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How Ketosis Affects Women?

Published on: September 11, 2019

How Ketosis Affects Women?

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When it comes to keto for women, we ought to take a different approach. Women’s bodies are complex, and this is largely due to the effects of the female hormones.

Hormones naturally respond to the foods we eat. Knowing this, can help you plan your diet in a way that supports your health.

You might be having questions like:

“Will keto balance my hormones or do the opposite?”

“If I plan to get pregnant, should I continue to eat low carb?”

If you want to know its safety and how ketosis impacts your body, read this article.

Is Ketosis Safe for Women?

There’s a huge misconception about ketosis that needs debunking:

Keto messes up your hormones.

You may have heard about women jumping onto the keto bandwagon. After a while, complaints arise such as:

  • Pre-menstrual syndrome (PMS)
  • Amenorrhea
  • Irregular periods
  • Mood swings

…and more.


Before you diagnose ketosis as the cause of hormonal issues, you might want to check:

  • Other pre-existing health issues you have
  • Whether you are executing the diet properly (a well-formulated keto diet) [1]
  • Your current stress levels
  • Your micronutrient intake
  • Whether you are truly in nutritional ketosis

It’s easy to make conclusions especially without doing proper research.

If there’s one thing we should understand is that ketosis is based on science.

Ketosis is a normal and safemetabolic process that is known to help with a variety of conditions. It improves several important health markers. These include your blood glucose, insulin, blood pressure, and lipid profile.

So, to answer your question:

Ketosis is generally safe for women.

But because women experience hormone fluctuations, it’s essential to pay close attention to how you use ketosis.

Let’s tackle some common misconceptions about ketosis and hormones:


Myth #1: A keto diet causes hypothyroidism.

Some people conclude that because carbohydrate reduction lowers T3, one develops hypothyroidism. This is an oversimplification.

Hypothyroidism is when your thyroid hormone levels drop. That includes your T3. When you have an underactive thyroid, your metabolic rate decreases [2].

Other consequences include weight gain, increased blood pressure, and elevated LDL cholesterol [2].

A well-formulated keto diet does not cause these problems. In fact, it will improve these health markers.

Here’s what a 2017 study reveals:

While carb reduction lowers T3, lowered T3 doesn’t imply hypothyroid disease. Lower T3 (in the low-carb context) is associated with longevity. Meanwhile, higher T3 due to high-carb diets predicts a shorter lifespan [3].

Myth #2: A keto diet elevates your cortisol which leads to a variety of health problems.


Dietary changes can stress your body. If you are trying out nutritional ketosis for the first time, you should expect your body to react and adjust.

Think about the temporary unpleasant symptoms of keto flu:

Headache, weakness, muscle cramps, and brain fog.

But the thing is, you are capable of handling this stressor.


However, being under chronic stress before trying keto could explain why you experience the following:

  • Absence of menstruation (Amenorrhea) [4]
  • Decreased fertility [5]
  • Acne breakouts [6]
  • Reduced sex drive [7]

Ketosis itself does not trigger these hormone-related health issues. But it may add to the chronic stress that you already have.

Make sure to evaluate your stress levels before trying a new diet like keto.


How Ketosis Affects Women

First, let’s do a quick recap:

A ketogenic diet entails reducing your carbohydrates to increase your ketone levels. 20-50 grams per day is the standard carb limit for someone on the diet. The idea is that only 5-10% of your daily calories should come from carbs.

Aside from limiting carbs, you need to increase your dietary fats and keep protein moderate.

Should you worry about ketosis for your menstrual cycle and if you plan to become pregnant soon?

Here’s what you need to know.

Menstrual Cycle

Contrary to popular belief, this will amaze you:

Nutritional ketosis relieves PMS symptoms and promotes fertility.

You may also have heard of women who say that they got their period back after doing keto. Yes, that’s another benefit.

How come?

To explain the science behind it, we’ll start with the fact that carbohydrates raise your blood glucose. Insulin rises in response, allowing your cells to absorb glucose [8].

A diet that’s full of refined carbohydrates causes blood sugar spikes and insulin resistance. Insulin resistance negatively impacts a woman’s reproductive hormones. You are more likely to develop polycystic ovary syndrome (PCOS).

Most women with polycystic ovary syndrome (PCOS) are insulin resistant [9].

High insulin levels increase the production of testosterone from the ovaries [9]. Too much testosterone in women leads can make them infertile. Irregular or absent periods are also common in PCOS [10, 11].


As you can see, a keto diet keeps your blood glucose and insulin to low but healthy levels. This prevents insulin resistance and helps with your menstrual cycle.

One study tackled the effect of a low-carb diet on PCOS. The researchers recruited eleven women who had a body mass index >27 kg/m2 and a diagnosis of PCOS [12].

The researchers asked the subjects to reduce their carbs to less than 20 grams or less daily for 24 weeks [12]. The result?

Five women who completed the study experienced a reduction in the following [12]:

  • Bodyweight
  • Testosterone levels
  • LH (Luteinizing hormone) to FSH (Follicle-stimulating hormone) ratio
  • Fasting insulin levels

What’s more, two women got pregnant despite the fact that they had infertility issues [12].


Pregnancy and Breastfeeding

Pregnancy is a special time in your life. you are not just eating for yourself. you are also considering the nourishment of your unborn child [13].

Experts recommend that you take more micronutrients to support your child’s development [13].

But you are wondering: “Should I continue my keto diet while I’m pregnant?”

The truth is, there is no solid answer to this question. It is difficult or impossible to study a keto diet for pregnant women due to safety concerns and the complexity of pregnancy [14].

There are women who were able to maintain a healthy pregnancy while eating a low-carb and high-fat diet [14].

Yet, you should not make these claims your sole reason for going keto during pregnancy [14].

What we can do is look at some facts about pregnancy and use them to make informed decisions.

Here’s what you should know:

Carbohydrates help with nausea and vomiting during the first trimester.

Morning sickness is common during the first trimester. Hormonal changes trigger nausea and vomiting in the morning. Symptoms usually resolve as the day progresses [15].

Study shows that carbohydrate-rich foods ease or reduce a pregnant woman’s nausea. Good options include rice, potatoes, dry toast [16].

Potassium, found in high-carb fruits like bananas and pears, also helps prevent morning sickness [16].


Pregnant women have a higher tendency towards ketosis.

It’s no secret that pregnancy is “a state of accelerated starvation.”

During early pregnancy, placental lactogen, progesterone, and prolactin increase. An increase in these hormones stimulates your appetite [17, 18, 19, 20]. Your body also favors fat storage.

We appreciate a woman’s tendency to ketosis during the second half of pregnancy. Increased lipolysis enables you to use free fatty acids. Study shows that ketone production increases in pregnancy. Ketogenesis is also higher at night time in pregnant women than non-pregnant women [17].


The ketones that your body produces pass through your placenta. The fetus utilizes your ketones as its source of energy [17].

But please take note that studies about pregnancy ketonemia and fetal development are limited [17].

Bottom line:

Nutritional ketosis is not necessary to achieve a healthy pregnancy. Your focus should be on making sure that you get all the nutrients you need to support your baby’s growth.

A lot of women choose to go keto to achieve weight loss. Pregnancy is not an ideal time to worry about that.

How about while you are breastfeeding?

Like pregnancy, research about the keto diet and breastfeeding is limited. Thus, we can't say that breastfeeding while going low-carb keto is safe for mothers [21].

However, we can mention one study about diet and milk production:

7 healthy lactating women with no history of gestational diabetes were randomly asked to eat either the following [22]:

  • Low-carb, high-fat diet (30% carbohydrate, 55% fat, and 15% protein)
  • High-carbohydrate, low-fat diet (60% carbohydrate, 25% fat, and 15% protein)

This was the result:

Both diets did not affect the subjects’ milk production. Milk volume was the same during both studies [22].

Here’s more:

The low-carb, high-fat increased the fat content in subjects’ milk. Also, subjects on this diet spent more energy during breastfeeding [22].

Based on this study, we can say that lactating women can lose more weight on a low-carb, high-fat diet. At the same time, they get to produce the same amount of milk [22].

Benefits of Ketosis for Women

We are done talking about the relationship between ketosis and physiologic changes that happen in a woman’s life - menstruation and pregnancy.

Now, let’s explore the benefits of keto for women who are non-pregnant.

(Take note that we emphasize “non-pregnant” because again, there’s not enough research to back the safety of ketosis during pregnancy.)

So, how can keto work for you? What positive changes can you expect?


1. Healthy fats balance your hormones

Dietary fats play an essential role in producing hormones in your body [23]. When eating fat, make sure to choose healthy options. Examples include salmon, oysters, flaxseeds, chia seeds, and walnuts.

A study showed that omega-3 consumed on a low-carbohydrate diet increases FSH levels and decreases testosterone levels [24]. FSH or your follicle-stimulating hormone helps your eggs mature. It regulates your menstrual cycle [25].

2. Better complexion

If you are dealing with oily skin and acne, your food could be the culprit. Foods that are high in carbohydrates increase your androgen levels. The effect is increased sebum production and inflammation which trigger acne [26].

Sugar is so abundant in a Western diet. Examples of foods with a high glycemic index include white rice, white bread, and potatoes[26, 27].

Study shows that people in non-Westernized populations like Papua New Guinea and Paraguay have no acne [26].

By reducing dietary carbohydrates, your sebum and acne production also reduces.

Here’s another way to boost skin health on keto:

Choose foods that contain an abundance of micronutrients.

Omega-3 fatty acids found in fatty fish lower skin inflammation. They also reduce damage from UV exposure [28, 29]. Sunflower seeds and avocados contain vitamin E, which also reduces inflammation and speeds up wound healing [29, 30].

3. Decreases the side effects of menopause

Menopause is an expected part of the aging process. It commonly happens about 12 months after your last period when the woman is between ages 45 and 55 [31, 32].

Menopausal women experience uncomfortable symptoms such as:

  • Hot flashes
  • Irregular periods
  • Vaginal dryness
  • Night sweats
  • Dry skin

Not just that, menopause can affect a woman’s energy levels, causing her to feel tired all the time.

All of these symptoms happen because of a decline in reproductive hormones. Your estrogen levels drop, as well as progesterone and testosterone [33].

These hormonal fluctuations can also put a woman at risk for weight gain.

Nutritional ketosis reduces menopause symptoms by balancing hormones and controlling blood glucose.

4. Helps ease PMS symptoms

Premenstrual syndrome or PMS refers to symptoms that women feel days before their period. Over 90% of women claim that they experience bloating, headaches, and increased moodiness [34].

Other PMS symptoms include increased food cravings, insomnia, anxiety, and poor concentration. Hormonal fluctuations cause these symptoms, and the keto diet can help control them.


By now, you would agree that ketosis for women is a complex topic. We hope that we were able to help you understand it better. We have discussed the effects of a keto diet on your menstrual cycle.

Ketosis balances hormones, reducing a lot of problems women complain about. But when it comes to pregnancy, it’s a different story.

To be on the safe side, always consult with a doctor if you plan to try this nutritional approach.


  • A low-carb, high-fat diet won’t mess with your hormones. As a matter of fact, it is great for hormone balance.
  • The diet can help with the effects of hormonal imbalance such as amenorrhea, infertility, weight gain, and more
  • Ketosis is safe for women, in general. But with pregnant and lactating women, there’s a lack of evidence.
  • During pregnancy and lactation, it’s best to stick to a diet that doesn’t limit carbs, is clean, and high in nutrients. That way, you can meet the increasing demands of your body and fetus.


  1. Phinney S, Bailey B, Volek J. The Ten Defining Characteristics of a Well-Formulated Ketogenic Diet. 2018 August 13 -
  2. Harvard Health Publishing. The lowdown on thyroid slowdown. 2014 March -
  3. O'Hearn LA. Ketogenic Diets, Caloric Restriction, and... View all references

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