- Girl Talk: The Keto Diet While on Your Period
- Surviving Your Period on Keto
- Can the Keto Diet Affect Your Period?
- The Weird Way the Ketogenic Diet Affects Your Period
- How Worried Should You Be if Keto Ends up Affecting Your Menstrual Cycle?
- How to Get Your Period Back to Normal on Keto
- How Keto May Also Help Periods Return
- A Final Word Of Caution About Keto and Your Period
- Can the Keto Diet Ease Your Worst PMS Symptoms? We Asked an Expert
- The keto diet can make constipation worse
- The keto diet can cause bloating
- Keto might make you more irritable
- You may also feel super fatigued
- The keto diet might help with your breakouts
- So will the keto diet ease or worsen PMS?
- Drastically reducing carb intake can put stress on the body
- The high fat-hormone connection
- What it could mean for fertility
- Keto and Menstruation: Can Keto Affect a Woman’s Period?
- Let’s start with Period 101:
- So, can keto affect your period?
- But my period is going “crazy”!
- Journal of Obesity & Weight Loss Therapy Open Access
- Keto and the Menstrual Cycle: Is There Reason To Worry?
- Menstrual Cycle 101
- What the Research Tells Us About Keto and Menstruation
- 5 Ways Keto-Related Factors *Might* Affect Your Menstrual Cycle
- What Should I Take From These Findings?
- But I’m Telling You, Keto Made My Period Go Haywire!
- About the Author
Girl Talk: The Keto Diet While on Your Period
Photo by Dean Drobot/.com
Hey girl, let’s talk.
You know the feeling, I’m sure. You’re rocking that keto diet, the weight is coming off so fast that you get on the scale and do a little happy dance. Your daily food log is a shining example of perfect macros. Those ketones are making you feel so clear, focused, and ready to take on the world with all that extra energy. Then, BAM! It’s period time and you begin to feel like it’s all coming undone.
Surviving Your Period on Keto
For many women on a keto diet, periods can often be a time of discouragement and temptation. With cramps, cravings, bloating, fatigue, and all the other symptoms that come along with this time of the month, it’s not always a time where we feel the most powerful and in control.
First and foremost, stay away from the scale. Lock it up, don’t step on it, and forget about it for the entire duration of your period. In fact, if you’re one of the fortunate women that has a regular cycle and predictable periods, put your scale away early because premenstrual weight gain can begin to appear up to 5 days before the start of your period.
Weight gain before and during a period is quite normal for most women, though the specific reasons still aren’t entirely clear to researchers.1 It’s thought that a combination of hormone changes, water retention from increased estrogen levels, and emotional eating are the culprits.
Hiding under a blanket and binge-watching Netflix with a half gallon of ice cream isn’t going to cut it – unless, of course, you’ve made your own keto-friendly ice cream. Many women experience intense cravings for sweets and salty snacks while on their periods, and this doesn’t have to be a time where you deprive yourself of those things if you’re willing to get creative.
Want chocolate? Have a few pieces from a keto approved dark chocolate bar. Want ice cream? Use this opportunity to try out a new recipe. Periods don’t have to mean suffering, even for the keto gals. Making the occasional treat fit into your macros just requires a little extra effort – effort that pays off tenfold when you’ve compromised with your cravings and still stayed on track.
Feel like you’re always eating on your period? You’re not alone. A lot of women feel increased hunger while on their periods and eating more isn’t necessarily a bad thing. If you’re making smart choices with your macros, going over your daily calories by a marginal number isn’t going to be the end of the world. Of course, this isn’t a habit you should get used to indulging in on the regular. But, girl, if it gets you through this time, then go for it.
Stay strong, keto sister! Surviving your period on keto is possible, and you’re not alone in this monthly struggle to stay on the right path. Have a great tip for making it through shark week while staying in your macros? Leave a comment below!
Can the Keto Diet Affect Your Period?
If you somehow haven’t heard about the keto diet yet, here’s a crash course: It’s a not-so-new diet, originally developed for treating epilepsy, that involves limiting your intake of carbs and loading up on fats, such as butter and meat. And while it seems counterintuitive at first glance, it can be a surprisingly effective—if not exactly sustainable—means of losing weight. This may sound appealing when you’ve got basically no free time, but drastically changing your diet can affect your body, including your reproductive system and, yes, your menstrual cycle. Consider this your guide to the connection between the ketogenic diet and your period.
First, it’s important to know that any type of weight loss has repercussions throughout the entire body. “The first thing that’s affected by any rapid weight changes is a woman’s menstrual cycle,” says Adeeti Gupta, MD, a board-certified ob-gyn and the founder of Walk In GYN Care in New York, NY. “Women may either get irregular, heavy bleeding or start skipping their periods, while a long-term underweight situation can lead to no periods at all.” That’s because when weight changes are extreme or sudden, as is the case with strict diets, it can affect the entire hormonal pathway, according to Gupta — which will obviously be a problem if you’re trying to get pregnant. As hormones control your menstrual cycle, it’s no surprise that it’s likely the first change you’ll notice.
And not eating enough calories regularly, no matter the diet, can always cause you to miss your period. Overall, if your diet “is causing you to consume too low a calorie amount, you might develop amenorrhea, or cessation of your menstrual cycle,” says nutritionist Keri Gans, RD. The same goes if your diet is off-balance. A well-rounded diet is essential to keeping your menstrual cycle on schedule, and that includes having the right proportions of carbs, fats, and proteins—something the keto diet throws off.
“However, there is no clear percentage defined for the exact amount of carbs needed for women to maintain normal functions,” Gupta explains. What is clear, though, is how much body fat you need to have your period: 15%. “If the body fat falls below that, then women may not get periods and have other conditions such as bone loss, hot flashes, etc,” she adds.
If you’re following the keto diet and notice changes to your menstrual cycle—whether it’s become irregular or your period has disappeared altogether—it’s worth taking seriously. “Start balancing out your diet and seek a gynecologist,” Gupta suggests. “You will need to check your hormone levels, blood counts, and may need an ultrasound as well.” And if you already have irregular periods, proceed with caution with this diet. “I don’t like to say ‘Avoid altogether,’ but I would keep it within limits and avoid very rapid weight loss and extremes of diet changes,” Gupta advises. (And if you’re a new mom who’s breastfeeding, here’s what you need to know.)
Interestingly, one very small study suggested that a ketogenic diet low in carbohydrates could actually improve weight, testosterone levels, and fasting insulin in women with obesity and polycystic ovarian syndrome (PCOS). In it, 11 women with a BMI in the overweight or obese range and a clinical diagnosis of PCOS limited their intake of carbohydrates to 20 grams for 24 weeks. The five women who completed the study experienced significant improvements in a number of health markers.
But this may not be keto so much as the diet. “Weight loss by any method improves the symptoms of PCOS,” Gupta says. “PCOS is a condition where being overweight is a factor as well as a result, so rapid weight loss by any method improves the symptoms.” She’s a fan of more balanced diets for weight loss.
If you’ve been intrigued by the keto diet trend, or have questions about how any new diet might be affecting your period, talk to your doctor, who can help you work to find the right weight management program for your body.
If you start keto and then your periods go wild, what now? Relax! If you are using a ketogenic diet for weight loss, there are a couple of things happening concurrently. One, your calories have been reduced, which can trigger a stress response in your body. Be honest: Are you cutting your calories too low? Are you really eating as much as you think you are? Ketogenic diets are appetite-suppressing, which can be useful when trying to reduce calorie intake but can backfire if you aren’t actually eating enough. Remember: The body sees undereating as a stressor; elevated cortisol will throttle your progesterone levels, and a missed period is a red flag to evaluate and adjust your calorie intake.
Another reason you could be experiencing erratic periods has to do with fat loss and the release of stored hormones and toxins. Adipose tissue is not just a storage space for fat—all kinds of things are stored here! They include fat-soluble vitamins, hormones, pollutants, toxins, and a variety of other substances that are foreign to the body. While stored, they are slowly released into the bloodstream, but they are rapidly freed during weight loss as the fat deposits are burned for energy. As these extra components enter the blood, your hormones and menstrual cycle may be affected. As we know, hormone balance is a delicate process, and even slight increases can trigger deviations in the system. Your body will either metabolize and excrete the excess that’s been released or reabsorb it, so any imbalance this causes is only temporary. Ultimately you will be better off, as the pollutants in your body tend to decrease by about 15 percent after weight loss. This also supports the argument for a slow and steady approach to fat loss, as you don’t want to load your liver with an overabundance of toxins to metabolize all at once.
Finally, a drop in carbohydrates has the potential to affect thyroid hormone production. For those susceptible to impaired thyroid function, this could also affect your menstrual cycle.
A dramatic drop in carbohydrates can undoubtedly affect your menstrual cycle, specifically if you are at risk of or have a thyroid-related disease. Beginning a keto diet doesn’t have to be all or nothing; you don’t have to go from high carb to no carb in the blink of an eye. Gradually ease into carbohydrate restriction if cutting carbohydrates quickly is problematic. You can also eat carbs strategically to counterbalance this effect. Listen to the clues your body gives you and adjust your approach accordingly.
The Weird Way the Ketogenic Diet Affects Your Period
RELATED: How Keeping a Period Diary Helps Your Health
How Worried Should You Be if Keto Ends up Affecting Your Menstrual Cycle?
Decreasing estrogen levels can be cause for concern. “Lower estrogen levels have certain side effects that go along with that, vaginal dryness, but the long-term health concern would be the increased risk of bone loss,” Dr. Thoppil says. According to the Mayo Clinic, osteoporosis is a known complication of amenorrhea. To protect the bones, he sometimes recommends patients supplement with a natural estrogen. Estradiol (estrace) is an example of a natural estrogen supplement.
Of course, low estrogen and missed periods can also affect fertility. But, “if you’re not worried about getting pregnant — so ovulation is not the end all be all — from a pure health standpoint ,” says Thoppil. If you’ve had regular cycles before and continue seeing irregularities for three to six months, he recommends seeing your doctor.
RELATED: The Possible Short- and Long-Term Effects of the Keto Diet
How to Get Your Period Back to Normal on Keto
Thoppil says most people have a threshold, a “happy weight,” where they’ll resume regular periods. He admits it’s very individual and can involve a bit of trial and error. “The first thing I would do is try to increase weight a little bit and see if that helps,” he says. Maybe that means increasing your calorie intake by 250 calories per day or toning down your high-intensity workouts. “For some, 5 pounds would make a difference and return the menses,” Thoppil says.
Dr. Petre suggests staying close to the maximum amount of carbs you’re able to eat each day while maintaining ketosis (it’s different for everyone, but usually between 20 and 50 grams). Or she says to consider keto cycling, which involves keeping your body is in ketosis for five days followed by two days of higher carb intake.
How long it will take to return to normal depends on when you settle into that threshold weight. “It could be as soon as within the month,” Thoppil says. “But everybody’s body is different in how they respond and what they need for adequate nutrition.”
RELATED: Is It Safe to Have Sex During Your Period?
How Keto May Also Help Periods Return
Interestingly, just as having success on keto can make your cycle disappear, the reverse may also be true: Overweight people who lose weight on keto may see periods return. “Weight gain often leads to difficulty with ovulation,” Thoppil says. “There are probably people who resume menses because they’re ketogenic.” In fact, he says there are likely just as many people who fall into this camp as those who lose their cycle.
For those women, this side effect is a good thing. “In a larger picture, the weight loss is beneficial and will restore the hormonal balance once the healthy body weight has been established and the brain adjusts to it,” Petre says. “Regular ovulation and periods will follow.”
RELATED: 8 Steps Beginners Should Take Before Trying the Keto Diet
A Final Word Of Caution About Keto and Your Period
Keep in mind that your diet may not be to blame at all. Missed periods can be a sign of a larger health issue, such as hormone imbalance, genetic abnormalities, or polycystic ovary syndrome (PCOS), according to the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Kizer says losing your cycle — on keto or otherwise — is a good reason to visit your doctor.
RELATED: 10 Ways to Relieve Period Cramps
Can the Keto Diet Ease Your Worst PMS Symptoms? We Asked an Expert
It’s easy to see why the ketogenic diet continues to be so trendy. It can lead to weight loss, and followers get to eat the high-fat foods just about every other eating plan discourages. (A refresher: The keto diet restricts your daily intake of carbohydrates to about 5% and increases fats to about 75% of your daily calories, with the rest coming from protein.)
But some women are reporting yet another keto diet benefit: They claim it can help fight some of the PMS symptoms that do a number on your brain and body during your pre-period week. To be clear, there is no research outlining the exact effects of the keto diet on PMS symptoms.
But any new supposed benefit of the keto diet catches our interest, so we ran it by an expert. What we found is that the keto diet might do more harm than good when it comes to alleviating PMS. Here’s how that can happen.
The keto diet can make constipation worse
Constipation is a classic PMS symptom. One way to manage this symptom is to increase your fiber intake. But you likely won’t be doing that on the keto diet. “The keto diet lack of fiber can only further enhance that problem for certain women,” nutritionist Keri Gans, RDN, tells Health.
Mayo Clinic says dietary changes can be used to manage PMS symptoms. “Choose foods high in complex carbohydrates, such as fruits, vegetables, and whole grains,” Mayo Clinic advises. This is obviously a problematic treatment for anyone on the keto diet, which restricts the amount of carbs you eat.
The keto diet can cause bloating
Many women report feeling bloated while experiencing PMS. “Premenstrual water retention is likely caused by fluctuations in your hormones. Your diet also might play a role,” Mayo Clinic explains.
Gans says that feeling bloated and being constipated sort of go hand-in-hand. “They’re almost connected,” she explains. In fact, bloating is a common cause of constipation, Johns Hopkins Medicine reports. That said, the dietary changes that can help you stay regular during PMS can also help you feel less bloated. But they’re pretty much off-limits if you’re doing the keto diet.
RELATED: Does the Keto Diet Cause Hair Loss? We Asked an Expert
Keto might make you more irritable
PMS sometimes puts you in a crabby state of mind. Tension, anxiety, crying spells, anger—most of us have been there. Following a diet as restricted as keto could add to the stress and make PMS mood swings even worse.
“You’re in a bad mood when you’re PMSing,” says Gans. “Just the strain, the stress —that’s only going to make you more unhappy. It’s an emotional toll. Any restrictive diet is going to when you’re PMSing.”
You may also feel super fatigued
Fatigue is a symptom of both the keto diet and PMS. The reason for your exhaustion on keto comes back to a lack of carbohydrates. “Remember, the keto diet’s eliminating almost all carbohydrates, our preferred fuel. As a general rule, carbs are our body’s preferred source of energy. would only, then, lead to fatigue,” Gans says.
The keto diet might help with your breakouts
Now that we’ve explained how the keto diet can make your PMS symptoms worse, we’ll throw keto fans a bone: Since the diet requires that you eliminate many processed foods that have tons of sugar, it could lessen the severity of your PMS-induced breakouts.
RELATED: 5 Long-Term Health Risks of Going Keto
“The keto diet is eliminating refined sugars,” Gans says. “Menstrual acne, a flare-up of blemishes every month that coincides with menstruation, is fairly common. And according to the American Academy of Dermatology, “Scientists believe that following a low-glycemic diet may reduce acne because this diet eliminates spikes in your blood sugar.”
So will the keto diet ease or worsen PMS?
While we can’t tell you whether or not the keto diet is right for you, we can say that it appears to intensify a number of PMS symptoms women struggle with. That said, we’re here for any and all natural acne remedies as long as they’re safe. If you have any questions about whether the keto diet is right for you, consult a nutritionist. You can also take any questions about PMS to your ob-gyn.
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- By Isadora Baum
- By Maggie O’Neill
Hormonal naturopathic doctor and The Hormone Boost author Natasha Turner, ND, listened intensely as a female patient sat across from her, lamenting on her struggles with maintaining a healthy weight. “I’ve been doing keto for months and at first, the weight was falling off me so easily. But now I’m gaining it back. I have no idea what happened!” Dr. Turner recalls the woman saying.
Dr. Turner wasn’t surprised. Ever since the ketogenic diet exploded in popularity, she’s been fielding complaints like this on a regular basis, primarily from her female patients. “I’m seeing a consistent trend of women adopting the ketogenic diet and the majority of them do not lose weight,” she says. She says she’s seen lots of patients who end up gaining unwanted weight, losing muscle, and developing signs of adrenal fatigue while on the buzzy eating plan.
Hold up, what’s keto again? Check out this video for all the need-to-know intel:
This isn’t just something “keto haters” are warning about. A study published last year in the journal Diabetes (and recently presented at a conference) points to this potential downside, too. When researchers looked at how the ketogenic diet affected male and female mice, they found that while the male mice in the study lost weight, female mice ended up gaining weight. They also developed impaired glucose intolerance, a sign of prediabetes.
Of course, mice are very different from humans—so these findings don’t automatically mean that the ketogenic diet will mess with all women’s blood sugar levels and weight. But hormonal experts like Dr. Turner and others say that while many women may experience short-term success on keto, it may also have some sex-specific downsides. Why? Blame your hormones.
Drastically reducing carb intake can put stress on the body
Carbs have been painted as the devil, but all three experts I spoke to said that carbohydrates are a key part of women’s health. Not only do they contain crucial vitamins and nutrients like fiber, but the female body in particular needs a good amount carbohydrates along with fats and protein in order to sustain healthy hormone levels, says Aimee Raupp, MS, LAc, a licensed herbalist and acupuncturist specializing in fertility. “When we don’t get those complex carbs, we have a shift in serotonin levels, a shift in progesterone, and shift in insulin metabolism. All of that in turn affects our health and can make insulin levels go up and cause us to gain weight,” adds integrative health expert and Superwoman Rx author Taz Bhatia, MD.
According to Dr. Turner, cutting carbs very drastically can cause an increase in cortisol—the “stress” hormone. “According to the keto rules, followers are only allowed 30 grams of carbs a day from green vegetables. No starchy carbs. No fruit,” she says. (Some variations, like the ketotarian diet, do allow for some fruit and more relaxed carb macros). “This puts stress on the body, which raises cortisol levels.”
Why does this happen? Dr. Turner says that while in theory, people on the ketogenic diet burn fat for energy, it can actually dip into the body’s protein reserves because some people need more protein than what’s allowed for on the diet’s ratios. “You have to consume a minimum amount of protein to preserve your muscle mass,” she says—about 46 grams of protein a day for the average sedentary woman, although very active women need even more. Burning protein for energy instead of fat or carbs causes stress on the body, Dr. Turner says, spiking cortisol levels.
When cortisol levels are high over long periods of time, the body compensates by producing more testosterone and estrogen, and less progesterone. This hormonal change could cause problems like acne and missed periods, or worsen existing conditions like endometriosis or PCOS, says Raupp. While men and women can see their cortisol levels spike from cutting carbs, Dr. Bhatia says women tend to be more sensitive to changes in cortisol levels because our hormonal balance is more complex.
Plus, if people are doing keto over long periods of time, Dr. Turner fears that they could be putting themselves at risk for insulin resistance and prediabetes, which could ultimately lead to type 2 diabetes and other health issues. Why? Because elevated cortisol levels have been associated with those health issues. “The same thing happens when you wake up in the morning after not getting enough sleep,” she says. “Being sleep-deprived makes you have higher levels of cortisol, and it’s proven that those patients are more insulin resistant and have more glucose intolerance. It’s also related to change of cortisol levels.”
The high fat-hormone connection
Dr. Turner says another factor at play with keto is all of the fat. She says a diet high in fat spurs more estrogen production, which is also linked to weight gain (at least in mice). “Higher estrogen levels suppress the thyroid in women, which can lead to weight gain,” she explains.
Basically, the thyroid controls the metabolic process, which is the control system for weight management, energy levels, sex drive, concentration, and mood. When estrogen levels go up, thyroid activity goes down in attempt to balance it out. Likewise, when estrogen levels go down—such as during menopause, the thyroid goes up. It’s a very delicate dance.
“It’s a triple whammy,” Dr. Turner says of the keto diet. “One is that it increases your risk of having high cortisol because of the carbohydrate restriction. Two, it’s going to increase the production of estrogen because of the high fat diet. And three, these two changes—the high cortisol and high estrogen—suppress your thyroid and makes you more prone to weight gain.”
Dr. Bhatia agrees. “The reason why this is so critical for women is because the thyroid regulates so many other hormones,” she says. “Women’s hormonal systems are so delicate that doing anything to the extreme stresses the hormones, whether it makes you estrogen dominant or thyroid resistant. This is why women will maybe initially lose weight, but then plateau or even gain weight.”
What it could mean for fertility
Beyond weight, the ketogenic diet could have some serious consequences for fertility, says Raupp. “A menstrual cycle and optimal fertility is a luxury that the body imparts when it has enough to sustain itself,” she says. “When the body doesn’t feel like it can sustain itself, the hormones that impact fertility and menstruation will be compromised because the last thing on its list is to support and nourish another life if it can’t support and nourish its own life.”
Raupp says the strict macros on keto (particularly when combined with intermittent fasting) can create exactly this situation. “You are growing a human, or trying to, and going extremely low-carb or going for longer periods of time without eating tricks the body into a state of chronic stress,” she says. Hence the above-mentioned cortisol spikes, which subsequently suppresses the hormones that support fertility.
While keto advocates often claim that the eating plan can help balance hormones and can be used to manage conditions like endometriosis and PCOS (there are small studies that back this up), Raupp says she’s not convinced. “I’ve been in clinical practice for 15 years and the only thing I have ever seen work for balancing hormones is eating a nutrient-dense diet filled with healthy carbs, fats and protein,” she says.
Of course, some women really do claim to enjoy benefits and long-term success on the ketogenic diet. Dr. Turner says the jury is still out on how beneficial the eating plan will prove to be over time for women or men—as of yet, there’s no study out there yet that has extensively looked at the potential sex differences of the keto diet in humans. This is one case where time will tell. That is, if a whole bunch of let-down women don’t first.
What has been proven effective? Filling up on a primarily plant-based diet supplemented with omega 3-rich fish. No matter which eating plan you follow, there’s tons of healthy inspo for you in Well+Good’s gorgeous new cookbook.
Keto and Menstruation: Can Keto Affect a Woman’s Period?
The short answer is yes!
Diet, weight, and stress all contribute to changes in hormones in both women and men. However, due to women’s reproductive systems, they often experience greater hormonal side-effects when it comes to diet and weight changes. For this reason, you’ll find several keto forums, websites, and books specifically targeted to women and keto.
Nutrition greatly affects how our bodies perform and function, so changes in menstruation when going keto shouldn’t be a surprise. However, some women experience changes in their period more than others.
Is there a reason to worry? This really can depend on several factors, but overall, a healthy, well-formulated keto diet appears to help rather than hinder a woman’s reproductive health (a.k.a. your period and hormones).
Let’s start with Period 101:
A woman’s menstrual cycle consists of 4 different phases with significant hormone changes in each phase. A typical menstrual cycle averages 28 days, give or take a week.
- Menstrual phase: day 1 is the first day of your period and lasts ~3-7 days.
- Follicular phase: overlaps with menstrual phase from day 1 and lasts ~ 16 days on average.
- Ovulation phase (a.k.a. “baby-making” phase): starts ~ day 14, right smack in the middle of the menstrual cycle and lasts ~ 24 hours.
- Luteal phase (a.k.a. PMS phase): lasts ~ 14 days after ovulation phase.
A few of the hormones affected by menstruation, diet, and stress include the luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, progesterone, insulin, cortisol, leptin, and ghrelin.
Within each phase, several hormones are affected, resulting in both physical and emotional changes. It’s also important to note that certain phases (PMS phase) also affect other hormones (like insulin and cortisol), causing fluctuations in both insulin sensitivity and blood glucose levels.
What does this mean? Lower ketone readings, weight changes, and increased food/carb cravings are totally NORMAL and a good sign of a healthy reproductive cycle.
So, can keto affect your period?
Unfortunately, research in this area is lacking, but many women anecdotally report both positive and negative changes in their menstrual cycle when first starting keto.
In my experience, those who report negative changes typically find that things normalize (and often improve) after a few months into a healthy keto lifestyle. In fact, low-carb diets like keto have been shown to help many women with PCOS (polycystic ovarian syndrome), one of the leading causes of female infertility and menstrual irregularity. That said, only one small study so far has tested the effect of a keto diet on PCOS with positive results.
But my period is going “crazy”!
Here are a few reasons why:
- Rapid weight loss
- Stress (physical and emotional)
- Excessive caloric restriction
Keto or not, the reasons above can (and will) cause changes in hormones, affecting a woman’s menstrual cycle. Try taking a step back and observe if you’re overly restricting carbs, protein, fat, and calories in general. Then maybe consider whether increasing some of these may rebalance hormones and physical stress.
However, if you’re consuming a well-formulated keto diet, you may just want to give your body some time to adjust to this new lifestyle change.
Keep in mind that changes in your period don’t automatically mean things are wrong. Unwanted and unpleasant side effects – such as a period lasting longer than normal, spotting, or irregularity in timing – don’t necessarily mean things are bad or unhealthy. If your period is going “crazy”, but overall you’re feeling good, consider giving your body a couple of months to adapt, or reach out to your medical provider.
In the meantime, be sure you’re getting optimal nutrition, calories, and practicing good habits to eliminate stress (sleep, meditation, walking, sunlight exposure, yoga, etc.).
First and foremost, always listen to your body, adjust your diet if you need to, and take time to find your own personal version of keto that works for you (think Intuitive Keto)!
Every so often, blood will make a guest appearance in your panties outside of its expected monthly residency. But even though spotting might be annoying for your laundry schedule, according to Fahimeh Sasan, M.D., an ob-gyn at Mount Sinai, if it’s only happening between menstruation every once in a while, then you don’t have too much to worry about. “But if you’re experiencing it persistently,” especially if you aren’t on a new contraceptive, Sasan warns that “a fibroid or uterine polyp could be causing abnormal bleeding, in which case you should see a doctor.” (Both polyps and fibroids are treatable—although they could contribute to infertility if they’re serious and go ignored.)
Most culprits for spotting, however, are much less nefarious. We talked to Sasan about what might be causing your spotting.
According to the Mayo Clinic, breakthrough bleeding is common with women taking any kind of birth control pill, particularly in their first few months of use. “Your body is just adjusting to something new,” Sasan says. “Sometimes it’s a fluke and will never happen again, and for others it could be an indication that they need to be on a higher dosage of pill.” This is also common in women who recently got an IUD, switched to the injection, or got an implant. Although, again, if the breakthrough bleeding isn’t going away after three months, it’s a good idea to check things out with a doctor.
Related: What’s That On Your Hoo-Ha? 5 Vaginal Conditions You Need To Know About
Anxiety doesn’t just mess with your mental well-being—according to Sasan, it can also change up your menstrual cycle. “Our whole system is connected,” she says. “So if you’re under a lot of stress, our brain talks to our ovaries, talk to our uterus.” In short, there’s a whole shift in your hormonal balance, and spotting can result.
Find out why you might have a late period—other than pregnancy:
Anticoagulants, also known as blood thinners, help keep your blood from clotting. They’re often prescribed to people who’ve suffered issues with blood clots in the past. While these meds can curb your risk of heart attacks and strokes if you’re prone to clots, they can also have a messy consequence since, as Sasan points out, “Blood thinner thins your blood and makes you bleed.” A study out of the Royal Free Hospital in London confirms that this anti-coagulant-induced free flow is really a thing. Talk to your doctor about how to manage your side effects.
(Get the latest health, weight loss, fitness, and sex intel delivered straight to your inbox. Sign up for our “Daily Dose” newsletter.)
“People who’ve undergone extreme weight loss can stop getting their period because their bodies think that there’s not enough body fat, from an evolutionary perspective, to support a baby,” Sasan says. This could lead to the complete halting of menstruation, or perhaps some minor spotting from time to time. While an extra few pounds isn’t going to do much of anything, extreme weight gain or loss can impact your period cycle due to hormonal imbalances.
Related: The Signs Of Ovarian Cancer EVERY Woman Should Know About
Although Sasan points out that this doesn’t happen for all women, some notice a day or two of spotting around the time of their ovulation, which occurs about two weeks prior to menstruation. Although some people believe that you can’t get pregnant while you’re bleeding, in fact you can only get pregnant surrounding your ovulation. (So if you’re bleeding at around this time fame and want to avoid pregnancy, make sure you’re practicing safe sex.)
Related: You’ll Never Guess What Researchers Found Living In Semen
Spotting doesn’t always happen shortly before a period. According to the American Pregnancy Organization, about 20 percent of women experience spotting during the first 12 weeks of their pregnancy.
When it comes to periods, I consider myself lucky—mine shows up each month like clockwork; no need for tracking apps or a flag on my G-cal. But a few months ago my regularly scheduled programming went dark. I went through possible reasons for the ghosting: pregnant? Not a chance. Birth control? Used every time. Meds? Nothing new there. Then it hit me: The only change was my diet.
I’d been test-driving the ketogenic diet—the trendy but oh-so-restrictive eating plan that has people pumped over its ability to burn through body fat by seriously restricting carbohydrates in favor of meals packed with healthy high-fat foods. By limiting carbs, you drain your body’s main source of fuel, which forces your body to use fuel from fat, or ketones, as a substitute source of energy, says Ariane Hundt, a clinical nutritionist in New York City.
The radical shift can produce crazy results: I lost 11 pounds and 3 percent body fat in a month. That’s not necessarily a dangerous amount of weight to drop, but it’s certainly more than the recommended one to two pounds per week, and that alone could explain why I skipped my period, says Rekha Kumar, M.D., an endocrinologist specializing in weight control at Weill Cornell Medicine in New York City. When you lose weight quickly, your body registers the loss as a threat, and any system deemed unnecessary for survival begins to shut down to conserve resources. For women, the baby-making machine is typically first to go.
But that’s not the only way rapid weight loss might affect your period. “If you do one extreme thing to your body, there’s likely other downstream effects on important hormones,” Dr. Kumar says. Losing weight fast creates a state of stress in your body, which can trigger your adrenal glands to fire out more cortisol, also known as the stress hormone. Extra cortisol coursing through your system can lead to libido and menstrual changes and potentially suppress ovarian function if levels get too high. The potential end result: a disappearing period.
Skipping a period isn’t necessarily a big deal—it’s normal for your cycle to fluctuate every now and again, Dr. Kumar says—but when connected to a change in your diet, it could signal bigger health risks if your period is MIA long-term. In that case, you have to worry about the same things that postmenopausal women worry about, says Zandra Palma, M.D., a functional medicine physician at Parsley Health in New York City. Think: loss of muscle mass and bone mineral density. If you miss Aunt Flo too long, you can also risk potential fertility problems down the line—difficulty with ovulation is the reason about a quarter of all infertile couples can’t conceive, according to the Mayo Clinic.
It’s unclear how many women on Keto have had their periods pull a disappearing act. Forums like Reddit are filled with stories like mine, but exact stats are hard to pin down. And many patients may not mention it to a doctor because, like me, a month or two of having a rogue cycle could be enough to scare them back to a well-balanced eating plan ASAP. As soon as that happens, the body starts to recover. (Dr. Palma says it can take up to three months for your period and the rest of your body to rebound.)
Even though your body will bounce back once you return to a balanced eating plan, doctors say it’s important to recognize just how much extreme diets can affect your body beyond the number that shows up on the scale. “It is unfortunate that some young women have placed such an emphasis on being thin that they would sacrifice their long-term health,” Dr. Kumar says.
That’s not to say the keto diet is bad for everyone, she adds. “When someone goes on the keto diet, , Are they an appropriate candidate for it?” says Dr. Kumar. For someone who has a high body fat percentage, the keto diet may actually help restore an irregular cycle. But for those who just want to lose a couple extra pounds, “that’s where you really see a potential risk in terms of somebody jeopardizing their fertility or menstrual cycle,” Dr. Kumar says. To find a healthy balance, talk to a doctor or nutrition expert who can help you understand how a diet like keto might affect your reproductive health.
In my case, keto wasn’t the right pick. I’ve found a more balanced diet—higher in protein, a little less fat, and moderate helpings of carbs—that’s allowed my ovulation to return to its regularly scheduled programming while I enjoy cauliflower pizza, tons of leafy greens, and even a slice (or two) out of the bread basket.
Journal of Obesity & Weight Loss Therapy
Ketogenic diet (KD) is also known as LCHF (Low carb high fat) diet. This diet involves carbohydrate intake typically less than 20 g per day, high amount of fat and moderate amount of protein the main aim is to low down the blood glucose level along with insulin level. After the state is achieved body use fats as a source of energy instead of carbohydrates and body becomes the fat burning machine. It is also important to limit protein because in many studies it has been proved that excess protein converts to glucose and can raise the blood sugar level .
A person is said to be in ketosis when the fasting blood glucose is between 60-80 mg/dl. The difference between ketogenic diet and other low carb diet is a low carb diet may contain much protein.
When a person is “in ketosis”, fasting morning blood glucose levels tend to average between 60 mg/dl and 85 mg/dl and blood ketone levels rise to at least 0.5 mM (with much higher levels recommended for certain conditions). These parameters distinguish ketogenic diets from other low-carbohydrate diets, which may contain much amount of protein and/or carbohydrate to produce these metabolic effects (Figure 1).
Figure 1: Role of carbohydrates on adrenals.
The state of excessive calorie deficit, stress levels and excessive workout out specially exercises including cardiovascular system (running, cross-fit, skipping) stimulates the glands.
In long term excessive stress, exercise and poor carbs deficit diet can put high amount of pressure on glands and there will be high production of stress hormone called cortisol. And ultimately the HPA axis will disturbed .
The ketogenic diet was accepted as a remedy for epilepsy in the 1920s and 30s. The purpose of fasting in the treatment of this disease has been acknowledged to the humankind for thousands of years and was analyzed in detail by ancient Greek and Indian physicians . An early discourse in the Hippocratic Corpus, “On the Sacred Disease,” explains how modifications in diet served a role in epilepsy management. He also explains in “Epidemics”, how a man was treated from epilepsy when he refrained completely from ingesting food or drink .
The primary modern scientific study into fasting as a treatment of epilepsy was accompanied in France, in 1911. Formerly, potassium bromide was used to cure epileptics, but these compound reduced patients’ mental abilities. Instead, twenty epilepsy patients obeyed a low-calorie, vegetarian food plan that was merged with fasting . Two patients showed substantial improvements, although most could not stick to the dietary limitations. However, the diet was found to recover the patient’s mental abilities compared with the outcomes of taking potassium bromide .
During the initial 20th century, an American named Bernarr McFadden propagated the aim of fasting as a means of reinstating health. His student osteopath, Hugh Conklin, initiated fasting as a treatment method for monitoring epilepsy. Coklin anticipated that epileptic seizures were triggered by a toxin secreted in the intestine and recommended that fasting for 18 to 25 days could cause the toxin to disintegrate. His epileptic patients were put on a “water diet,” which he stated alleviated 90% of children and 50% of adults. Inspection of the study that was accomplished later showed that, 20% of Coklin’s patients became seizure-free, while 50% confirmed some improvement. The fasting therapy was soon accepted as a part of widely held therapy for epilepsy and in 1916; Dr McMurray informed to the New York Medical Journal that he had magnificently treated epileptic patients by prescribing a fast, followed by a diet free of starch and sugar .
It was in 1921 that an endocrinologist Rollin Woodyatt observed that three water-soluble compounds, acetone, β-hydroxybutyrate and acetoacetate (together called ketone bodies) were produced by the liver as a product of starvation or if they obeyed a diet rich in fat and low in carbohydrates. Russel Wilder from the Mayo Clinic termed it the “ketogenic diet” and used it as a treatment for epilepsy.
Later research in the 1960s showed that more ketones are produced by medium-chain triglycerides (MCTs) per unit of energy because they are transferred quickly to the liver via the hepatic portal vein, as opposed to the lymphatic system. In 1971, Peter Huttenlocher formulated a ketogenic diet where 60% of the calories came from MCT oil, which permitted more protein and carbohydrates to be involved in relation to the original ketogenic diet, so that parents could cook more delicious meals for their children with epilepsy. Many hospitals also approved the MCT diet in place of the original ketogenic diet, although some used a combination of the two .
Low Carb, Stress and Amenorrhea
Amenorrhea is a condition when women’s menstrual flow/Aunt flow is supressed for more than 90 days or so. The Amenorrhea is classified broadly into two categories.
The reasons contributing primary are Turner syndrome, Mullerian syndrome vaginal atresia Cryptomenorrhea, Imperforate hymen and Secondary involves Pregnancy-menopause, breastfeeding, polycystic ovaries (pcod/pcos), drug induction (Figure 2).
Figure 2: Types of Amenorrhea.
However, the most common secondary amenorrhea is hypothalamic amenorrhea which is related to exercise, stress and eating disorders such as bulimia. Studies suggest that low carb diets, too much stress enhance the stress hormone called “Cortisol”.
Amenorrhea is mostly observed in athletes, marathon runners and women’s performing exerted exercise involving low body weight. The low body weight, few carbs/calories and excessive exercise switch on body’s starvation mode. When the calorie intake and the carb intake is less than the required for maintenance of different body system problem is created.
The major problem is the estrogen deficit state which can cause infertility, vaginal atrophy and can increase the chances of osteoporosis.
In a retrospective study performed from 1994-2002 on 45 children, aged 12-19 years. The children enrolled were patients and were put on ketogenic diet .
In order to represent a starvation state efficiently, each patient must be as close to his or her standard body weight so that we can strategize weight loss in our patients .
Twenty-seven (60%) of the adolescents stated a decline in their weight during the intake of the ketogenic diet out of which seven revealed an unintentional weight loss of ≥ 25% of their preliminary body weight. At the same time, 18 patients were cured with VPA (with which weight gain is an identified side effect) while 13 (72%) were capable to lose weight. Four adolescents remarked a decrease in energy related with the weight loss, all of whom were below their ideal body weight at diet commencement.
Nine (45%) girls informed menstrual issues during the consumption of the ketogenic diet precisely, amenorrhea (six) and delayed puberty (three). Only four of nine girls with menstrual abnormalities had weight loss. One adolescent started hormonal therapy (combination oestrogen/progesterone oral contraceptive) to stimulate menses; eight experienced a return of normal menses after diet termination. One girl reported menorrhagia after diet withdrawal; this was subsequently cured with an oral contraceptive. Two individuals stated a rise in seizure activity; two, thinning hair and/or hair loss, both of which were altered with vitamin supplementation; two, increased bruising or bleeding; and two, prejudiced reports of restricted growth .
Limitations and Recommendations
The gap of knowledge however still exists despite of these many research and conclusions obtained. The mechanism of working of different low carbohydrate diets in the body is still not notable. Currently, many health centers of ketogenic diet and ketogenic kitchens around the world are in popular demand. However, most nutritionist, healthcare physicians and dietitians have no accurate certification or training in the ketogenic diet. Therefore, it leads to incorrect macros calculation. It is our hope and belief that when physicians and health care professionals are sufficiently trained there will be no such problems. These questions are not answered till date, while continuous efforts are made to solve the tangled mystery of the diet. It can be foreseen that research and it’s finding will make the good utility of the same more frequent.
Birth control pills and Paleo diet
Of course, taking pills is the solution to turn back the hormonal system. Hormonal pills can help amenorrhea. These pills contain combination of estrogen and progesterone in low doses. These pills come in 21-day or 28-day tablet pack. However, some are taken for 5 days twice a day. And after the last dose within a week withdrawal bleed can be experienced.
But for long run for weight management along with health Paleo can be adopted.
Paleo diet is about eliminating the grains, legumes and dairy. The former two is due to the presence of phytic acid and the latter is because of lactose which is hard to digest. Paleo is a long term diet which can be followed. The differences can be collated in Table 1.
|Grains||Not allowed||Not allowed|
|Dairy||Not allowed||Not allowed|
|Legumes (peanuts) and beans||Not allowed (peanuts-controversial)||Not allowed|
|Fats and oils (healthy)||Allowed||Moderate|
Table 1: Ketogenic vs Paleo categories of food.
Nutrients and macros
Calorie counting is now associated with a new diet fever called” IIFM”. IIFM stands for ‘If it fits my macros’. This diet targets to analyze and monitor calorie deficit state together with the account of calories coming from macronutrients/macros-Typically from carbohydrates, proteins and fats. In short, how much you are eating and what you are eating can drastically enhance the weight loss, muscle building parameters and maintain hormonal balance.
The various applications help to stay on track as shown in Figure 3.
Figure 3: Macros (Ketogenic vs Paleo).
Macros manipulation is a booster for getting the hormones back on track and also requires to convince your body that it’s not in danger. This includes proper sleep, cutting of extensive cardiovascular exercises and probably eating carbohydrates in sufficient amount.
Keto and the Menstrual Cycle: Is There Reason To Worry?
By Lindsay Taylor, PhD
It seems every “keto for women” forum abounds with stories about menstrual cycles gone wild in the first few months of keto. Irregular cycles, breakthrough bleeding, and periods lasting much longer than normal are common complaints. Sometimes these stories are cited as evidence that keto isn’t good for women, at least not premenopausal women, and that we need carbs for healthy hormones. Yet, many women don’t notice any changes in their menstrual cycles at all, while others report improvement in PMS symptoms and cycle regularity from the get-go.
What gives? Why do some women’s cycles apparently become wacky when they start keto, while others feel like keto is the key to period bliss? Can keto “mess up” the menstrual cycle?
We know that diet—what and how much we eat—can profoundly affect our hormones. This is true for both women and men. One of the reasons people are so excited about ketogenic diets is specifically because keto shows promise for helping to regulate hormones and improve cellular sensitivity to hormones such as insulin and leptin.
At the same time, women’s hormones are especially sensitive not only to dietary changes but also to downstream effects such as body fat loss. Furthermore, one of the ways women’s bodies respond to stressors is by turning down the dial on our reproductive systems. It’s reasonable to hypothesize, then, that women might have a tougher time adapting to or sustaining a ketogenic diet. Keto can be stressful depending on one’s approach, and that might negatively impact women’s reproductive health. But do the data actually bear that out, or is so-called “keto period” more misplaced hype than genuine fact?
Note that throughout this post, I’m going to use the term “reproductive health” to refer to all aspects of women’s menstrual cycle, reproductive hormones, and fertility. Even if you aren’t interested in reproducing right now, your body’s willingness to reproduce is an important indicator of overall health. When your reproductive health goes awry—irregular or absent periods (amenorrhea) or hormone imbalances—that’s a big red flag. Of course, post-menopausal women can also experience hormone imbalances that affect their health and quality of life (and low-carb and keto diets can be a great option for them).
Menstrual Cycle 101
Let’s briefly review what constitutes a normal, healthy menstrual cycle, understanding that everybody’s “normal” will be a little different. A typical cycle lasts from 21 to 24 days on the short end to 31 to 35 days on the long end, with 28 days being the median. Day 1 is the first day of your period and begins the follicular phase, which lasts until ovulation. Just before ovulation, levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), and estradiol (a form of estrogen) spike. Next comes the luteal phase covering the approximately 14 days from ovulation to menses. LH, FSH, and estradiol drop, while progesterone rises. Estradiol bumps up again in the middle of the luteal phase. If a fertilized egg is not implanted, menstruation commences, and the whole cycles starts over again. All this is regulated by a complex communication network under the hypothalamic–pituitary–gonadal (HPG) axis, which is closely tied to the actions of the adrenal (the A in HPA axis) and thyroid glands.
Across the cycle, fluctuations in body weight are common as fluid is retained and then released along with shifts in estrogen and progesterone. Changes in blood glucose are also normal, and insulin-dependent diabetics often find that they need to adjust their dose at different times of their cycles to keep their blood sugar in check. The most common pattern is higher blood glucose readings in the pre-menstrual period (the second half of the luteal phase), and lower readings after starting your period and before ovulation. This is generally attributed to the fact that progesterone, which is highest during the luteal phase, is known to reduce insulin sensitivity. However, different women experience different patterns, which can also be affected by other factors such as oral contraceptive use.
Normal fluctuations in insulin resistance and blood glucose can mean that women get lower ketone readings at certain times of the month than others. When these occur premenstrually—and so they tend to coincide with a period of (transient) weight gain and food/carbohydrate cravings—women often feel as though they are doing something wrong. Rest assured that these variations reflect normal physiology.
The many factors that affect your cycle and the levels of your sex hormones include: other hormones, gut health and microbiome, metabolic health (e.g., insulin sensitivity), environmental toxins, stress, sleep, immune health, nutrient deficiencies, activity level and energy expenditure, and age. Each affects the others, and all (except age of course) can be affected by diet. It’s no surprise, then, that it can be extremely difficult to pin down a root cause of menstrual changes or reproductive issues.
What the Research Tells Us About Keto and Menstruation
As I said at the outset, there are lots of anecdotes, both positive and negative. In my experience, most women whose cycles seem to go crazy when they start keto find that things get back to normal—and often a better version of normal—after a few months.
First, it’s tricky to determine the effects of keto per se, since many people combine a ketogenic diet with calorie restriction (intentionally to lose weight or unintentionally due to the appetite suppressing effects of keto) and with fasting (intermittent and/or extended). Each of these can independently impact the factors listed above, lead to weight loss, and affect the menstrual cycle and reproductive health.
So, is there any evidence that keto itself causes changes to menstruation?
The scientific evidence is scant….
The one statistic you’ll see floating around the interwebs is “45% of (adolescent) females experience irregular menstrual cycles on keto.” This statistic comes from one small study of adolescent girls using a therapeutic ketogenic diet to treat epilepsy. Six of the twenty girls reported amenorrhea (loss of period) and three were diagnosed with delayed puberty. However, the ketogenic diet used for epilepsy is different and usually much stricter than an “everyday” keto diet needs to be, and epilepsy is frequently associated with menstrual dysfunction regardless of diet.
To extrapolate the findings of this study and argue that nearly half of teenage girls (or women generally) are likely to experience menstrual problems from going keto is a huge leap.
The fact is, I’m unable to find any studies done in healthy human females (or mice for that matter) demonstrating that otherwise normal menstrual cycles are disturbed by going keto.
5 Ways Keto-Related Factors *Might* Affect Your Menstrual Cycle
With the limited amount of research looking directly at keto and menstruation, let’s look first at whether there are direct effects of carbohydrate restriction or elevated ketone production on the menstrual cycle. Those are the defining characteristics of keto and what differentiates keto from other ways of eating. Then we can examine indirect effects that occur due to factors such as weight loss. These are not unique to keto, though they might be more likely on a ketogenic diet compared to other ways of eating.
There is no real body of evidence that looks at ketogenic levels of carb restriction and menstruation, but there are some clues. In this small study, functional hypothalamic amenorrhea (FHA) was associated with dietary fat restriction; women with FHA actually ate non-significantly more carbs than matched controls and nearly identical total calories. Likewise, in this small study, FHA was associated with lower fat intake but no significant difference in carb intake.
This meta-analysis looked at the effect of low-carb (not keto) diets on markers of reproductive health among overweight women. The researchers found four studies that examined effects on menstruation; all showed improved menstrual regularity and/or ovulation rates. Of six studies that looked at levels of reproductive hormones, five reported significant improvements.
Carb restriction also results in decreased insulin production. Hyperinsulinemia and insulin resistance are frequently associated with polycystic ovarian syndrome (PCOS), one of the leading causes of female infertility and a frequent cause of menstrual irregularity. There is currently a lot of interest in using keto to treat PCOS, but only one small study has so far directly tested the effectiveness of a ketogenic diet to treat PCOS, with positive results.
No studies have looked at the direct effects of ketones on menstruation.
Of course weight loss is not unique to keto, but keto can be very effective for weight loss. Some women experience rapid weight loss when first starting a keto diet. Weight loss in and of itself can impact menstruation through a variety of pathways. A key way is by reducing the hormone leptin. Leptin’s main job is to communicate energy availability to the hypothalamus—high levels of leptin tell the hypothalamus that we have enough energy on board, which also means we can reproduce. Low leptin can disrupt the menstrual cycle and is linked to hypothalamic amenorrhea.
Body fat loss can also affect estrogen levels since estrogen is both stored and produced in adipocytes (fat cells). While fat loss in the long term will decrease estrogen production, it is possible that rapid fat loss might temporarily raise estrogen levels and can also affect estrogen-progesterone balance. These transient changes in estrogen levels might underlie some of the menstrual irregularities women report.
Stress can impact the menstrual cycle in myriad ways. Cortisol acts on the hypothalamus and pituitary glands, affecting hormone levels, sleep, immune function, and gut health, to name a few. Diets can be a source of stress, both at the physiological and psychological levels. Keto has a reputation for being especially stressful because it is more restrictive than other low-carb diets, but this can be mitigated by following the Keto Reset tips for women.
Thyroid dysregulation is another common cause of menstrual irregularities, and there remains a pervasive belief that keto is bad for thyroid health. Indeed, the thyroid is sensitive to nutrient deficiencies and caloric restriction, and thyroid hormones, especially T3, do frequently decline on keto. However, as Mark has discussed in a previous post, changes in T3 levels might not be a problem, especially in the absence of other problematic symptoms. Moreover, many practitioners now use keto as a cornerstone in their treatment of thyroid disorders.
What Should I Take From These Findings?
The first takeaway: there just isn’t much direct evidence about how keto might affect your menstrual cycle, positively or negatively. We have some studies suggesting that low-carb diets improve some aspects of menstruation and reproductive health, but keto is more than just another low-carb diet. Ketones themselves have important physiological properties, such as being directly anti-inflammatory, which might positively impact women’s reproductive health.
Second, the ways that keto is likely to (negatively) affect menstruation aren’t unique to keto, they’re common to any diet: hormone shifts mediated by energy balance, stress, and weight loss.
Furthermore, since keto is so often combined with caloric restriction, time-restricted eating, and fasting, even the anecdotal evidence might not be able to tell us all that much. If a woman is eating ketogenically, in a big caloric deficit, and doing OMAD (one meal a day), and her leptin plummets, how are we to know what really caused it? We don’t have good evidence that otherwise healthy women start a well-executed ketogenic diet and end up messing up their menstrual cycles.
That said, women do need to be cognizant of the sum total of the signals they are sending their bodies when it comes to energy availability and stress. A lot of women come to the keto diet with a history of adrenal, thyroid, metabolic, and reproductive issues. It’s important that they’re extra careful about how they approach keto. Done correctly, it might be just what the doctor ordered. I encourage any woman who’s dealing with other hormonal issues to work with a medical practitioner to tailor a keto diet to her unique needs.
But I’m Telling You, Keto Made My Period Go Haywire!
Ok, I believe you, really! But changes do not necessarily equal dysfunction. It is normal to experience hormone fluctuations when you make a massive—or even a relatively small but important—shift in your nutrition. Sometimes those fluctuations are unpleasant or unwanted, such as a period that lasts 14 days or one that arrives a week before you planned while you’re on vacation. However, that doesn’t make them bad from a health perspective. We need to respect that our bodies are dynamic systems. Changing the input will invariably change the output, and the system might need a few months to adapt to a new normal.
If your cycle goes wonky but you’re otherwise feeling good, give it a few months to sort itself out. If after a few months it’s still all over the place (or definitely if you’re having other disruptive symptoms), enlist help. In the meantime, check to make sure you’re not short-changing yourself nutritionally or calorically. Scale back on fasting efforts, and consider shifting more toward a traditional Primal way of eating.
At the end of the day, if you go keto and experience negative effects, stop. Keto is super hyped right now, but if your body is sending you clear signals that keto is not a good approach for you at this time, don’t do it. You can always try again later. It might be that your first attempt at keto didn’t work, but with a few adjustments and some experimentation over time you can find a version of keto that works for you.
Thanks for reading, everyone. Do you have comments, questions, or feedback? Let me know below.
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Fontana R, Della Torre S. The Deep Correlation between Energy Metabolism and Reproduction: A View on the Effects of Nutrition for Women Fertility. Nutrients. 2016;8(2):87.
Klok MD, Jakobsdottir S, Drent ML. The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obesity Reviews 2007;8(1):21-34.
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TAGS:  hormones, Hype, Keto, women’s health
About the Author
Lindsay Taylor, Ph.D., is a senior writer and community manager for Primal Nutrition, a certified Primal Health Coach, and the co-author of three keto cookbooks.
As a writer for Mark’s Daily Apple and the leader of the thriving Keto Reset and Primal Endurance communities, Lindsay’s job is to help people learn the whats, whys, and hows of leading a health-focused life. Before joining the Primal team, she earned her master’s and Ph.D. in Social and Personality Psychology from the University of California, Berkeley, where she also worked as a researcher and instructor.
Lindsay lives in Northern California with her husband and two sports-obsessed sons. In her free time, she enjoys ultra running, triathlon, camping, and game nights. Follow along on Instagram @theusefuldish as Lindsay attempts to juggle work, family, and endurance training, all while maintaining a healthy balance and, most of all, having fun in life. For more info, visit lindsaytaylor.co.