How To Use the Ketogenic Diet to Conquer PCOS-Related Fertility Issues
For women with PCOS, fertility can be an up-hill battle. With so many experts talking about how to fight PCOS, it’s hard to know just who to listen to.
Plans work for a week or a month, but as results diminish, it is easy to lose faith. With every failure, our fertility drifts a little further away and we are left feeling like nothing will ever help.
We try cleanses where subsisting on green juice and bone broth for three to five days only to gain back any loses in mere minutes. Working out is great for muscle growth and stamina, but weight loss is slow and at times, it makes us more hungry than we were on days we didn’t work out.
As days turn into months, the more drastic options like weight loss medications and surgeries look more and more appealing.
But maybe the answer is as simple as understanding what causes the body to go haywire and then finding a way to reverse it. It could be as simple as understanding how insulin affects PCOS and weight gain, and then finding a way to shut off insulin production so the body then feeds off its own fat. Wait, is that a real thing? Sound too good to be true? Let’s break this down.
What is PCOS?
Polycystic Ovary Syndrome (PCOS) affects 10% of women of a childbearing age and is the most common endocrine disorder among them. PCOS is characterized by hormonal imbalances in the body and is marked by excess testosterone which includes really fun things like excess body hair, irregular and heavy menstrual cycles, and sometimes, infertility.
It is also associated with insulin resistance, central obesity, type 2 diabetes, ovarian cysts, sleep apnea, and hyperinsulinemia.
Obesity can have an adverse effect on fertility. This is an especially relevant issue for those women suffering from PCOS who have a dual struggle with weight gain as the dangerous cycle of insulin sensitivity makes it difficult for women to maintain weight, much less lose it.
Some women with PCOS also stop ovulating as a result of a metabolic system gone wild and, as we know, ovulation is the first critical step in becoming pregnant.
Polycystic Ovary Syndrome (PCOS) affects 10% of women of a childbearing age and is the most common endocrine disorder among them.
What is the Ketogenic Diet?
The Ketogenic Diet (often shortened to “Keto”) is a high-fat, low-carb diet that is very similar to the wildly popular Atkins Diet. You reduce carbs to a very low level (20 grams or less) and replace them with fats, which puts your body into a metabolic state called ketosis. Ideally, this turns the body into a “fat-burning machine,” (yes, please!) burning fat for fuel instead of glucose (sugar).
It is important to note you will want to prioritize monosaturated and saturated fats over polyunsaturated fats.
Ketones, small fuel molecules in the body, are used when blood sugar (from carbohydrates) are in low supply. With no available carbohydrates to burn for energy, the body burns fat instead. This is why the Ketogenic Diet has been shown to reduce weight quickly and drastically, especially in those areas we want to see it the most, the abdominals, hips, and thighs.
Benefits of the Ketogenic Diet for Increasing Fertility
All of those yummy carbohydrates we eat stimulate insulin production. Those with PCOS usually have the extra misfortune of insulin sensitivity or resistance where the body keeps making insulin because it is not properly used and then it just sort of meanders around inside of you, wrecking all sorts of havoc (like weight gain).
Fat, on the other hand, has zero effect on insulin. The body does not create insulin when fat enters the body; it just stays the same. So, eating fewer carbs will lower the amount of circulating insulin in the body, thus less fat stored in the adipose cells which means a leaner body and reduction in weight.
This weight loss reduces insulin levels and can also help women who are not ovulating regularly regain healthy ovulation which improves fertility.
Excessive free insulin has been shown to increase the amount of testosterone produced by the ovaries. By reducing free circulating insulin in the body, many of the symptoms of PCOS are removed or lessened (like the all too fun extra furriness and extreme periods), and this works toward greater hormonal balance and weight reduction making the body a better place for a baby overall.
In fact, in one study, eleven women diagnosed with PCOS followed a ketogenic diet for six months found immense success. At the end of six months, the women lost an average of 12% of their body weight and reduced their fasting insulin by more than half!
The great fertility news is the diet also improved sex hormone levels and two of the women were able to conceive despite a past of infertility. This is what we call the proof in the ketogenic pudding.
What do you eat on a Ketogenic Diet?
Like Atkins, you predominately eat a diet based on fats, proteins, vegetables, and minimal full-fat dairy, as low or non-fat dairy has shown an opposite effect in women with PCOS. Trust me, full-fat dairy tastes way better.
Your aim is to eat no more than 20 grams of carbohydrates per day (but some people start by limiting their carbs to 40-50 grams first and then wean themselves off slowly). The lower in carbs you go, the more drastic and immediate the weight loss and hormonal regulation.
Olive oil, coconut oil, and (gasp!) butter are all on the approved list. In fact, about 70% of your calories should come from fat. Yes, you get to eat real butter again!
Meats like pork, beef, chicken and turkey give you protein for energy. Here’s the great news: you can enjoy fatty pieces of steak like T-bones and ribeyes. You can even enjoy fish and seafood since they have those great, heard-to-get Omega 3’s.
3. Full Fat Dairy
Embrace your inner French man or women and enjoy the pleasures of full-fat (or as I like to call it, real) cheese again. You can also enjoy cream and eggs as well.
4. Fruits and Vegetables
You will want to focus on vegetables that grow above the ground like spinach, broccoli, tomatoes, avocados, zucchini, and beans to name a few. While many fruits are off limits, you can enjoy moderate amounts of fiber-full berries like raspberries, blueberries, blackberries, and strawberries.
5. Miscellaneous Healthy Fats
Some of the best snack foods with excellent, heart-healthy fat include olives, avocados, seeds, and nuts.
With so many yummy options to choose from, you won’t even miss these foods to avoid:
- Fruits (other than those mentioned above)
- High-carbohydrate vegetables like potatoes (all varieties) and other root vegetables
- Breads and pastas
- Processed Foods
- Sugary foods like cereals, cookies, and baked goods
- Soda and Juices
Additional Health Benefits of a Ketogenic Diet
Not only does a Ketogenic Diet help you lose weight, it has also been shown to improve your body in several other ways as well. Things like mental clarity, healthier cells, and cancer-prevention are some of the great “side effects” of a ketogenic diet.
1. Improves Brain Health
Fat has neuroprotective and neurotherapeutic which means it protects and heals your brain cells. It also lowers inflammation which makes running, dancing, and just breathing easier. Many people remark that not only does their body work better when they enter ketosis, but they have more mental clarity and improved cognition and are no longer experiencing “brain fog” which is common with many diets. It has also been shown to reduce migraine frequency and intensity.
2. Reduces Metabolic Conditions
As one of the major benefits of nutritional ketosis is correcting insulin, it’s no wonder that it’s used to fight obesity, metabolic syndrome, and diabetes for everyone. Ketosis has been shown to make steady improvements in several symptoms of metabolic syndrome like abdominal obesity, high blood pressure, elevated triglycerides, elevated blood sugar, and low LDL cholesterol.
Nonalcoholic fatty liver disease (NAFLD), which is strongly associated with diabetes and metabolic syndrome, is also helped by a ketogenic diet. In one study, obese men with NAFLD showed significant improvements in weight, blood pressure, liver enzymes and liver fat within four short months of adopting a ketogenic diet.
3. Cancer Prevention
Fight cancer with keto! There are an estimated 1.6 million new cancer cases diagnosed each year and nearly 600,000 deaths from cancer each year. More and more researchers and doctors are starting to believe that cancer is a mitochondrial and metabolic disease, meaning it is affected by poor diet and toxic environments (which makes sense, right?). It is believed that cancer needs insulin to flourish and by drastically reducing carbs and proteins (both of which stimulate insulin production, though protein at a much lower level), cancer cells are starved and unable to reproduce or survive.
4. Optimizes Mitochondrial Health
Mitochondria are little powerhouses that live in the cells and generates nearly all the energy you need to survive. When large groups of them stop functioning, disease (specifically the neurogenerative type) is introduced into the body. A ketogenic diet rich in dietary fats (be sure to pick heart-healthy fats predominately) contains fatty acids critical to the forming of cellular membranes creating stronger and healthier cells. This leads to more energy and greater resistance to disease and all the energy you would need to climb Kilmanjaro, or maybe just to finish that cycling class. Still, more energy and stronger cells improves total health overall.
How do I know if I am in Ketosis?
One of the easiest ways to know if you are in ketosis is to test bodily functions with urine strips, blood ketone meters, or breath ketone analyzers. Other ways to test are as simple as asking yourself a few questions:
- Am I experiencing dry mouth?
- Am I experiencing excessive thirst?
- Am I experiencing increased urination?
- Does my breath smell fruity or like nail polish remover?
- Am I less hungry?
- Do I feel like I have more energy?
If you are answering “Yes!” to one of more of these questions, it is very likely you are in ketosis and have stoked the fires of your fat-burning furnace—Good Job!
How else can I improve fertility?
I believe that to be successful, you should optimize on anything you think can help. So, another way to increase fertility is by giving the body the essential nutrients and vitamins that are especially necessary for healthy conception.
Essential herbs like Ashwagandha help to reduce stress and cortisol levels,
Black Cohosh to increase progesterone levels for healthy ovulation, and Stinging Nettle to nourish the uterine lining and support reproductive health in men and women. The addition of Para-aminobenzoic acid (PABA), among other key compounds, is promising as in one study it lead to a successful pregnancy in 75% of the women involved. Taking two supplements per day in conjunction with a ketogenic diet to increase fertility is just an additional way you can boost your health and fertility.
Who should avoid a Ketogenic Diet?
Sadly, the Ketogenic Diet is not meant for everyone. The following people may need to adapt the diet or may want to avoid it:
- People taking diabetes medication
- People taking medications for high blood pressure
- Women who are breastfeeding