Keto for PCOS: Better Ovulation, Weight Loss & Insulin Control

In this article, we're looking at the science behind the benefits adopting keto for PCOS.

Finding a fix for your worst PCOS symptoms feels like you’re constantly enduring the frustration of endless trial and error. 

Some days, it feels like the number of failed attempts just keeps piling up.

Well, keto for PCOS might be just what you need to get your hormones and overall health back on track.

Extensive research shows keto for PCOS may help balance hormones, suppress inflammation, boost weight loss, and improve insulin sensitivity.

I’ve given the keto diet a try with great success - I saw it bring major improvements to my PCOS symptoms. For me, turning to natural approaches like diet and exercise, came after years of trying every medication and treatment under the sun to fix my irregular periods and hormonal acne. With diet, and especially a low-carb eating pattern, I finally found a lasting solution to my hormone imbalance. 

However, keto may be challenging  - and risky - to follow in the long term. In this article, we’ll look at the science behind the keto benefits for PCOS, plus how to start this diet safely.

3 proven benefits of the Keto diet for PCOS

Keto for PCOS is chock full of benefits, and it’s known for treating the hormone imbalance at the root of PCOS.

One study published in the 2020 Journal of Obstetrics and Gynecology Research found the keto diet regulated menstrual cycles and reduced body weight in women with PCOS. Not only that, but researchers saw a major improvement in participants' liver function and blood glucose levels.

Study authors note:

“In addition to improving the menstrual cycle, KD had the additional benefits of reducing blood glucose and body weight, improving liver function, and treating fatty liver compared to traditional pharmacological treatment in women with PCOS and liver dysfunction who were obese.”

The results of this study show the keto diet may provide an effective and safe alternative to traditional pharmacological treatment for PCOS. 

Below, we get into the details of the keto benefits for PCOS.


1. Lower insulin levels


One of the most powerful benefits of the keto diet for PCOS is that it may lower insulin levels and increase your body's sensitivity to insulin.


PCOS is often associated with insulin resistance, where your body doesn’t respond properly to insulin. Insulin resistance leads to elevated levels of insulin in the body, and this causes a ton of negative health effects. Some of the complications connected to insulin resistance include type 2 diabetes and cardiovascular disease.


The keto diet works to reduce insulin levels by restricting carbohydrates, which helps reduce the amount of glucose in the bloodstream. This, in turn, lowers the amount of insulin the body needs to produce. 


Indeed, evidence suggests the keto diet may improve insulin sensitivity. In 2020, researchers examined the effect of a keto diet on 14 women with PCOS. After following keto for 12 weeks, the participants had a significant reduction in insulin levels. Researchers suggest that the keto diet activates certain proteins that help the body control sugar and respond better to insulin.


But research is mixed.

An animal study published in the Journal of Physiology suggests a keto diet may worsen insulin resistance. 

When I was on a keto diet, I checked my insulin levels and they were within the normal range. Tracking a couple of indicators is always useful. For one thing, you get to see if what you’re doing is having a measurable, positive effect on your hormone levels. For another, you’ll be able to flag potential problems early. While on keto, I worked with an integrative doctor - someone who takes diet, exercise, and supplements into account when coming up with a health plan.


2. Regular ovulation


One of the ways PCOS manifests in the body is through irregular periods and ovulation. It’s thought that sustained high levels of testosterone produced by the ovaries interfere with ovulation.

The lack of ovulation in PCOS can contribute to infertility and difficulties in conceiving.  Honestly, it can be one of the distressing PCOS symptoms. Even when I wasn’t trying to get pregnant, I worried about my irregular periods. Instinctively, I knew something was wrong.

What’s worse, is you might get completely inaccurate advice from your doctor. My gynecologist once told me my erratic periods were no cause for concern and that birth control would keep them regular. So, I stayed on the pills for years even though they made me moody and anxious.

Studies have shown that following a keto diet can reduce the levels of insulin and androgens in the body. Specifically, some evidence suggests keto may regulate testosterone. Balancing these hormones can restore regular ovulation.


Researchers from the Endocrinology & Metabolism Institute and the National Diabetes and Obesity Research Institute also found a keto diet may promote ovulation in PCOS patients. All study participants had a history of infertility. Researchers monitored the women for six months. During this time, all of the participants started getting their periods regularly, while two fell pregnant.


Additionally, some of the participants started getting regular periods a month after starting the diet. And while some of the women in the study were taking metformin, the insulin sensitising medication, researchers credit the diet with the most success. For example, two of the participants had been on metformin for years without normal ovulation. Their periods only became regular once they started keto. 

Researchers also pointed to previous studies that showed metformin was only able to restore regular periods and ovulation in 25% to 50% of cases.


“...we conclude in our cases that the diet was more effective in restoring regular periods than metformin. However, larger studies are still needed to compare the effects of diet to metformin and also to see if combining both treatments has an additive benefit.”


A 2022 Nutrients journal study linked keto to an increase in progesterone levels, leading to better ovulatory function. Having enough progesterone during a specific phase of the menstrual cycle is important for the lining of the uterus to be healthy and ready for a fertilized egg to implant.  

3. Increased weight loss


PCOS is commonly associated with insulin resistance, which can make it challenging to lose weight. The keto diet has been shown to promote weight loss.


Generally, there’s an established link between keto and weight loss. For example, a meta-analysis and systematic review by the European Association for the Study of Obesity found:

“First, the VLCKD was shown to result in a significant weight loss in the short, intermediate, and long terms and improvement in body composition parameters as well as glycemic and lipid profiles. Second, when compared with other weight loss interventions of the same duration, the VLCKD showed a major effect on reduction of body weight, fat mass, waist circumference.”


For PCOS specifically, a study of 25 PCOS patients showed keto led to a “significant reduction” in body mass index and waist circumference.


Is the keto diet good for PCOS?

As we’ve seen, studies have found that women with PCOS who adopt a keto diet saw improvements in insulin sensitivity, weight loss, and ovulation. 

As a high-fat, low-carbohydrate diet, keto forces the body to burn fat as fuel instead of carbohydrates. This helps to reduce levels of insulin and androgens in the body, which can help bring your hormones into balance. 

Despite these benefits, it's worth noting that there’s limited research looking into the long-term effects of keto for PCOS. Notably, some research says it's an option more suited to the short term.


How much weight can you lose on keto with PCOS?


The amount of weight you’ll lose on keto depends on things like your metabolism, starting weight, and adherence to the diet.

One study of overweight and obese women with PCOS saw an average weight loss of 9.4kg after 45 days. Another study found women lost between 8 and 16 kgs over the course of six months.

Regardless of what diet you follow, getting enough vitamins and minerals is essential. You’ll want to fill your diet with a variety of foods, such as lean proteins, low-glycemic fruits and vegetables, healthy fats, and whole grains.

In addition to diet, exercise is key if you want to reach your ideal weight. Beyond weight loss, regular physical activity can also boost your mood and improve your sleep.

Check out this keto calculator to determine how much you need to eat to reach your weight loss goals.

Manage your PCOS naturally

There’s no denying the keto diet has been shown to be effective for weight loss and hormone balance for PCOS. 

Though, the reality is it might not be easy or healthy to sustain this diet in the long term. On keto, you’re pretty much cutting tons of foods. Here’s where it’s useful to check with a professional about your concerns and goals. Have them run tests on your insulin levels so you’re better able to track your progress. You can also self-check for other signs you’re heading in the right direction. Are your periods regular? Is your skin clearing up?

Keep in mind that you’ll likely need to customise any eating plans to match your preferences. Personally, I couldn’t do strict keto in the long term. I’ve adopted a more relaxed low-carb eating pattern and try to avoid processed fast foods. Plus, I take hormone-balancing supplements and get regular exercise.  

You might find you do better with smaller changes than drastic overhauls to your eating patterns. I know I do. Perhaps, you prefer a less restrictive diet like the Mediterranean or insulin resistance diet. These options provide your body with all the nutrients you need, while still reducing your risk of PCOS-related diseases.

Remember: with a commitment to healthy eating and exercise, you’ll soon see the benefits of better habits. 

Image credit: Photo by Ron Lach