Is “the keto crotch” true?


Is the “foul-smelling” vagina on the keto diet true? Can you have post-menopausal bleedings on keto? What diet do you recommend if one has high testosterone levels? And, can keto improve testosterone and libido in men?

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

Changes in pH

I just read an article that says keto will change your body’s pH in a negative way causing a foul-smelling vagina. Is this true and how can we avoid it?


Dr. Fox:

In all the time I have been getting patients to start this diet, I have never had a patient complain of this problem. If anything, the vaginal environment will be greatly improved resulting in a more normal mix of bacteria and fewer problems.

Read more about the infamous “Keto crotch” here.


Post menopausal bleeding

While losing weight on keto, I’ve been having light post-menopausal bleeding. I’ve had all the invasive tests that have ruled out a serious cause such as cancer. Last regular period was 9 years ago. I’m 60 years old now. Will this balance out as I get the rest of the weight off? I’ve lost 35 pounds but still have 35-40 pounds to lose.

Thank you, Dr. Fox,

Dr. Fox:

Bleeding is not something that we see in the postmenopausal period as a result of the nutrition change. You are the second with a similar complaint. I can’t think of any obvious physiologic reason the diet would cause this. It is possible that ketosis extends fertility into the later age groups – we just have not seen this effect. I will keep my eye out for this issue. It is possible that ketosis could restore some of the egg stem cells and you are experiencing this in some way. Sorry I couldn’t be of more help to you now.

High testosteron

Hello Dr,
I would like to know which diet you recommend me as I’m trying to get pregnant. I have high testosterone and I have a lot of acne – do you recommend a low-carb diet or keto diet?

Thank you,

Dr. Fox:

I am a strong supporter that nature wants all of us to be ketogenic. It seems to generate the best pregnancy rate in my experience.



Can keto improve testosterone and libido in men? Also, does it lower or block estrogen in men?

I got married but I had libido problems with wify, so I have done a blood analysis and it turns out that I have high estrogen and low testosterone. Also, I have had these symptoms since I was a teenager and I am now 31. This affected the quality of sperms and the quality of life by always having a constant depression.

Is it possible to gain back my sex life and become a father?


Dr. Fox:

Metabolic improvement through ketogenic nutrition can most likely improve those symptoms and will gradually pick up the testosterone and therefore the sexual function will follow. It may be a slow process. Increases in adipose from insulin resistance increases the conversion of testosterone to estrogen in the fat cells. Estrogen is a potent inhibitor of FSH and LH the testicular stimulation hormones. This results in low testosterone. The problem of increased estrogen due to adipose tissue is further worsened by low testosterone – a vicious cycle. It is important to consider some level of testosterone replacement early on. This aids weight (fat) loss and decreases estrogen levels. Be patient and at some point, the testosterone replacement might be stopped and normal levels return. Best of 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:

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