Ask Doveras: “Should I go keto if I have irregular cycles or PCOS?”

Q&A: “Should I Go Keto if I Have Irregular Cycles or PCOS?”

Can this diet regulate fertility hormones and help you get pregnant?

The Short Answer

There is some evidence that a keto diet may be a short term solution, but it's challenging as a long term solve.

Plus, the evidence is clear that whole grains are great for ovulation-related infertility and hormone imbalances.
We therefore don't recommend this diet for people with PCOS or irregular periods. Focus on whole grains instead!

The Long Answer

This has been a very popular topic, with lots of studies coming out just in the last year or two!

Here is what we know for sure: cutting back on sugars can help manage PCOS, which is often related to issues with insulin sensitivity. It may also be beneficial for addressing irregular periods.

Carbs are one of the first places to look when trying to reduce sugar intake. This is because different carb types can trigger a drastically different response from our bodies. Refined and ultra processed foods, for example, spike our blood sugar, while whole grains don't have as large of an impact.

A keto diet is a one way of addressing carbs consumption, since it is by definition a low-carb, high-fat diet. In other words, it cuts out carbs, and therefore drastically reduces sugar intake. And it is true, there is emerging evidence that shows a keto diet may help improve reproductive hormone imbalances, including those associated with a PCOS diagnosis (1, 2, 3, 4).

However, sustaining a keto diet for weeks, months, or years is extremely challenging. These studies on the benefits of keto for PCOS patients also only look at people with higher body weights, but we know that there are many phenotypes of PCOS and this intervention may not be suitable for all.

Plus, we're hesitant to recommend this diet because numerous high quality studies have shown the benefits of increasing whole grain consumption for everyone trying to conceive, including people with PCOS. This is because adding more whole grains to your diet can also support insulin sensitivity.

So, we currently recommend focusing on cutting out refined grains/carbs rather than cutting out the entire macro nutrient.

If and as the evidence changes, we'll be sure to update our stance, but— according to Harvard Professor Jorge Chavarro and Emory Professor Audrey Gaskins — this is the best way to weigh the current state of evidence in favor of whole grains vs. keto.

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