“Help! I have PCOS and just can’t seem to lose more weight”


What can you do if you have a very hard time losing weight because of PCOS? Can you reverse premature ovarian failure on a keto diet? And does menstrual pain improve on low carb?

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

PCOS and storing of fat

I am almost 49 and was diagnosed with PCOS about 30 years ago. I have been doing keto for about 2 months now and lost 3 inches (8 cm) off my waist and 3 off my belly-button area which is great as this is the area where PCOS puts the fat. I have only lost 7 lbs (3 kg) though and have another 13 lbs (6 kg) to go (I want to be 14 lbs – 6 kg more than my teens as it’s better for the face!!) but just can’t seem to lose more.

I don’t eat a huge amount as I’m just not hungry most of the time but have done keto test strips and I am in ketosis – am I possibly eating too little as I know with PCOS we can store efficiently. The only thing I eat that maybe more carbs than it should be is live greek full-fat yoghurt (easiyo that you make yourself) every day as it helps to keep my gut healthy (I am rarely ill since having it daily for the last 4 years). I eat fat balls (coconut and coconut oil) daily to make sure my fat intake is high enough.

I am pleased with the inch loss but want to lose the weight (I only walk and do yoga currently).

Thank you,

Dr. Fox:

First, if you are only a little off your ideal body weight (BMI = 22/23) I would not stress over it. Stress however, is often what hangs people up. Caffeine stimulates the stress system and increases cortisol production preventing weight loss. Poor sleep, often worsened by low estrogen causes stress. At least 7-8 hours required. At 49, it is likely that your estrogen is low and supplementation may help.

Working on these areas may help you dramatically. Remember though, as we age our metabolic systems do change and we may find it difficult to return completely to age 18 – I have the same problem!!

Good luck.



My husband and I have just done an IVF cycle that was unsuccessful with donor eggs. I have been diagnosed with pre-mature ovarian failure. I am 39. Is POF (premature ovarian failure) reversible and is it good to be in a ketogenic state while doing an IVF cycle for future reference?

Thank you,

Dr. Fox:

I’m sorry you were unsuccessful. Donor egg is an involved process and tough to endure without success. The ketogenic nutrition approach will not reverse your POF and currently there is no cure.

In the future we will be able to take somatic cells, like skin cells and reverse engineer them to eggs. For now, egg donor is likely your only option.

The diet does frequently improve all aspects of fertility including the endometrium and its receptivity which is important for egg donor cycles.

Hope this helps. You should do well with egg donor since it has a very high success rate.

Menstrual pain and LCHF

My 33 year-old daughter, who eats the standard American diet, has menstrual cramps severe enough to require hormone replacement therapy (HRT).

She was recently diagnosed with an inferior vena cava clot and has had to discontinue the HRT, leaving her with severe cyclical pain.

I do not know of a formal diagnosis for the menstrual pain, but she is lean, fertile and in otherwise excellent health. Is there any evidence that a LCHF diet might improve her severe monthly menstrual pain?


Dr. Fox:

Based on your description, she most likely has endometriosis and adenomyosis. I have had many patients who pursued ketogenic nutrition tell me their pain improved.

Surgery to excise the endometriosis and cut the uterine nerve could also be effective. Excision needs to be the method used at surgery to relieve pain. This technique is not found many places in the U.S.

Good luck.

More questions and answers

Questions and answers about low carb

Read all earlier questions and answers to Dr. Fox – and ask your own! – here:

Ask Dr. Fox about nutrition, low carb and fertilityy – for members (free trial available)

Videos with Dr. Fox



How to reverse PCOS with low carb

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