Is a keto diet a good choice for lean women?


Are the benefits of a keto diet as great for lean women as they are for overweight women?

Get the answer to this and other questions – can low carb and intermittent fasting help regulate my cycles? – in this week’s Q&A with the fertility specialist Dr. Fox:

A ketogenic/low-carb diet for lean women?

Hi Dr. Fox, thank you for your time.

I have been searching online for information about ketogenic diet or low carb for lean women (BMI 19-20). I listened to your insight about the AAA personality, it is not the case :)

As I have not found information, I wondered if you could provide your experience with treating difficulties in getting pregnant for otherwise healthy women (hormone levels normal and so on) using the ketogenic/low-carb diet.

I have been paleo for the past year, but I’m thinking maybe it’s not low enough for my needs and considering lowering. In terms of my food intake: I eat twice a day, usually a salad, meat/fish/eggs/liver usually in a generous amount of butter/some animal fat, in the evening I add a sweet potato or potato, sometimes piece of fruit. Exercise: once or twice a week about 40 mins of body weight exercises.

Thank you in advance,

Dr. Fox:

We believe that the ketogenic diet is equally helpful for your phenotype as well as the obese insulin resistant group. If you become keto-adapted, you would not likely experience hypoglycemia (hunger) that can cause and exaggerate a stress response that ultimately results in much lower pregnancy rates. This diet is also excellent for pregnancy as well.

I would avoid potatoes and almost all fruit. Some of these are allowed on paleo. I also suggest avoiding excessive aerobic exercise, although moderate exercise is Ok. The diet then serves as a stress reducer. Also stop caffeine.

Good luck

Coffee versus green tea?

You mentioned that in preparation to get pregnant, coffee is a thing that is important not to consume. Have you got an opinion about green tea?


Dr. Fox:

Yes sorry, coffee is just the poster child for caffeine. The offensive agent is caffeine, so if the green tea has no caffeine, it would be OK. Decaf coffee is also not OK because it still has caffeine just less. Hope this helps?

Remember that caffeine and amphetamine are closely related. Doesn’t sound very positive for a fetus??

LCHF and IF to regulate cycles?


I have irregular cycles. No other known cause for my irregular other than my weight (no confirmed PCOS).

I’m reading conflicting information of the effects of IF on a menstrual cycle. I’d like to continue both LCHF and IF if I can.

Since I’ve started (about six weeks ago), I’ve lost 22 lbs (10 kg). I have much more to go (100+ lbs – 45+ kg), but am happy with my results so far.

I’m currently on day 60 of my cycle and my OB prescribed Provera for every 90 days in case I don’t menstruate on my own.

Is it realistic to expect to get a regular cycle after some more substantial weight loss? We’d like to conceive a second child on the next year or so.

Thank you!

Dr. Fox:

Ketogenic diet can improve cycle length for some people. So if you were a 60-day cycle person, with the diet you might go the 45 or 35 days. Maybe not all the way to 28 days though, unless you are extremely compliant and approach normal body weight (BMI 22).

In my opinion, IF is only safe from a cycle standpoint after keto-adaptation period (4-6 weeks) so you may be at that point now?? In my experience, if you are not ketogenic, fasting can create stress which is a negative factor for ovulation and metabolism.

Best of luck.

More questions and answers

Questions and answers about low carb

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


  1. Jc
    U have a list of specific foods that belongs to a fasting diet? Is sweet potato and water melons-yellow /red allowed?
    Reply: #2
  2. Peter Biörck Team Diet Doctor
    Hi Jc!

    Sorry, both sweet potato and water melon contains a lot of carbs so try to avoid them. But water melon in resonable amounts as a part of a sallad could be OK.

    U have a list of specific foods that belongs to a fasting diet? Is sweet potato and water melons-yellow /red allowed?

  3. Ramshiya
    How to solve unwanted facial hair?
    Reply: #4
  4. Kristin Parker Team Diet Doctor

    How to solve unwanted facial hair?

    That may depend on the root cause of the facial hair. It's a common symptom of PCOS, so you may find this helpful.

  5. Kristin
    I have been finding with my PCOS on keto that my cycles are slowly becoming more regular or normal. On carbs, my cycle is maybe 6 monthly. Off carbs, I can have a monthly cycle. I'm 3 years on with eating keto, and I actually compared my cycles from last year to this year so far, and discovered they are slowly tightening up with less variable in timing (ie last year between 25 and 35 days to this year 28 to 32 days). I have been struggling with premenstrual pain in my back and hips quite badly up to 1 week prior to my cycle, but in the last 3 months I commenced Happy Hormones which is a natural blend containing ingredients such as black cohosh and Chinese yam among others, and that has really helped to eradicate most of the pre-pain I was suffering. In relation to hirsuitism (facial hair), I have been noticing a reduction in this. I still have to wax semi regularly, but the affected area seems smaller and sparser, so I can only hope this continues to get better.

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