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Keto Diet And Menstrual Cycle: Is it a good diet for hormones?

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The ketogenic, or “keto,” diet has gained substantial popularity in recent years as a high-fat, very low-carbohydrate approach to weight loss and other health benefits. However, this dietary approach can also have unexpected effects on menstrual cycles. While an irregular menstrual cycle can be concerning for those following a ketogenic diet, it is important to note that there is no need for immediate panic. By the end of this blog, you’ll have learned all about how to cope with it.

Is the keto diet all bad for my menstrual cycle?

Actually, it might not. 

According to the Office on Women’s Health, the keto diet can be beneficial for women with polycystic ovarian syndrome (PCOS), a complex hormonal disorder that can disrupt ovulation and menstrual cycles. PCOS is characterized by insulin resistance, often involving excess production of androgens and limited estrogen production. This hormonal dysregulation can lead to a variety of symptoms, including weight gain, extra body hair, and oily skin.

“The keto diet, however, may help reduce inflammation and insulin resistance, which can contribute to the higher than usual insulin levels observed in PCOS patients,” says Ula Abed Alwahab, M.D., an endocrinologist at the Cleveland Clinic. By minimizing the intake of refined carbs and sugars, the keto diet can help manage blood sugar spikes and dips, which in turn can positively impact hormone regulation in PCOS. Also, weight loss on the keto diet can alleviate some of the symptoms associated with PCOS, such as irregular periods, excess hair growth, and acne.

Reasons that a ketogenic diet may mess with your period

#1: Rapid weight loss

      A study reported that there is a strong correlation between weight loss and reduced estrogen levels. Since the ketogenic diet often leads to dramatic weight loss and hence decreased estrogen levels, it may cause a late or skipped menstrual cycle in some females following this dietary approach. 

      #2: Insufficient carbohydrate intake

        When an individual adopts a ketogenic diet, the reduced carbohydrate intake leads to lower blood glucose levels. This decreased glucose availability signals the body to decrease the production of gonadotropin-releasing hormone (GnRH), as GnRH secretion is sensitive to glucose levels. The diminished GnRH production then disrupts the normal hormonal signaling that drives the menstrual cycle, potentially resulting in irregular or missed periods.

        Ways to maintain a regular menstrual cycle while following a ketogenic diet

        If you are experiencing menstrual irregularities when on a keto diet, you may take the following actions to potentially help restore normal menstruation.

        #1: Ensure adequate calorie intake

          As discussed previously, hormonal imbalance can sometimes be a result of large weight fluctuations, such as when transitioning to a keto diet. If you are following a keto diet and are experiencing an irregular menstrual cycle, it may be helpful to gain a small amount of weight back.

          To achieve this, you can try slightly increasing your daily caloric intake or slightly reducing the intensity of your exercise routine if it is currently at a very high level. Making small, gradual adjustments to your diet and exercise habits can help regulate your hormone levels and restore a normal menstrual cycle.

          #2: Adopt keto cycling

            Keto cycling, also known as the cyclic ketogenic diet, is a dietary approach in which you adhere to a standard ketogenic diet protocol 5–6 days per week, followed by 1–2 days of higher carb consumption. These higher-carb days are frequently called “refeeding days,” as they are meant to replenish your body’s depleted glucose reserves.

            This carbohydrate refeeding can help to prevent the disruptions to the menstrual cycle that are sometimes seen with a strict, long-term ketogenic diet. The increased carbohydrates during the non-ketogenic phases can help stabilize blood sugar levels and support the hormonal fluctuations necessary for regular ovulation and menstruation. By incorporating this strategic carbohydrate ‘breaks’, women following a keto cycling approach may be able to experience the metabolic benefits of ketosis while also avoiding the potential reproductive side effects that can occur with a prolonged, very low-carb diet. 

            Summary

            Keto diet has shown promising effects in women with PCOS. However, hormonal abnormalities may also result from eating too few calories or carbs when following on the ketogenic diet. 

            Nonetheless, the ideal carbohydrate intake varies greatly between individuals. A very low-carb diet works best for some people, whereas a moderate-to-high-carb diet works better for others. To figure out what your optimal carb intake is, it is vital to speak with a healthcare provider, such as your doctor or a registered dietitian.

            References 

            https://onlinelibrary.wiley.com/doi/full/10.1046/j.1528-1157.2003.57002.x

            https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3635052

            https://www.sciencedirect.com/science/article/pii/S0015028201030102

            https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205187

            https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome

            https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovary-syndrome-pcos

            https://www.verywellhealth.com/keto-cycling-8667077