Keto Diet: Friend Or Foe For Women's Health?

The keto diet is a high-fat, low-carb approach to eating that has been linked to weight loss and other health benefits. However, it can also have a strange effect on a person's period. Some women on the keto diet report irregular periods, while others say their monthly cycle vanished altogether. Dramatic changes to your diet can lead to hormonal changes that may influence your menstrual cycle.

Keto and hormonal changes

The keto diet is a high-fat, very low-carb approach that has been linked to weight loss and other health benefits. However, it can also have a strange effect on your period. Some women who follow the keto diet report irregular periods, while others say their monthly cycle vanished altogether. This phenomenon is called amenorrhea and seems to be one of the main side effects of the diet. In some research, 45% of female participants reported menstrual dysfunction.

Dramatic changes to your diet, such as those that the keto diet entails, can lead to hormonal changes that may influence your menstrual cycle. This is because, to have a normal period, you have to have a pulsatile release of hormones from the brain. Any stressor, such as weight loss or excessive exercise, can affect that pulsatile release, causing irregular or absent periods.

One of the main hormones involved in the menstrual cycle is estrogen, which is responsible for regulating it. As weight drops, so do estrogen levels. Another hormone that seems to affect period regularity is the gonadotropin-releasing hormone (GnRH). GnRH is the signal for the pituitary production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which stimulate ovarian production of estrogen and progesterone and, therefore, ovulation. Body composition changes that come with weight loss can alter GnRH levels, and the disruption of GnRH causes reduced estrogen, which can lead to amenorrhea.

Additionally, a low-calorie diet may affect the adrenals, which are located at the top of your kidneys. The adrenals interact with the hypothalamus and pituitary, which are both located in the brain, to keep your hormones in balance. This interaction is known as the hypothalamic-pituitary-adrenal (HPA) axis and is responsible for regulating your stress levels, mood, emotions, digestion, immune system, sex drive, metabolism, and energy levels, among other things. Long-term stress can cause an overproduction of the hormones cortisol and norepinephrine, creating an imbalance that increases pressure on the hypothalamus, pituitary, and adrenal glands, which may eventually lead to HPA axis dysfunction. Symptoms of HPA axis dysfunction include sleep problems, a weakened immune system, and a greater risk of long-term health problems such as cardiovascular disease, stomach ulcers, and mental health conditions.

While the keto diet may cause hormonal changes that lead to irregular periods or amenorrhea, it is important to note that this can happen with any diet that severely restricts calories, not just keto. Additionally, there are individual differences in how people respond to different diets, and what works for one person may not work for another. If you are concerned about any changes in your menstrual cycle, it is important to consult your doctor.

Keto and irregular periods

The keto diet is a high-fat, very low-carb approach that has been linked to weight loss and other health benefits. However, it can also have a strange effect on your period. Some women who follow the keto diet report irregular periods, while others say their monthly cycle vanished altogether. This phenomenon is called amenorrhea.

Irregular or disappearing periods can be traced to hormone changes. "To have a normal period, you have to have a pulsatile release of hormones from the brain," says Dr. John Thoppil, a board-certified obstetrician-gynecologist. "Any sort of stressor — weight loss or a lot of exercise — can affect that pulsatile release that has to happen for this normal choreography of hormone release that allows you to have regular menses."

One of the main hormones involved is estrogen, which regulates the menstrual cycle. As weight drops, so do estrogen levels. Additionally, the gonadotropin-releasing hormone (GnRH) plays a role. GnRH signals the pituitary gland to produce follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which stimulate the ovaries to produce estrogen and progesterone, leading to ovulation. Disruption of GnRH causes reduced estrogen, which can lead to amenorrhea.

If you are concerned about irregular periods or amenorrhea while on the keto diet, there are a few things you can try:

• Increase your weight slightly to see if that helps. This may involve increasing your calorie intake or reducing the intensity of your workouts.
• Stay close to the maximum amount of carbs you can eat each day while still maintaining ketosis. This varies for each individual but is usually between 20 and 50 grams.
• Try keto cycling, which involves keeping your body in ketosis for five days, followed by two days of higher carb intake.
• If irregularities continue for three to six months, consider consulting a doctor.

It is important to note that missed or abnormal periods can be due to various health conditions, so be sure to seek medical advice if your periods are not regular.

Keto and amenorrhea

The keto diet is a high-fat, low-carb approach that has been linked to weight loss and other health benefits. However, it can also have a strange effect on the menstrual cycle of some women. Some women on the keto diet report irregular periods, while others say their monthly cycle vanished altogether—a phenomenon called amenorrhea. Amenorrhea seems to be one of the main side effects of the diet. In some research, 45% of female participants reported menstrual dysfunction.

There could be several reasons why the keto diet might cause amenorrhea. One reason could be the quick weight loss that is often associated with the diet. As weight drops, estrogen levels also drop. Estrogen is responsible for regulating the menstrual cycle, so a decrease in estrogen levels can lead to irregular or absent periods. Another reason could be the disruption of the gonadotropin-releasing hormone (GnRH) due to body composition changes that come with weight loss. GnRH is responsible for signalling the pituitary production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which stimulate ovarian production of estrogen and progesterone, and therefore ovulation. The disruption of GnRH can cause a decrease in estrogen levels, which can lead to amenorrhea.

If keto is affecting your menstrual cycle, there are a few things you can try. Thoppil, a board-certified obstetrician-gynecologist, suggests trying to increase weight a little bit and see if that helps. This could mean increasing your calorie intake or toning down your high-intensity workouts. You could also try staying close to the maximum amount of carbs you can eat each day while still maintaining ketosis, which is usually between 20 and 50 grams. Another option is keto cycling, which involves keeping your body in ketosis for five days followed by two days of higher carb intake. If you've had regular cycles before and continue seeing irregularities for three to six months, it is recommended to see your doctor.

Other considerations

It's important to note that your diet may not be the only factor affecting your menstrual cycle. Missed periods can be a sign of a larger health issue, such as hormone imbalance, genetic abnormalities, or polycystic ovary syndrome (PCOS). Amenorrhea can also have other health implications, such as an increased risk of bone loss and fertility issues. Therefore, it is always a good idea to consult your doctor if you are experiencing any changes in your menstrual cycle.

Keto and fertility

The keto diet is a low-carb, high-fat diet that puts your body into a metabolic state called ketosis. Usually, our bodies burn carbohydrates for energy, but when we restrict carbs, our bodies enter a ketosis state and start breaking down stored fat for energy instead.

The keto diet has been linked to improved fertility in women with polycystic ovary syndrome (PCOS). PCOS is a common hormone disorder in women that can cause infertility, as well as an increased risk of developing diabetes, obesity, and other metabolic health issues. Research suggests that the keto diet may help women with PCOS lose weight, improve fertility, optimize cholesterol levels, and normalize menstrual cycles.

A meta-analysis of clinical trials found that women with PCOS who followed the keto diet for at least 45 days experienced significant weight loss and improved reproductive hormone levels. Their follicle-stimulating hormone ratio was lower, indicating an increased chance of ovulation, and they also had lower testosterone levels, which can help with symptoms of excess male sex hormones, such as excess hair growth.

Additionally, the keto diet has been found to reduce circulating insulin levels, improve hormonal imbalances, and resume ovulation, leading to improved pregnancy rates. This is particularly true for overweight and obese women with PCOS. However, more research is needed to determine the optimal duration and timing of the keto diet for fertility purposes, as well as its effectiveness in non-PCOS-related infertility.

It is important to note that the keto diet may cause spotting, especially in women on birth control. This is likely due to hormonal changes and usually regulates after a few months. If you are experiencing spotting or other menstrual irregularities while on the keto diet, it is recommended to consult a doctor.

Keto and vaginal health

The keto diet is a high-fat, very low-carb approach that has been linked to weight loss and other health benefits. However, it can also have some strange effects on vaginal health. Some women who follow the keto diet report irregular periods or spotting, while others say their monthly cycle vanished altogether – a phenomenon called amenorrhea. In fact, amenorrhea seems to be one of the main side effects of the diet.

Hormonal Changes

Dramatic changes to your diet, such as the keto diet, can lead to hormonal changes that may influence your menstrual cycle. These hormonal changes can also cause an increase in vaginal discharge and odour, a condition known as "keto crotch". While this has not been scientifically proven, it is possible that keto crotch could be a sign of bacterial vaginosis (BV). A high-fat diet may increase the risk of bacterial infections related to BV by encouraging the growth of other bacteria.

Weight Loss

Quick weight loss is another possible cause of irregular periods or amenorrhea. As weight drops, so do estrogen levels. This drop in estrogen can lead to vaginal dryness and an increased risk of bone loss, such as osteoporosis. It can also affect fertility.

Other Health Conditions

Missed or irregular periods can also be a sign of other health conditions, such as hormone imbalance, genetic abnormalities, or polycystic ovary syndrome (PCOS). It is important to see a doctor if your periods are not regular, especially if you have been following the keto diet.

Returning to Normal

If you are experiencing irregular periods or amenorrhea due to the keto diet, there are a few things you can try. John Thoppil, MD, a board-certified obstetrician-gynecologist, suggests trying to gain a little weight to see if that helps. This could involve increasing your calorie intake or reducing the intensity of your workouts. You could also try staying close to the maximum amount of carbs you can eat while still maintaining ketosis, or try keto cycling, which involves 5 days in ketosis followed by 2 days of higher carb intake.

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