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COLUMBUS, Ohio – Could the right diet actually kickstart reproductive health? For women struggling with irregular or absent menstrual cycles, the popular ketogenic diet might offer an unexpected solution, according to researchers from The Ohio State University.

In a striking discovery published in PLoS ONE, researchers found that women who followed a keto diet or took ketone supplements experienced significant changes in their menstrual cycles – including the restart of periods that had been absent for over a year. Even more remarkably, one 33-year-old participant experienced her first-ever period after just five days on the diet.

“There were six women who hadn’t had a period in over a year– who felt like their typical cycles were over. And their periods actually restarted on the diet,” says Madison Kackley, the study’s lead author and research scientist at Ohio State, in a media release.

What is a keto diet?

The ketogenic diet, often called “keto” for short, is a low-carbohydrate, high-fat eating plan that changes how the body fuels itself. Instead of using glucose from carbohydrates as its primary energy source, the body switches to burning fat and producing ketones – a state known as “nutritional ketosis.”

The small but significant study followed 19 healthy but overweight women with an average age of 34. Researchers divided them into three groups: some followed a ketogenic diet alone, others combined the diet with ketone supplements, and a control group followed a low-fat diet. To ensure accuracy, the research team provided all meals throughout the six-week study period.

The results were remarkable: 11 out of 13 women who achieved nutritional ketosis reported changes in their menstrual cycles, either in frequency or intensity. This effect appeared to be independent of weight loss, as women in all groups lost similar amounts of body fat. Notably, the only participants who didn’t experience menstrual changes were taking oral contraceptives.

Ketogenic diet Ingredients for keto diet High good fat healthy food Ingredients for healthy foods selection Balanced healthy ingredients of unsaturated fats for the heart and blood vesselsKetogenic diet Ingredients for keto diet High good fat healthy food Ingredients for healthy foods selection Balanced healthy ingredients of unsaturated fats for the heart and blood vessels
The ketogenic diet, often called “keto” for short, is a low-carbohydrate, high-fat eating plan that changes how the body fuels itself. (© ShStock – stock.adobe.com)

While the study’s sample size was modest, its findings could go on to help countless women worldwide. An estimated 5-7% of American women of reproductive age go without periods for three months or longer each year, a condition that can be both distressing and medically concerning.

“This research is incredibly important because there are so many unanswered questions for women,” Kackley says. “We’re trying to change things for women and give them some control – something we historically haven’t had over our reproductive status.”

The researchers theorize that ketones might play a crucial role in regulating women’s hormonal health, going beyond their traditional role as an energy source. This could open new doors for treating various women’s health conditions, including polycystic ovary syndrome, perimenopause, and postpartum depression – all areas that Kackley’s lab is currently investigating.

Looking ahead, Kackley’s team is working to understand exactly how ketones influence menstrual cycles. They’re conducting comprehensive monitoring of women’s bodies throughout their cycles, tracking everything from muscle strength and fat composition to hormone levels and body temperature – data that, surprisingly, has never been collected in this way before.

While more research is necessary to fully understand the connection between ketones and menstrual health, this initial study suggests that the ketogenic diet might offer more benefits than just weight loss. For women struggling with irregular or absent periods, it could provide a potential dietary approach to regaining control over their reproductive health.

However, as with any significant dietary change, women should consult with their healthcare providers before starting a ketogenic diet, particularly if they have underlying health conditions or are taking medications.

Paper Summary

Methodology

This study followed a controlled dietary intervention comparing the effects of a ketogenic diet (KD) with a low-fat diet (LFD) in overweight and obese pre-menopausal women. Participants were randomly assigned to one of three groups: KD with ketone salts (KD+KS), KD with a placebo (KD+PL), or the LFD. Each diet was hypocaloric, meaning it provided fewer calories than the participants’ baseline energy needs to promote weight loss. Meals were precisely prepared in a metabolic kitchen to control the exact macronutrient content and ensure consistency across the study.

The KD included low-carbohydrate, high-fat foods, while the LFD included higher carbohydrate and lower fat intake. Over six weeks, participants attended bi-weekly visits for body measurements and blood tests to monitor weight, body composition, blood markers, and self-reported menstrual changes.

Key Results

Both the KD and LFD groups achieved significant weight loss, averaging around 7 kg (15 lbs) with reductions in body fat and improvements in insulin sensitivity and blood lipid levels. Women on the KD reported notable changes in their menstrual cycles, with some regaining menstruation after more than a year of absence. The LFD group did not report any menstrual changes, suggesting a unique effect of the KD on menstrual health independent of weight loss.

Study Limitations

One limitation of this study was the reliance on self-reported menstrual changes, which can be subjective. Additionally, the lack of specific hormone tracking (e.g., estrogen, progesterone) means it is unclear which biological factors drove the menstrual changes. The short study duration (six weeks) also limits the ability to generalize these findings to long-term effects, particularly in women with different metabolic or reproductive profiles.

Discussion & Takeaways

The findings suggest that a ketogenic diet may uniquely influence menstrual health in ways that go beyond the effects of weight loss alone. For some women, reducing carbohydrate intake and achieving nutritional ketosis may help restore regular menstrual cycles or impact menstrual characteristics like frequency and intensity. The study provides insights into dietary impacts on reproductive health, highlighting the potential for individualized dietary recommendations, especially for women dealing with conditions like polycystic ovary syndrome (PCOS) or irregular cycles.

Funding & Disclosures

This study was funded by Metagenics, Inc., which supplied the ketone supplements used in the KD+KS group. While the sponsor contributed to the study design, it did not influence data collection, analysis, or reporting. One researcher, Jeff S. Volek, disclosed financial interests, including royalties for low-carbohydrate nutrition books and a consulting role with Virta Health, Inc., but no other authors reported conflicts of interest.



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