Effects of Ketogenic Diet on Reproductive Hormones in Women With Polycystic Ovary Syndrome

Abstract

Context Ketogenic diet has recently made a comeback as a part of lifestyle and dietary modifications in patients with polycystic ovary syndrome (PCOS). Despite studies suggesting its beneficial effects in reversing hormonal imbalance in women with PCOS, evidence has been patchy and derived from small populations under varying conditions. Objective To pool evidence from clinical trials to study the effects of ketogenic diet on reproductive hormones (LH/FSH ratio, free testosterone, serum progesterone) and observe evidence of weight change. Methods PubMed, ScienceDirect, Scopus, and Web of Science core collection were searched for clinical trials evaluating the effects of ketogenic diet in established PCOS women consistent with the Rotterdam classification. Single- or double-arm studies that included an outcome of interest were included. Two investigators worked independently to screen potential articles and a designated investigator extracted data on study characteristics and evaluated the outcomes. Data were pooled using a random-effects model. The quality of selected studies was assessed using the Cochrane Risk of Bias Tool. Results Following ≥45 days of intervention with ketogenic diet among women with PCOS, significant improvement was observed in reproductive hormone levels, with reduced LH/FSH ratio (d −0.851; 95% CI −1.015, −0.686; P < .001), reduced serum free testosterone (d −0.223; 95% CI −0.328, −0.119; P < .001), and an increased in serum sex hormone binding globulin (SHBG) (d 9.086; 95% CI 3.379, 14.792; P = .002). Significant weight loss was unanimously observed in all included studies (d −11.56; 95% CI −14.97, −8.15; P < .001). Conclusion Short-term ketogenic diet potentially improved hormonal imbalances commonly associated with PCOS.

High Fat Diet and Polycystic Ovary Syndrome (PCOS) in Adolescence: An Overview of Nutritional Strategies

“…The authors concluded that VLCKD could improve metabolic and ovulatory dysfunction in patients with PCOS [95]. A recent review conducted by Khalid et al has confirmed the data just described, highlighting how a short-term ketogenic diet potentially improved hormonal imbalances commonly associated with PCOS [99].…”

“…Among the different types of KD studies, VCKD can be considered an effective dietary intervention for the short-term treatment of patients with PCOS, as it rapidly leads to weight loss, with improvements in body composition and metabolic profile [94,96]. Specifically, the high-fat nutritional protocols proposed in the literature (such as KD) appear to provide benefits to patients with PCOS in terms of weight loss and control of metabolic parameters such as IR, glucose metabolism, lipid profile, and hormonal homeostasis [94,97,99]. Among the different types of KD studies, VCKD can be considered an effective dietary intervention for the short-term treatment of patients with PCOS, as it rapidly leads to weight loss, with improvements in body composition and metabolic profile [94,96].…”