Can keto help reduce or eliminate uterine fibroids?


Can a keto diet help reduce or eliminate uterine fibroids? What’s the best birth control for women with PCOS? And how to treat mood swings on a keto diet?

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

Can keto help reduce or eliminate uterine fibroids?

I am 39 and I was diagnosed with a fibroid of 6 cm (or 2.4 in) on the upper part of my uterus, and as I’m unable to do an operation right now (due to the coronavirus situation), I thought that maybe a keto diet can help.

I thought if keto may help the elimination of cancer cells, then it might also help reduce the growth of fibroids. Is this true? Is the metabolic system of the fibroid cells sensitive to a keto diet, in a similar way that cancerous cells are?

Many thanks,

Dr. Fox:

Elpi, this is a great question.

Unfortunately, there is no data on this topic. I do tell patients all the time that polyps, cancer, skin tags, etc., all are tumorous growth known to be stimulated by insulin. I know of no reason fibroids would not follow the same path. Therefore, I encourage many patients with fibroids to pursue LCHF to slow development and recurrence.


What’s the best birth control for women 40+ with PCOS?

Hi Dr. Fox!

I’m 42 and will soon need to remove my Mirena IUD.

My family is complete – thanks to your advocacy of low carb – and my primary goal is now birth control that minimizes PCOS symptoms without creating additional inflammation as my hs-CRP levels are a touch high. I’m also still obese, though I’m working on that.

What’s the best option for someone who needs to balance hormones and not introduce additional inflammation (as I believe Mirena and other IUDs typically do)?

Thank you!

Dr. Fox:

Ali, this is a common question.

There are positives and negatives in my mind now to oral contraceptive pill (OCP) ovarian suppression for PCOS.

There is a benefit to suppression of male hormone production from the ovary, we just need to protect estrogen levels. The negative aspect relates to most women on OCPs experiencing low estrogen effect, something that would definitely have been the case with the Mirena and its progesterone component.

Therefore, now for our PCOS patients, we recommend supplementing estrogen in addition to the suppression with OCPs. Often we make up our own OCP through the use of Norethindrone acetate 5 mg per day and combining it with estradiol, preferable in a non-oral preparation such as weekly injections or patch shooting for estrogen levels of 150 or more, although oral estrogen can be used.

Contrary to popular belief, PCOS is a lower than normal estrogen state long term. Estrogen definitely counteracts the influence of male hormones on the skin and hair changes associated with PCOS (positive).

Low estrogen can make one more insulin resistant. For example, if OCPs or the IUD is utilized, the male-hormone production goes down, but the low-estrogen effect can increase insulin resistance, maybe to the point of canceling the benefit through worsening weight gain and other insulin-resistance stimulated disease. If Mirena is chosen we need to add estradiol to balance the estrogen suppressing effect. We shoot for estradiol levels >150 pg/ml or so.

I’m sorry this is a very technical answer but hopefully, you can understand my logic.


What to do about mood swings on keto?


My girlfriend started keto two weeks ago, and recently she’s showing mood swings and becoming agitated over nothing.

Is it connected? What can she do?


Dr. Fox:

Tom, good question.

As with any drug withdrawal, ketogenic nutrition can produce odd symptoms in the first seven days as the body withdraws from carbohydrates. Beyond that for the next two months, some people may suffer from hypoglycemia until they become keto-adapted. Hypoglycemia causes anxiety and mood changes.

If this is the case, I recommend eating at least 200 calories every three hours without fail during that two-month period. Once adapted, longer intervals without fuel are much better tolerated.

Hope that helps.


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