How to potentially reverse PCOS with low carb
Fortunately, there’s a potentially effective lifestyle treatment available.
Here are the most common symptoms associated with PCOS:
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 and elevated insulin levels.4 This also includes hypertension and cholesterol abnormalities.5
It is well known that lifestyle changes resulting in weight loss can improve PCOS symptoms, and so 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. The low-carb diet is one of the most effective treatments that consistently and reliably lowers insulin levels and reverses insulin resistance.7 Therefore, a low-carb diet should be considered for any treatment plan for PCOS.
Although not all studies agree, much of the limited available science shows great promise:
- One small 2005 study followed 11 women with PCOS as they went on a ketogenic low-carb diet for six months. The 5 women who completed the study greatly improved their weight, hormonal status and perceived amount of body hair. Two of them became pregnant despite previous infertility problems.8
- A 2013 study shows that even a very modest reduction in carbohydrates (from 55 to 41 percent of energy) can result in significant improvements in weight, hormones and risk factors for women with PCOS.9
- A 2017 review of relevant studies finds that low-carbohydrate diets tend to “reduce circulating insulin levels, improve hormonal imbalance and resume ovulation to improve pregnancy rates”.10
- Finally, in a recent 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).11
Beyond the scientific evidence cited above, the clinical experience of doctors using it support low carb as an effective treatment for PCOS.12
Reversing PCOS and getting pregnant
There are several stories of women reversing their PCOS symptoms and even suddenly getting pregnant after going low carb.13 It can sometimes feel like a miracle. Although of course, it’s not that kind of miracle, so getting pregnant still requires a partner, even on low carb.
This is simple biology. Low carb can lower insulin and reverse insulin resistance in PCOS, 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.14
Here are some brave women who have shared their stories:
Here’s a longer post on the topic:
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.
Some health care professionals have also found carbohydrate restriction incredibly effective for helping people with PCOS reverse their disease and get pregnant.15 This includes a group of Australian dietitians that we previously wrote about.
Dr. Fox found that compared to only using drugs, adding a low-carb diet for PCOS patients increased the chance of pregnancy from 45% to over 90%!16 This may save many people from needing in vitro fertilization, a very expensive option that still sometimes fails, by instead getting pregnant in a safe and inexpensive way.
Here are three interviews with Dr. Fox:
- In the first one he discusses the benefits of low-carb diets (ideally below 20 grams of carbs per day) in PCOS.
- The second one is about how avoiding stressors – like frequent and intense exercise – can make it easier to get pregnant.
- The third one is about the important role nutrition plays in women’s reproductive health.
Dr. Michael Fox can be contacted at the Jacksonville Center for Reproductive Medicine.
More about PCOS and keto
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
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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] ↩
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] ↩
The likely reason is both an excess of male hormones and increased sensitivity to these hormones:
These hormonal disturbances may also result in a deepening of the voice and male-pattern baldness. ↩
These cholesterol abnormalities are called metabolic dyslipidemia and include high triglycerides and low levels of HDL cholesterol:
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]
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] ↩
These two publications are both from the same study:
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] ↩