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Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women. In this article, we explore some promising research for treating the disorder, and the relationship between the ketogenic diet and PCOS. 

What is PCOS?

It’s a complex syndrome and autoimmune condition caused by a hormonal imbalance between luteinizing hormone (LH) and follicle-stimulating hormone (FSH). When LH production increases above normal ranges, the body starts producing androgens, like testosterone, which can lead to irregular menses, infertility, and a higher risk of ovarian cancer. Other signs and symptoms of PCOS include ovarian cysts, excessive body hair, acne, weight gain, and low sex drive. Currently, PCOS is reported to impact 12 to 21 percent of women of reproductive age, but up to 70 percent remain undiagnosed. While PCOS is characterized by reproductive complications, the metabolic complications associated with diet give reason to consider the ketogenic diet as a treatment option for the condition. 

What Causes PCOS?

While the exact cause of PCOS is unknown, researchers speculate it’s a mixture of genetic predisposition and numerous lifestyle factors. Interestingly, insulin resistance is commonly associated with PCOS, which comes as no surprise since hyperinsulinemia (having high insulin levels) increases LH production.

Insulin resistance is also a primary cause of weight gain, which is also why we see that nearly 50 percent of all women with PCOS are obese or overweight and 75 percent of all infertile obese women have PCOS. Outside of being the most common cause of female infertility, PCOS has also been associated with several cardiovascular disease risk factors, diabetes, and hypertension.

Treatment Options for PCOS

Currently, there are no pharmacological treatments for PCOS, thus researchers have started to look into dietary and lifestyle interventions for treatment. While it is hard to determine if the insulin resistance that is so commonly seen in PCOS is a result or cause of the condition, the fact that insulin resistance is present, offers up a therapeutic target: improving insulin sensitivity. 

New research suggests that improving insulin sensitivity⁠—and weight loss⁠—are likely the most effective means to treat PCOS. In fact, losing as little as 5 to 10 percent of body mass (i.e. 15 to 30 pounds for 300 pound female) can significantly improve hormonal imbalances, increase fertility and reduce the rates of miscarriages. Furthermore, increasing insulin sensitivity will reduce excess androgen hormone production, normalizing the balance between LH and FSH. 

Since improving insulin resistance and body weight seem to play such big factors, the ketogenic diet offers a very promising dietary intervention for PCOS. 

Impact of the Ketogenic Diet on PCOS

The ketogenic diet is most notably known for its impact on weight loss, epilepsy, type 2 diabetes, neurological disorders, and even certain types of cancer. However, due to emerging research and anecdotal evidence, keto is now being considered for many additional conditions, such as PCOS. 

Besides the fact that eliminating excess glucose from the diet will significantly improve health parameters, low-carbohydrate diets have been proven to be remarkably effective for reducing insulin concentrations and improving insulin sensitivity. 

Since the ketogenic diet can improve insulin sensitivity and aid in weight loss, researchers have started to look into the diet for treating females with PCOS. While the research is limited, it is promising; a 2005 study in a small group of obese women diagnosed with PCOS found that limiting carbohydrate intake to 20 grams or less per day for 24 weeks resulted in:

    • 12% reduction in body mass
    • 22% reduction in testosterone
    • 36% reduction in LH/FSH ratio
    • 54% reduction in fasting insulin levels

While these findings demonstrate proof of concept for utilizing the ketogenic diet for PCOS, perhaps the most impressive finding was that two women from the study became pregnant during the study despite previous fertility complications! 

Since this study came out, some practitioners have adopted the ketogenic diet as a treatment for PCOS, many anecdotal stories have been reported, and there are several studies in progress to provide further insight.

The Final Word

Despite many women suffering from PCOS, too many women go undiagnosed, and options for treatment of PCOS have been ineffective. Insulin resistance, a driver of PCOS, offers a therapeutic target that can be addressed through various lifestyle improvements including the ketogenic diet; however, much more additional research is needed.

We hope that this promising research will spark more interest in the academic community to continue studying this condition and help the many women who are suffering.

 

References

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