Polycystic ovarian syndrome (PCOS) is one of the most common hormonal imbalances experienced by women. It is considered a leading type of endocrine disruption in women in their childbearing years, and has been recognized for over 75 years. Researchers are learning more about PCOS, and have discovered that it often correlates with insulin resistance. PCOS is associated with excess weight, mood swings, and infertility. Estimates for how many women have PCOS are just that, but it may affect up to 21% of women in their reproductive years. The problem is, less than half of women who have PCOS are properly diagnosed, so there are potentially millions of women who have symptoms that they have trouble making sense of. Symptoms may include:
Symptoms are more than just annoying, for PCOS can also cause infertility. In fact, up to 72% of women with PCOS experience infertility, compared to just 16% of women without PCOS. The condition is also associated with higher risk of development of type 2 diabetes, as well as high blood pressure, high cholesterol, heart disease, and metabolic syndrome. The good news is, doctors are learning to recognize PCOS, and there are lifestyle changes that can help with PCOS symptoms. The Ketogenic Lifestyle and PCOS The ketogenic lifestyle centers around a ketogenic diet, which is high in healthy fats (60-80%), adequate amounts of protein (10-30%) and low in carbohydrates (5-10%). This type of eating strategy has been shown to facilitate weight loss. Morbidly obese study subjects have experienced double the rate of weight loss compared to low-fat diet subjects. The keto diet was originally developed for children with epilepsy by Dr. Russell Wilder at The Mayo Clinic in the 1920’s. When an individual obtains the majority of their calories from healthy fats, overtime, the body shifts into nutritional ketosis. In nutritional ketosis, the liver breaks down fatty acids into by products called ketones, which are metabolized for energy rather than glucose. As a result, the body burns fat for fuel more quickly and efficiently. The ketogenic lifestyle has also been linked to reduced “brain fog”, less inflammation and oxidative stress. As a result of these physiological improvements, the risk of chronic disease is reduced. Why might women with PCOS benefit from a ketogenic lifestyle? Since a ketogenic diet limits the release of the fat storing hormone, insulin, it is more effective for weight loss than a low-fat diet. Weight loss in PCOS patients is associated with improvements in symptoms, including fertility. And because the keto diet causes the body to use ketones rather than glucose for energy, it is excellent at combating insulin resistance, which is associated with both type 2 diabetes and infertility. 
The ketogenic lifestyle depends on eating healthy fats and proteins, with limited carbohydrates. Getting Carbohydrate Levels Right How much carbohydrate you’ll need to cut to experience ketosis can very from person to person. A standard ketogenic diet consists of 5-10% carbohydrate or under 40 net carbs (total carbohydrate minus fiber). Some individuals can tolerate higher levels than others, so you will need to experiment a bit to find the level that stimulates fat loss for you. To make the transition easier, we recommend gradually reducing your carbs by cutting your net carbs by half 1 week at a time until you’re eating 40 net carbs or less. This will help your body adapt to the use of ketones vs glucose with less side effects, like low energy and cravings. Fiber and Protein to Combat Insulin Resistance High-fiber vegetables are an important part of the ketogenic lifestyle. Not only do they reduce general inflammation and combat insulin resistance, they digest slowly, so you feel satisfied longer. The amount of protein you need depends on several factors, and there are convenient online calculators that can help you determine how much you need. Your height, weight, age, body fat percentage, and activity levels are other factors that help determine how much protein you need. Healthy fats include polyunsaturated fats, which are found in nuts, fatty fish, and seeds and include omega-3 and omega-6 fatty acids. Unsaturated fats (with the exception of trans fats, which are technically unsaturated, yet unhealthy) are part of a ketogenic lifestyle as well. Olive oil, seafood, and unsalted nuts are good sources of these. And despite the vilification of all saturated fats for decades, we now know that these fats are primarily health promoting. So, include saturated fats like coconut oil, grass-fed butter and ghee, pasture raised whole eggs and mayonnaise into your ketogenic meal plan. A ketogenic lifestyle should also incorporate regular exercise, good sleep habits, and stress management for maximum benefit. Women with PCOS can suffer with anything from mildly annoying symptoms to infertility. The ketogenic diet has actually been shown in clinical studies to increase weight loss, stimulate improved hormone levels, and reduce insulin resistance. Some women with PCOS may have to take medications, but even so, the ketogenic lifestyle is beneficial. If you’re interested in learning more about healthy nutrition, exercise, and other lifestyle improvements, we invite you to contact us at any time.
