How to potentially reverse PCOS with low carb

Polycystic ovary syndrome (PCOS) is a common disorder that affects up to 10% of women of childbearing age and appears to be increasing over time.1 Beyond menstrual problems and other physical symptoms, it’s a leading cause of infertility.2

Fortunately, there’s a potentially effective lifestyle treatment available: a low-carb diet.

Symptoms

Here are the most common symptoms associated with PCOS:

PCOS

  • Menstrual irregularities like irregular, skipped or heavy periods.
  • Inability to get pregnant.
  • Acne.
  • Excess facial and body hair, showing up in a male pattern (including the upper lip, chin, and chest).3
  • Obesity

Cause and treatment

PCOS is much more common in women with excess weight, type 2 diabetes, previous gestational diabetes and other conditions related to insulin resistance.4 This also includes hypertension and cholesterol abnormalities.5

It’s well known that lifestyle changes resulting in weight loss can improve PCOS symptoms, as can the type 2 diabetes drug metformin.6

Given the strong connection to excess weight, high insulin levels, and other metabolic problems, a low-carb diet is potentially ideal for reversing PCOS.

Eating low carb is one of the most effective treatments that consistently and reliably helps with weight loss, lowers insulin levels, and reverses insulin resistance.7 Therefore, a low-carb diet should be considered as an option for any PCOS treatment plan.

Although there isn’t a lot of published research on low carb and PCOS, much of the available science shows great promise:

  • In 2005, researchers followed 11 women with PCOS as they went on a keto diet for six months. The five women who completed the study lost weight and improved their hormonal status and perceived amount of body hair. What’s more, two of the women became pregnant during the study, despite previous infertility problems.8
  • A 2013 study found that even a very modest reduction in carbohydrates (41% of calories) can lead to significant improvements in weight, hormones and risk factors for women with PCOS.9
  • A 2017 review of clinical trials found that low-carb diets tend to “reduce circulating insulin levels, improve hormonal imbalance and resume ovulation to improve pregnancy rates.”10 A 2019 meta-analysis of randomized trials showed similar findings, concluding “proper control of carbohydrate intake provides beneficial effects on some aspects of PCOS and may represent one of the important interventions improving the clinical symptoms of affected patients.”11
  • A 2020 study, 14 women with PCOS followed a ketogenic Mediterranean diet for 12 weeks. By the end of the study, they achieved lower blood glucose and insulin levels, improvements in reproductive hormone levels and function, reduction of heart disease risk factors, and an average weight loss of 20 pounds (9.4 kg).12
  • Finally, a 2021 systematic review of RCTs concluded that dietary interventions improve PCOS symptoms, and low-carb is likely the best for fertility and restoring normal menstruation.13

Beyond the scientific evidence discussed above, low carb’s benefits for women with PCOS are supported by the clinical experience of doctors who have used it with their patients.14

Reversing PCOS and getting pregnant

There are several stories of women reversing their PCOS symptoms and in some cases suddenly getting pregnant after going low carb.15 It can sometimes feel like a miracle. Of course, it’s not that kind of miracle, but it’s still pretty impressive.

This is simple biology. Cutting back on carbs can help with weight loss, lower insulin levels, and reverse insulin resistance, which may help to balance the hormonal system. This can enable ovulation and a normal menstrual cycle, in addition to improving or eliminating other symptoms.16

Learn more from these brave women who have shared their stories:

  • 'I am the absolute happiest I have ever been. Ever.'
  • Keto and intermittent fasting: 'I am completely blown away by the changes'
  • Keto helped Carolina reverse PCOS and lose 200 pounds
  • "Within three months of starting a well-formulated ketogenic diet, all flares were gone!"
  • "I got my life back!"
All PCOS success stories

Here’s a longer post on the topic:

charmain-pregnancy-16-9

Trying to conceive? Try the better baby diet of beef, butter & bacon

GuideIt’s possible that cutting carbs prior to conception might improve a woman’s chances of becoming pregnant.

Professional experience

Some health care professionals have also found that carb restriction can be incredibly effective for helping people with PCOS reverse their disease and get pregnant.17 This includes a group of Australian dietitians that we previously wrote about.

Fertility specialist Dr. Michael Fox has more than a decade of experience helping patients with PCOS and infertility, using a low-carb diet.

Dr. Fox found that compared to only using drugs, adding a low-carb diet for PCOS patients increased their chance of pregnancy from 45% to over 90%!18

This may save many people from needing in-vitro fertilization — a very expensive option that isn’t always successful — by instead getting pregnant in a safe, inexpensive way.

Dr. Michael Fox can be contacted at the Jacksonville Center for Reproductive Medicine.

More about PCOS and keto

jessica

Top 8 reasons to adopt a low-carb diet for PCOS

GuideAlmost all the symptoms of a common female condition called PCOS respond very well to a low-carb or ketogenic diet. Here are the top 8 reasons why.

More benefits of low carb

Why should you consider eating fewer carbs? There are many potential benefits, at all ages (although there’s hardly ever a reason for healthy kids to do a strict low-carb diet).

Here are some of the main benefits, and how to adapt a low-carb diet for your specific needs, to maximize the positive effects on your health.

The four most common benefits

More common benefits

Possible, less certain benefits

More

  1. Human Reproduction 2016: The Prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis [systematic review of observational studies; weak evidence]

    The following study demonstrated an increased incidence of PCOS between 2007 and 2017

    Human Reproduction 2021: Measuring the global disease burden of polycystic ovary syndrome in 194 countries: Global Burden of Disease Study 2017 [nonrandomized study, weak evidence]

  2. American Diabetes Association Diabetes Spectrum 2015: The role of polycystic ovary syndrome in reproductive and metabolic health: overview and approaches for treatment [overview article; ungraded]

  3. The likely reason is both an excess of male hormones and increased sensitivity to these hormones:Current Pharmaceutical Design 2016: Hirsutism in polycystic ovary syndrome: pathophysiology and management[overview article; ungraded]These hormonal disturbances may also result in a deepening of the voice and male-pattern baldness.

  4. International Journal of Reproductive Medicine 2014: Polycystic ovary syndrome, insulin resistance, and obesity: navigating the pathophysiologic labyrinth [overview article; ungraded]

  5. These cholesterol abnormalities are called metabolic dyslipidemia and include high triglycerides and low levels of HDL cholesterol:

    Obstetrics & Gynecology Science 2013: Dyslipidemia in women with polycystic ovary syndrome [overview article; ungraded]

  6. Cochrane Review 2011: Lifestyle changes in women with polycystic ovary syndrome [systematic review of randomized trials; strong evidence]

    Journal of Clinical Endocrinology and metabolism 2015: Randomized Controlled Trial of Preconception Interventions in Infertile Women With Polycystic Ovary Syndrome [moderate evidence]

    Medical Journal of Austrailia 2011: Assessment and management of polycystic ovary syndrome: summary of an evidence-based guideline [overview article; ungraded]

  7. Journal of Diabetes and Its Complications 2015: Effects of a high-protein/low carbohydrate versus a standard hypocaloric diet on adipocytokine levels and insulin resistance in obese patients along 9 months [randomized trial; moderate evidence]

    Nutrition Journal 2010: Changes in weight loss, body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women [randomized trial; moderate evidence]

    Lipids 2009: Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet [randomized trial; moderate evidence]

    Frontiers in Endocrinology 2019: Long-term effects of a novel continuous remote care intervention including nutritional ketosis for the management of type 2 diabetes: a 2-year non-randomized clinical trial [non-randomized study; weak evidence]

  8. Nutrition & Metabolism: The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: A pilot study [non-controlled study; weak evidence]

  9. These two publications are both from the same study:Clinical Endocrinology 2013: Favourable metabolic effects of a eucaloric lower-carbohydrate diet in women with PCOS [randomized crossover trial; moderate evidence]Metabolism 2014: Effects of a eucaloric reduced-carbohydrate diet on body composition and fat distribution in women with PCOS [randomized crossover trial; moderate evidence]

  10. Nutrients 2017: The effect of low carbohydrate diets on fertility hormones and outcomes in overweight and obese women: a systematic review [systematic review of randomized and non-randomized trials; moderate evidence]

  11. International Journal of Endocrinology 2019: The Effect of Low Carbohydrate Diet on Polycystic Ovary Syndrome: A Meta-Analysis of Randomized Controlled Trials [strong evidence]

  12. Journal of Translational Medicine 2020: Effects of a ketogenic diet in overweight women with polycystic ovary syndrome [non-controlled study; weak evidence]

  13. Frontiers in Endocrinology 2021: Dietary modification for reproductive health in women with polycystic ovary syndrome: A systematic review and meta-analysis [strong evidence]

  14. [clinical experience of low-carb clinicians; weak evidence]

  15. [anecdotal reports; very weak evidence]

  16. AACE Clinical Case Reports 2018: A ketogenic diet may restore fertility in women with polycystic ovary syndrome: a case series [case series; weak evidence]

  17. [clinical experience of low-carb clinicians; weak evidence]

  18. [clinical experience; weak evidence]