Post updated 11/4/2020

The effects of the ketogenic diet on polycystic ovarian syndrome (PCOS) is a hot topic of debate with conflicting scientific results.

Over the years, researchers found evidence that a low-carb diet, such as the ketogenic diet, could help patients with PCOS to lose weight, which is a primary treatment approach. However, these findings don’t tell the whole story.

In this article, we will take a look at the scientific data that deciphers the relationship between the keto diet and PCOS.

The ketogenic diet and polycystic ovarian syndrome (PCOS)

Although commonly believed to help patients with PCOS, the ketogenic diet could exacerbate this disease due to:

 Inadequate application of the keto diet

As you may already know, the ketogenic diet is a pattern of eating that reduces carbohydrate intake to 5–10% of your total caloric intake. At the same time, you’ll increase your fat intake to about 60%.

After 7–10 days of following this diet, the body depletes its storage of glucose in the stored form (i.e., glycogen). As a result, the liver enters a state known as ketosis, where ketone bodies get used to produce energy instead of glucose.

Unlike other diets, the ketogenic diet has strict rules when it comes to carbohydrate intake; after all, it is a metabolic state. In other words, consuming more carbs than you’re allowed to or taking a cheat day is enough to kick you out of ketosis.

Furthermore, sugar has addictive properties that manifest as withdrawal symptoms once you cut it out of your diet.

According to a 2015 meta-analysis, researchers found that the ketogenic diet has a compliance rate of 45%. This means that out of every 100 people on the keto diet, 55 of them will quit after a while.

Researchers noted that this rate of compliance is low compared to other diets.

Unfortunately, combining strict rules with a low compliance rate produces an unsustainable diet that cannot be considered a long-term solution for weight loss.

Differently put, if you’re not super disciplined with the ketogenic diet, you will inadvertently limit your food choices while not even being in ketosis.

Note that women with PCOS are more likely to have disordered eating habits, such as binge-eating. Therefore, opting for a strict diet that limits carb intake all of a sudden can be quite problematic.

Moreover, researchers are not sure of the long-term effects of the ketogenic diet since no reputable studies were conducted. In fact, many health experts only recommend following the keto diet for a brief time to jumpstart your weight loss journey. If you want a life-long diet, keto is not the right choice.

Rebound effect

Throughout several clinical studies (1, 2, 3), researchers confirmed the addictive properties of simple sugars, such as glucose and fructose.

According to research, simple sugars activate the same region in the brain that’s stimulated when we take recreational drugs. This region is a collection of neurons known as the nucleus accumbens (i.e., pleasure center).

If you are a bit familiar with neuroscience, you probably know that the nucleus accumbens gets activated whenever we engage in something pleasurable. This could be jogging, watching TV, or eating a piece of chocolate.

However, what makes a substance more addictive than others is its half-life (i.e., the duration of action). When a substance increases the levels of dopamine (a neurotransmitter found in the brain) briefly and intensely, we consider it to be quite addictive.

Unfortunately, these properties make people more prone to the rebound effect after following the ketogenic diet for a few weeks/months.

In the field of psychology, experts define the rebound effect as the emergence or re-emergence of certain habits after they were absent.

This implies that people following the keto diet may come back to consuming sugars even more robustly than they used to before.

Add this information to the low compliance rate we discussed above, and you got yourself the perfect recipe to load up in harmful, simple sugars.

Once this occurs, insulin production ramps up, leading to the classic spikes associated with insulin resistance. If you know anything about PCOS, you’ll be familiar with the notorious insulin resistance induced by this disease.

Therefore, it is the last thing you want to happen, especially when PCOS is the reason you started the keto diet.

To avoid all of this, opt for a healthy, balanced diet that contains all 3 macronutrients (e.g., carbs, fat, protein) in their regular ratios.

 Read this article for more information about the role of a healthy diet in PCOS .

Lack of dietary balance

As a rule of thumb, people on the ketogenic diet reduce their carbohydrate intake to less than 25–30 grams per day.

This means that the vast majority of fruits, most whole grains, and some vegetables are off the table. While these food elements do contain sugar, they are also loaded in extremely beneficial nutrients, such as vitamins, minerals, and antioxidants.

In one study, researchers stated that PCOS significantly reduces the number of circulating antioxidants in the bloodstream. Consequently, oxidative stress builds up in the intracellular and interstitial milieus, which eventually exacerbates the symptoms of PCOS.

If you’re not familiar with oxidative stress, here’s a brief definition:

Inside the cells, there are certain molecules known as reactive oxygen species, which destroy microbes (e.g., bacteria, viruses, fungi).

Unfortunately, these molecules cannot tell the difference between microbes and our own cells; therefore, if we lose the balance of reactive oxygen species (ROS), they start wreaking havoc on our own cells.

The body employed a smart system that involves antioxidants to counter the effects of ROS.

Of course, this system is not perfect and could easily lead to an excess number of ROS relative to antioxidants, which is collectively known as oxidative stress.

The inflammatory processes triggered by PCOS reduce the number of antioxidants, which worsens your symptoms, as well as other concurrent ailments (e.g., diabetes, chronic higher blood pressure).

Since many fruits, vegetables, and grains are no longer an option for people on the keto diet, you may find yourself short on antioxidants.

Takeaway message

Polycystic ovarian syndrome is a chronic illness that requires medical care and lifestyle modifications to improve symptoms.

Hopefully, this article managed to clear out some of the confusion about the keto diet and its effects on PCOS.

If you still have any questions or concerns, please don’t hesitate to share your thoughts in the comment section below.

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