Can fasting help treat endometriosis?


Should men and women approach the keto diet differently? What should women going through menopause do to lose weight? And can intermittent fasting improve endometriosis?

Get the answers to these questions in this week’s Q&A with fertility specialist Dr. Fox:

Should men and women approach keto differently?

As a woman, should I approach the keto diet differently than men?

I’m 57 and started keto with Diet Doctor five months ago. I lost 6 pounds (3 kilos) pretty quickly but have been stalled for about three months. I still need to lose about 10 to 15 pounds (5 to 7 kilos). I’m active and taking at least 10,000 steps on most days.

Am I doing something wrong?


Dr. Fox:

Great question.

I think males and females respond differently to the ketogenic diet. For example, I can go four to five days of fasting and not feel the least bit of stress, increased heart rate, or hunger, whereas my female colleagues begin experiencing these symptoms of stress after four or five hours. It’s not based on research, but this is my personal belief.

Some women likely have more insulin resistance than men and may be slower to respond to keto and need to be stricter with their carb intake to see results. Many males could likely tolerate 10 to 15 grams more carbs per day at the same insulin resistance level (again, this is my experience, not based on research).

However, I congratulate you on being 57 and only 10 to 15 pounds (5 to 7 kilos) overweight and recommend that you don’t fret over that small amount of weight. Metabolic rate does slow with age — being 59, I’ve certainly noticed this myself — but it only translates into a few pounds in your case.

Stress management is helpful, so try your best to reduce stress in your everyday life.

If you want to pursue intermittent fasting as a weight loss strategy, I’d recommend you to fast less frequently but for longer periods. For example, fast for 48 hours every two weeks or so. This brings your physiology into deeper ketosis intermittently, but beware that it might cause stress.

In contrast, a 16:8 intermittent fasting protocol can expose one to daily stress, which is less ideal, in my opinion. Unfortunately, this idea is widely promoted, and almost every woman I see now who has entered the ketosis world on their own is trying this method.

If one relates this to nature and the caveman world, the females likely hung back and cared for the children. That meant they were close to the food and ate more frequently than the males, who might have been out hunting all day. It is evident that nature set up the sexes in very different physiologic ways, and the keto diet may thus work differently for men and women.

Here is a Diet Doctor guide on weight loss stalls and another one on losing weight after menopause.

Thanks and good luck.


What should women going through menopause do to lose weight?


I did very good on keto a few years ago, but now that I’m going through menopause, I have stopped losing and started gaining weight. Help!

Have you found that women going through menopause need to do something different to lose weight? I lost 50 pounds (23 kilos) some years ago, but now I’ve gained some of that weight back, and I’m still not at my goal weight.

Thank you,

Dr. Fox:

Mary, great question.

One reason women gain weight in menopause is due to the loss of estrogen. We see it at all ages: When estrogen goes down, weight goes up. In the old days, when all women were routinely put on estrogen replacement at menopause, or even before — a good thing by the way in my opinion — many still gained weight, and the word on the street was that estrogen CAUSED weight gain.

Actually, it’s the opposite. But the estrogen replacement and its monitoring were archaic, and most women did not get enough estrogen and consequently gained weight. It’s apparent that estrogen supports a lower insulin resistance profile and helps maintain weight. To answer your question, consult with a health professional regarding hormone replacement, and I think you will see this trend improve. Good luck!

serious matured woman with crossed arms outdoor

Top 10 tips to lose weight on low carb or keto for women 40+

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Can fasting improve endometriosis?

What is your experience with patients who have endometriosis and doing intermittent fasting for autophagy? Can it improve the condition?


Dr. Fox:

Wow, some great questions lately!

I think the simple answer is: I don’t know. These intermittent fasting ideas are new and mostly theoretical (with some animal data that supports the overall theory). Intermittent fasting has not been studied in a wide variety of disease processes yet.

Autophagy is a partial process, meaning it is the way to rid a particular tissue of lagging or dying cells to clean up the overall tissue. Your question relates more to treatment or eradication of endometriosis, which would be the only thing beneficial to an endometriosis patient.

Endometriosis is a surgically treated disease. The problem is one has to receive the correct surgery, and it’s hard to come by. The vast majority (99+%) of gynecologists perform cautery or laser of endo, failing to get rid of the disease. The so-called recurrence is not a true recurrence but represents the persistence of the disease. A complete excision surgery of endometriosis cures the disease. We see it every day.

Pain, on the other hand, is complex and has multiple causes beyond endometriosis. If all sources are not addressed, one can be left with pain even after excision. Therefore, pain does not equal endometriosis, but unfortunately, this formula has been applied to women’s healthcare for over 50 years.

In summary, if you are seeking endometriosis treatment, I believe you should find an excision surgeon.

However, a cautionary note: There are different levels of expertise, even in the excision group. A good source of information is Nancy’s Nook, an online Facebook group. Read carefully the descriptions of doctors listed and choose someone who is operating at the highest level. Don’t be afraid to travel. At my clinic, we see patients from all over. While autophagy has the potential for great health benefits, I am doubtful that it will “treat” endometriosis.

Good luck!


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