of PCOS include (3):

  • Obesity, weight gain or difficulty losing weight
  • Excessive body hair, such as on the face or chin
  • Irregular periods or no periods
  • Hair thinning
  • Skin changes, such as acne, dark spots, or skin tags

PCOS is usually managed with a combination of medications and lifestyle changes. Generally, weight loss plans are recommended for women with PCOS and obesity because they can help improve insulin resistance and support hormonal balance (5).


PCOS is a condition caused by hormonal imbalances in women. This can lead to infertility, irregular periods or weight gain. You can manage the disease with medication and lifestyle changes.

On the low-carb, high-fat keto diet, your carbohydrate intake is drastically reduced, which forces the body into a state of ketosis ⁠—where you burn fat rather than carbohydrates for energy.

On a keto diet, most people reduce their carb intake to less than 50 grams of total carbs per day (6, seven).

Researchers have found that keto diets can improve insulin sensitivity, help balance hunger hormones, and promote weight loss in people with obesity and type 2 diabetes.

A handful of recent studies have also investigated the effects of keto diets on PCOS (6).

Insulin resistance

Insulin resistance is thought to contribute to the development of PCOS. The hormone insulin helps regulate blood sugar by moving glucose from the blood into cells, where it can be used for energy or stored for later use (8).

However, people with insulin resistance tend to have high blood sugar and insulin levels because their body compensates for the insulin resistance by producing more insulin (9).

Insulin resistance occurs when your cells stop responding appropriately to insulin, which raises blood sugar levels and causes the pancreas to produce insulin (ten).

Since insulin is also responsible for storing fat, high insulin levels and insulin resistance are also associated with weight gain and obesity. When left untreated, insulin resistance can also lead to type 2 diabetes.

Since the keto diet can help improve insulin sensitivity, it may be useful for PCOS management (9, 11).

In a 12-week study of 14 women with PCOS, a keto diet rich in plant foods (like low-carb vegetables) led to a significant drop in blood sugar and insulin levels, as well as better insulin resistance scores ⁠—indicating higher insulin sensitivity (12).

In another study of 18 women with PCOS, liver dysfunction and obesity, participants were given either conventional prescription medications or a ketogenic diet for 12 weeks.

The researchers found that the keto group experienced significant improvements in blood sugar levels, suggesting improved insulin sensitivity ⁠— although this study did not measure insulin or insulin resistance scores. insulin (13).

Finally, a 45-day study in 17 obese women with PCOS found that a keto diet reduced average blood sugar levels by 10 mg/dL and average insulin levels by nearly 13 micro-IU/mL. Insulin resistance scores, which reflect increased insulin sensitivity, also improved (14).

In short, recent research confirms that a ketogenic diet can significantly improve PCOS symptoms through effective insulin regulation.

Other effects

These same studies also noted significant improvements in weight, hormone levels, liver function, blood lipids, menstrual regularity, and fertility.

In one of the 12-week studies on a plant-rich keto diet, participants lost an average of nearly 21 pounds (9 kg). Additionally, they experienced significant improvements in triglyceride and cholesterol levels, as well as a reduction in testosterone (12).

In the 12-week study of PCOS and liver function in obese women, 6 out of 7 participants in the keto diet group had no signs of fatty liver disease at the end of the study. Additionally, these participants experienced significant weight loss (13).

In a 45-day study, participants lost an average of 21 pounds (9 kg) and significantly reduced fat mass and waist-to-hip ratio. Additionally, their testosterone, triglycerides, total cholesterol, and LDL (bad) cholesterol dropped while their HDL (good) cholesterol rose (14).

Additionally, during this study, 5 of 17 participants saw their periods return after several years without having had one, 12 women reported improved regularity of their periods, and 5 women became pregnant after many previous failed attempts. (14).

However, larger studies with longer durations are needed to learn more about the long-term effects of keto on PCOS.


Some small studies indicate that the keto diet can help with PCOS by improving insulin resistance, promoting weight loss, balancing hormones, and promoting regular periods.

The keto diet for PCOS can have drawbacks or challenges.

In some studies, researchers have found that following a keto diet increases cholesterol levels. This can be a concern for some people, especially those who already have high cholesterol (15, 16, 17).

Additionally, keto diets are found to be restrictive, so sticking to them can be difficult for many people. On keto, you will need to avoid bread, pasta, rice, cereals, potatoes, most fruits, and other foods high in sugar or carbohydrates.

If you decide to try keto to manage your PCOS, be sure to work closely with your healthcare provider so they can monitor your progress closely.

A less restrictive low-carb diet may provide similar benefits for PCOS while being easier to stick to long-term than a strict keto diet. In fact, similar results have been seen using less restrictive diets, such as a low-carb Mediterranean diet (18).


The keto diet can significantly raise your cholesterol levels. It is also extremely restrictive and can be difficult to follow long term. A less restrictive low-carb approach, however, may provide similar benefits.

Because PCOS is characterized by insulin resistance, the keto diet can help with PCOS management as it can improve your insulin sensitivity.

Additionally, researchers have found that the keto diet helps women with PCOS lose weight, improve their sex hormone balance, lower triglyceride and cholesterol levels, normalize their menstrual cycles, and improve fertility. .

However, keto is still a very restrictive diet for most lifestyles, so switching keto on and off can actually make your body more sensitive to carbohydrate-rich foods.

Additionally, more research on the effects of keto on PCOS is needed.

Either way, adopting a low-carb diet that you can stick to for a lifetime may offer some benefits for managing PCOS.