Researchers from Malaysia’s National Institute of Health have explored how the ketogenic diet may influence hormonal balance in women diagnosed with polycystic ovary syndrome (PCOS). The work suggests that reducing carbohydrate intake and elevating fat consumption can shift the body into ketosis, a metabolic state where fat becomes the primary energy source. In this context, the diet appears to modulate testosterone levels and could potentially support reproductive outcomes. The study appears in the Journal of the Endocrine Society.
PCOS is a common endocrine disorder characterized by higher-than-normal testosterone production, which can disrupt ovulation and complicate attempts to conceive. Additional metabolic features frequently observed with PCOS include insulin resistance and higher body weight, both of which can further impact fertility. Medical guidance often emphasizes lifestyle approaches, including weight management and dietary modification, as foundational elements of PCOS care.
In the current analysis, investigators synthesized data from seven studies involving women with PCOS who adhered to the ketogenic diet. Ketosis results from substantially lowering carbohydrate intake while increasing fat intake, prompting the body to use fat stores for energy and, over time, supporting weight loss and metabolic change. This synthesis aimed to identify consistent patterns across multiple trials rather than relying on a single study.
One of the lighter findings across the pooled data indicated that women with PCOS who followed a ketogenic pattern for at least 45 days tended to lose an average of about 11% of their body weight. While weight loss alone can positively affect hormonal balance and reproductive function, the broader metabolic context matters. Some participants also demonstrated reductions in circulating testosterone levels, a shift that may influence ovulatory function in several ways. The ratio of pituitary luteinizing hormone to follicle-stimulating hormone, a marker linked to ovarian activity, showed improvements in certain cohorts, suggesting the possibility of enhanced ovulatory readiness in some individuals. These observations add to a growing body of literature examining how dietary strategies can modulate ovarian physiology in PCOS. (Journal of the Endocrine Society)
Nevertheless, even with potential benefits, any low-carbohydrate eating plan carries important considerations. Diets high in fat and animal protein can have implications for cardiovascular health if not well planned, particularly when nutrient quality and fat sources are not carefully chosen. The balance of potential reproductive benefits with cardiovascular and metabolic risks remains an active area of investigation. Clinicians stress the need for personalized medical supervision, especially for individuals with preexisting conditions or those planning pregnancy, to ensure that energy, nutrient adequacy, and long-term safety are maintained. Ongoing research is needed to clarify which subgroups of women with PCOS may derive the most benefit, the optimal macronutrient balance, and how long interventions should be continued to support sustained improvements in fertility and metabolic health. (Journal of the Endocrine Society)
As the science evolves, early indicators emphasize individualized approaches rather than one-size-fits-all prescriptions. Healthcare providers typically integrate dietary guidance with other proven strategies, including physical activity, sleep optimization, and, when appropriate, medical therapies targeted at supporting ovulation and glucose regulation. For women with PCOS who are considering a ketogenic approach, a thorough assessment of goals, risks, and monitoring plans is essential to ensure that changes support both reproductive health and overall well-being. (Journal of the Endocrine Society)
In broader fertility discussions, age remains a factor for many couples. While attempting pregnancy after 35 can involve additional considerations, modern fertility care emphasizes evidence-based steps, personalized risk assessment, and supportive counseling as parts of a comprehensive plan. By aligning lifestyle interventions with medical guidance, individuals can pursue informed choices about diet, health, and family planning. (Journal of the Endocrine Society)