Keto PCOS Diet & Fertility: Research Hints at Benefits

In the United States, polycystic ovarian syndrome (PCOS) is the leading cause of female infertility. This hormonal condition causes women to either not ovulate or have irregular ovulation. According to the Centers for Disease Control and Prevention, up to 5 million women of reproductive age in the US are affected by PCOS, leading many individuals and couples to seek ways to overcome the issues related to this hormonal imbalance. We know that diet plays a crucial role in various aspects of health, so researchers from Malaysia examined potential dietary changes that might help improve fertility rates for women with PCOS. Specifically, they looked into the effects of the ketogenic diet on PCOS outcomes, and the findings were quite promising.

Published in the Journal of the Endocrine Society in September 2023, researchers combined clinical trials from sources like Scopus, ScienceDirect, Web of Science, and PubMed to study the impact of the keto diet on PCOS. The “data were pooled using a random-effects model,” according to the study. After analyzing all this data, the study authors determined that following a keto diet for at least 45 days in women diagnosed with PCOS led to significant improvements in reproductive hormone levels. This included lower free testosterone levels, reduced follicle-stimulating hormone ratios, which can enhance ovulation, and increased serum hormone binding globulin levels. Additionally, “significant weight loss was uniformly observed in all included studies.”

“We found a connection between the ketogenic diet and an improvement in reproductive hormone levels that affect fertility in women with PCOS,” said Karniza Khalid, M.B.B.S., M.Med.Sc., from the Ministry of Health in Kuala Lumpur, Malaysia, in a press release from the Endocrine Society. “These findings have important clinical implications, especially for endocrinologists, gynecologists, and dieticians who, in addition to medical treatment, should carefully plan and customize individual diet recommendations for women with PCOS.” This led the authors to conclude that “short-term ketogenic diet potentially improves hormonal imbalances commonly associated with PCOS.”

How to Eat Keto for PCOS

If you or someone you love suffers from PCOS and is looking for a natural way to potentially alleviate symptoms, adopting a keto diet is a great starting point. Here are some of the top foods to include when following a keto diet for PCOS:

• Healthy fats, particularly keto fats like omega-3s. These include items such as MCT oil, coconut, palm fruit, olive oil, flaxseeds, macadamia nuts, butter, ghee, avocado oil, cocoa butter, and more.
• High-protein foods like grass-fed beef, organ meats, poultry, cage-free eggs, and wild-caught fish.
• Non-starchy vegetables such as leafy greens, cruciferous veggies like broccoli and cauliflower, celery, zucchini, chives, leeks, some fermented vegetables, and fresh herbs.
• Low-sugar fruit in small amounts, including berries and avocado.
• Bone broth.
• Healthy condiments like unsweetened hot sauce and apple cider vinegar.
• Water.
• Black coffee and tea.

When following a keto diet for PCOS, there are certain foods that should be limited or avoided. These include:

• Full-fat dairy.
• Medium-starchy vegetables.
• Beans and legumes.
• Nuts and seeds.
• Most fruit.
• Most condiments.
• Fresh vegetable juice.
• Unsweetened almond or coconut milk.
• Bouillon.
• Water with lemon and/or lime juice.

Here are foods that are typically off-limits when following the keto diet for PCOS:

• Sugar, including syrups, honey, agave, and other sugars.
• Grains.
• Most non-berry fruits.
• Processed foods.
• High-calorie and sweetened drinks.

Other Ways to Manage PCOS

In addition to following a keto diet for PCOS, there are other natural methods to help manage this condition. These include:

• Getting sufficient rest.
• Exercising regularly.
• Avoiding endocrine disruptors such as pesticides, bisphenol A, phthalates, dioxins, phytoestrogens, DEHP, and DBP.
• Supplementing with inositol.
• Trying acupuncture.
• Increasing vitamin D intake.
• Using potential PCOS supplements like magnesium, zinc, calcium, omega-3s, chromium, N-acetylcysteine, folic acid, and ashwagandha.