PCOS is a health condition caused by an imbalance of reproductive hormones, according to the U.S. Department of Health & Human Services’ Office on Women’s Health (OWH). This hormone imbalance causes problems in the ovaries, which make an egg that’s released each month as part of your menstrual cycle. When you have PCOS, the egg might not develop the way it should, or it might not be released during ovulation, according to the OWH.

PCOS can cause a range of symptoms, including irregular periods, infertility, excess hair growth, severe acne, and weight gain, per the American College of Obstetricians and Gynecologists (ACOG). As many as four in five women with PCOS deal with weight issues in conjunction with the condition, ACOG says.

People with PCOS often deal with insulin resistance, according to the Centers for Disease Control and Prevention (CDC). This means that the body can make insulin, which helps blood sugar enter the body’s cells to provide energy, but can’t use it effectively. Insulin resistance increases the risk of developing type 2 diabetes. Insulin resistance can also lead to patches of thickened, velvety, darkened skin, a condition known as acanthosis nigricans, and this commonly occurs with PCOS, per ACOG.

So, how does the keto diet factor in here? The keto diet is an eating plan that focuses on minimizing your carbs and increasing your fat intake to get your body to use fat as a form of energy. People on the keto diet usually have no more than 50 grams of carbs a day, but some keto fans aim to have no more than 20 grams a day.

As you may (or may not) know, carbs convert into glucose (sugar) in the body, and insulin is needed to take that sugar to your cells for energy. Limiting your carb intake—like you would on the keto diet—can help relieve the insulin resistance that can occur as a result of having PCOS, but likely only for the short term, says Scott Keatley, RD, of Keatley Medical Nutrition Therapy. However, building lean body mass (read: muscle) and losing weight will help your body manage insulin resistance over the long term, he says.

There is some evidence that suggests a keto diet in particular can help women with PCOS lose weight and manage symptoms. A small study published in the Journal of Translational Medicine in early 2020 had 14 medically overweight women with PCOS undergo a keto diet. After 12 weeks on the diet, the researchers found that the women had a “significant reduction in body weight,” the study states, losing an average of 20 pounds and experiencing a reduction in BMI. They also had a decrease in their glucose and insulin blood levels, along with a decrease in the amount of testosterone circulating in their blood. “Our results suggest that a keto diet may be considered as a valuable non-pharmacological treatment for PCOS,” the study authors concluded.

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