Food Freedom Ecition 195 - Women & Keto

Ketosis is a metabolic state of greater ketone production and enhanced fat burning. Along with those extra ketones come a plethora of health benefits. For women, however, ketosis can sometimes trigger a range of unpleasant side effects. This makes many women think twice about jumping on the keto bandwagon.

From menstrual irregularities to excess weight gain, it can seem like keto is messing with female hormones. However, much of it depends on your health and eating patterns. There are ways to troubleshoot the ketogenic diet for women so they can safely reap all the benefits.

About Ketosis

When your body is not getting enough glucose to make energy, it starts to burn fats instead. The result of this is a buildup of molecules called ketones. Having more ketones in your body is known as ketosis. The mitochondria in your liver produce these ketones mostly to fuel your brain. Other organs including your muscles and heart can run on ketones when necessary.

Ketosis evolved to help humans thrive in times of starvation. In modern times, there is no need to starve to get into ketosis. Simply restricting carbs to below 50 grams per day is enough to put you in this metabolic state. This is the foundation of ketogenic diets combined with a higher fat intake to keep you feeling full and energized. 

Being in ketosis provides benefits beyond mere fat-burning:

·       Improved cardiovascular health

·       Control type II diabetes

·       Treat epilepsy

·       Reduce cancer risk

·       Treat PCOS

·       Treat brain diseases

·       Reduce acne

There's also ample evidence that keto increases mental and physical performance. To many, keto may seem like the next magic bullet but it is not all unicorns and rainbows. Side effects on a ketogenic diet do happen, and women can find this diet especially difficult to stick to.

Hormones & Nutrition

Ketosis for women can be tricky because any change in nutrients has a profound effect on female hormones. The delicate balance of sex and reproductive hormones is closely tied to a woman's overall health. Any disruption in this balance is bound to cause trouble. Female sex hormones affect health in multiple ways:

·       Estrogen and progesterone affect levels of neurotransmitters, explaining why changes in hormones impact mood, sleep, and mental functioning.

·       Estrogen is a key factor in bone metabolism, and drops in this hormone during menopause increase the risk of osteoporosis.

·       The levels of progesterone in the body affect thyroid hormones.

·       Estrogen protects cardiovascular health and metabolism.

·       Progesterone suppresses the immune system, especially during pregnancy

The balance of these two major female sex hormones is controlled by the pituitary gland, a small gland found in the base of the brain. Lifestyle and diet can also have a strong impact on this balance. Ketosis, in particular, can affect these hormones:

·       Ketosis lowers the levels of insulin, a pancreatic hormone essential for your body to use glucose. Ketosis also increases the levels of leptin, a hunger suppressing hormone.

·       Eating 5% more fat than usual increases estrogen and androgen levels by 12% in women after menopause.

·       Ketosis activates the hypothalamic–pituitary–adrenal axis (HPA axis). The HPA axis refers to the hormonal interaction between the hypothalamus, the pituitary gland, and the adrenal glands.

·       Studies show that fasting, which can induce ketosis, increases the levels of cortisol, a stress hormone. This is. Because the body perceives fasting as a threat.

·       Insulin sensitivity has a profound effect on sex hormone balance. Ketosis can help improve your insulin sensitivity.

Ketosis for Women

The health and integrity of the thyroid gland have an effect on reproductive health. Women with thyroid diseases, for example, often suffer from infertility and progesterone deficiency: Thyroid diseases disrupt pituitary gland functioning, and reproductive and overall hormonal health begin with this gland. 

The thyroid is particularly sensitive to nutritional deficiencies. Studies show that low-calorie diets and ketosis can cause a drop in thyroid hormones (T3) in some people. However, people who eat at least 50 grams of carbs a day don't seem to experience such problems.

Having low levels of certain thyroid hormones also reduces sex hormone binding globulin (SHBG) levels. This leads to ovaries producing more estrogen than necessary, which causes heavy and prolonged periods. In contrast, abnormally high thyroid hormone levels increase SHBG, causing light periods.

Ketogenic and low-carbohydrate diets mimic starvation, and the thyroid gland reacts to starvation by lowering the levels of certain hormones. If this happens to you, then you could try carb cycling or boosting your fat intake. The goal is to give your body enough energy other than carbs to run on and this will help normalize thyroid functioning.

Women on ketogenic diets often notice changes in their menstrual cycle. Some also complain that the diet is not helping them lose weight or that they have gained weight. Does this mean that the keto diet disrupts female hormones and is not suitable for women?

Not really. The ketogenic diet has the same strong effect on male hormones as it does on female. The effects are simply more outwardly noticeable in women. Women experiencing menstrual irregularities and weight gain on keto diets are not necessarily going through these things due to ketosis. Problems could be triggered by:

·       Weight loss – Ketosis often leads to quick weight loss, which is great if you started your keto journey overweight. Studies show that sharp drops in weight cause sharp drops in estrogen. This, in turn, causes anovulation and missed periods.

·       Low fat intake – Eating more fat should boost estrogen levels. However, much of the fat eaten gets used to make ketones. If you are eating too little fat for fear of gaining weight, this can negatively affect your cycles.

·       Insulin resistance – There's ample evidence that changes in sex hormones impact insulin sensitivity . Insulin sensitivity affects the body's ability to utilize glucose. Not being sensitive to insulin can lead to sugar cravings and weight gain.

·       Not being in ketosis – To get into ketosis, you absolutely must make sure you are not eating more than 30 grams of net carbs per day. Otherwise, you run the risk of storing all that extra fat you are eating and causing hormonal disruption.

·       Stress – The keto diet is stressful on your body only initially, which can lead to menstrual irregularities. Once keto-adapted, cortisol levels should drop and periods should become regular. If that doesn't happen, outside stressors can be the problem.

As far as the research on ketosis for women goes, most studies actually show that it improves female health. There multiple studies examining the effects of keto on menstruation, and all show that low-carb diets improve regularity of ovulation and menstruation.

Benefits of Keto for Women

Now that we've covered the potential downsides of ketosis for women, it's time to talk about the benefits. Some women benefit from ketosis more than others. Women who are obese, sedentary, have PCOS, epilepsy, insulin resistance, or other health problems, should definitely consider a ketogenic approach.

Metabolic disorders like obesity, PCOS, and diabetes respond well to ketogenic diets. This is due to ketosis lowering insulin, glucose, and weight. High levels of glucose and insulin and excessive body weight can disrupt the metabolism. These problems are more often than not a result of diets too high in unhealthy carbs and low in beneficial fats.

Ketosis can also normalize menstrual irregularities in women with PCOS. One study shows that after 24 weeks of being on keto, women with PCOS lost weight, had lower testosterone levels, and had balanced female hormones. Even without any metabolic disorders, menstrual problems can occur as a result of excess weight.

Having too much body fat increases estrogen levels. Fat tissue also functions as an endocrine organ with estrogen being produced in fat cells. The more fat one carries, the more estrogen the body makes. Having too much estrogen can worsen PMS symptoms.


If you are a woman experiencing problems on a ketogenic diet, there are some things you can do to change that. Most women following a ketogenic diet experience problems for reasons unrelated to ketosis. Ketosis for women is actually beneficial. There are a few situations where you may want to up your carb intake at least slightly – if you…

·       Are an athlete or highly active – To spare your muscles and boost your metabolism, carbs before and after workouts are important.

·       Have thyroid problems – Both hyper and hypothyroidism can get worse on low-carb diets. Make sure to eat at least 50 grams of carbs per day if you suffer from these issues.

Are pregnant or breastfeeding – a ketogenic approach is not recommended when you are pregnant or breastfeeding. Ketosis can be taxing on a body going through such major changes and possibly harmful to the baby.

Troubleshooting hormonal problems while going keto:

·       Eat more fat – Many challenges women experience on a keto diet are the result of not eating enough fat. Fat is your friend on keto; you absolutely need it to get enough energy and nutrients. If you don't keep your intake at the recommended levels, you'll put your body under immense stress and develop hormonal problems.

·       Eat more carbs – 30 grams of net carbs per day is enough to keep you in ketosis. However, you may need to eat more if you are highly active. Just make sure you are eating some carbs on keto to support normal thyroid functioning.

·       De-stress – Stress raises cortisol levels, and cortisol messes with your hormones and metabolism. When starting the keto diet, you need to keep stress at bay for the diet to work. Get 8 hours a sleep every day, try relaxation techniques, take long walks through the park, or listen to some relaxing music at the end of the day.

·       Exercise – Exercising enhances metabolic flexibility, which is your body's ability to switch to fat burning. It does so by increasing your muscle mass and muscles are efficient fat burners. This tip, obviously, applies if you're sedentary.

·       Maintain a healthy weight – Women need some amount of fat in their bodies for reproductive health. Generally, around 20-30 percent of body fat is the healthy range for most women. If you are underweight or have a low body fat percentage, then that could explain any menstrual irregularities you may be tackling.

In Conclusion

Ketosis for women is safe and can even be beneficial when formulated effectively. Women with metabolic disorders like obesity and PCOS benefit from being in ketosis. Ketosis helps them shed extra body fat and improve metabolism functioning, which, in turn, balances out female hormones.

Women who are highly active, underweight, losing weight rapidly, or not eating enough fats may experience menstrual irregularities on a keto diet. The production of female sex hormones relies on body fat and nutrition. Luckily, there are ways to correct this problem.

By eating enough carbs, not losing too much weight, and keeping stress at bay, you can reap the benefits of ketosis without worrying about your reproductive health. Studies show that keto works for women as well as it does for men. But you have to take the differences between the sexes into account when starting your keto journey.  

Michal Ofer