Women’s Health and Keto Diet

By Claire McDonnell Liu, Nutritionist at Leafie.org

A Ketogenic diet may have particular benefits for women’s reproductive health.  Healthcare professionals and research studies indicate that the LCHF diets may help to improve menstruation and fertility due to their potential to regulate hormones such as insulin and leptin, and increase cellular sensitivity.

Many women won’t notice any changes in their menstrual cycles when following a Keto diet, while others experience improved cycle regularity, reduced premenstrual syndrome (PMS) or return of periods after an absence. 

Dr. Tim O’Dowd is an Obstetrician, IVF Doctor, Founder of the Fertility Gold Coast Clinic and expert on nutrition for fertility and pregnancy.  Tim explains the significance of good nutrition for reproductive health and the impact poor nutrition can have on the body’s reproductive processes.  Introduces nutrition. “I am a Gynaecologist and IV Doctor and an advocate for Low Carb diets, this way of eating not only improves my patient’s overall health but improves their fertility and reproductive health”.

Ketosis and Weight Loss

Loss of body fat and / or periods of ketosis may lead to improved hormone levels responsible for regulating reproductive health.  Weight loss is not exclusive to Keto diets, but Keto can be particularly effective at producing rapid and sustained weight loss.

Tara Whelan is a Pharmacist, Credentialled Diabetes Educator and woman living with Type 1 Diabetes who has a specialist interest in women’s health and fertility.  Presenting at Low Carb Canberra 2020 Tara examines metabolic health and insulin resistance in women during their reproductive years. 

Tara explains the potential benefits following a LCHF diet could play in addressing underlying hormonal issues that may be affecting menstruation and / or fertility.  “When we eat low carb we have a reduced insulin response.  We are concentrating on hyperinsulinemia and targeting the main problem of many of the issues. When we reduce the level of insulin in women we can reduce the production of testosterone and increase Sex Hormone Binding Globulin (SHBG) and this again will limit amount of free testosterone” [as excessive free testosterone due to elevated insulin may lead to impaired ovulation].

Menstruation Irregularity

Some women however report cycle irregularity or amenorrhea (absence of periods) when following a Ketogenic diet.  Women’s body’s are thought to be more susceptible to hormone fluctuations arising from weight loss.  Rapid body fat loss might for example temporarily reduce levels of leptin, raise oestrogen and potentially lead to estrogen-progesterone imbalances, with the potential to disrupt the menstrual cycle.

Targeted or inadvertent caloric reduction may also impact the menstrual cycle. Calorie reduction may occur on a Keto diet for a variety of reasons, sometimes in combination:

• Combining keto with targeted calorie restriction
• Fasting: OMAD (one meal a day); time restricted fasts; longer abstinence fast periods.
• Lack of hunger, as the body accesses internal stored energy leading to eating fewer calories. 

Personal Health History

A women’s age, BMI, smoking history, alcohol use, weight history, sleep, medication, physical activity levels and overall health will all have a bearing and interact with other factors relating to their reproductive health.

Physiological and psychological stressors can also impact the menstrual cycle in a number of ways. For example Cortisol, the steroid hormone, can interact with the hypothalamus and pituitary glands potentially disrupting hormone levels, which can impact on reproductive function.

Women with a history of thyroid, adrenal, metabolic or reproductive health issues, such as Polycystic Ovary Syndrome, may be especially sensitive to calorie restriction.  These women are likely to require extra consideration working with their medical practitioner on how to tailor their diet to meet their specific needs.

Final Thoughts..

We know that Keto and Low Carb diets can affect men and women differently, so it makes sense to consider approaching the diet differently. Each women is different and so their optimal daily carbohydrate intake will differ generally and at different times of their cycle, with some women suiting a lower (20g/day) and some a higher (up to 130g/day) carbohydrate intake.  A healthcare practitioner with appropriate dietary experience should be able to help guide women to find the most sustainable and suitable dietary range for them. 

Woman following a Keto Diet may experience improvements in period regularity and a decrease in PMS symptoms.  Those women that experience menstrual cycle irregularity after losing a significant amount of body weight may consider tapering their diets to ensure the body is nourished and a healthy weight is maintained whilst introducing any changes gradually.