Fertility problems are common in polycystic ovary syndrome (PCOS). As a hormonal disorder, PCOS may make it more difficult to conceive and may even lead to ovulatory infertility, where the ovaries don’t release eggs on a regular basis.
With PCOS affecting so many, interest in dietary strategies to support hormone health and fertility has grown. This has made the ketogenic diet one of the most talked-about options for managing PCOS symptoms. The Keto diet for PCOS is often promoted as a way to reduce insulin resistance and regulate hormones which may, in some cases, aid in restoring ovulation.
Is the keto diet actually good for PCOS? While some may benefit greatly from nutritional ketosis, others may respond better to a different approach. So, is keto the right choice for you? Let’s look at the science to help determine if this approach is worth exploring.
What is the keto diet?
To understand how keto and PCOS are connected, it’s helpful to first know what this dietary approach actually does. The keto diet shifts your body into a state called ketosis. In ketosis, your body burns fat to keep your energy up instead of relying on carbohydrates.
Ketosis happens when carb intake drops significantly, usually below 50 grams per day. This causes insulin levels to fall and prompts the body to use fat as its primary energy source. Such a shift in metabolism can support fat loss, with some suggesting that it also lends to clearer thinking and more stable energy.
This diet is characterized by very low carbohydrate intake, moderate protein consumption, and high healthy fat. Typical keto-friendly foods include eggs, avocados, leafy greens, cheese, nuts, and fatty fish like salmon and mackerel. Refined carbohydrates like white bread, rice, and pasta, as well as sugar-heavy items, are generally restricted.
How does the keto diet improve PCOS symptoms?
Many people explore the ketogenic diet for PCOS symptom relief, but how exactly does it interact with the hormonal disorder?
Reduce insulin resistance
A core problem in PCOS is that the body no longer responds to insulin as it should. This insulin resistance can cause blood sugar to rapidly move between extreme highs and lows, leading to side effects like constant cravings.
While more studies are needed to fully understand how the keto diet may help with PCOS, current evidence suggests that its ability to lower insulin resistance can improve androgen (male hormone) levels that tend to be elevated in those with PCOS.
In one crossover study, researchers compared a standard diet with a low-carbohydrate diet in women with PCOS. The low-carb diet resulted in lower blood sugar levels, reduced fasting insulin and testosterone, and better insulin sensitivity.
Supports hormonal balance
A review of several clinical trials found that women with PCOS who followed a keto diet for at least 45 days had lower testosterone levels and improved follicle-stimulating hormone (FSH) levels. These hormonal changes ease symptoms such as excess hair growth and anovulation.
They may also help regulate menstrual cycles, as found in another study conducted by the Cleveland Clinic, where women all resumed regular periods after three months of practicing keto.
Helps with weight loss or weight management
For some individuals with PCOS, a ketogenic diet can support weight loss, which by itself can dramatically ease symptoms. One study looked into how low-carb diets like keto affect people with diabetes — a condition characterized by insulin resistance. Participants who stuck with a well-planned ketogenic diet saw better blood sugar control and lost excess weight, suggesting that it may work similarly for weight management in PCOS.
How does the keto diet support fertility?
The benefits described above lay the very foundation that best explains how the keto diet can be good for PCOS, especially when it comes to fertility.
Research shows that about 70 to 80% of women with PCOS struggle to get pregnant. This is often due to irregular ovulation caused by high insulin and testosterone levels. By lowering insulin resistance, balancing hormones, and supporting healthy weight loss, the keto diet is believed to also lead to more regular ovulation and higher chances of conceiving.
The previously mentioned Cleveland Clinic study found that more than half of the participants trying to conceive became pregnant after following a keto diet. In another trial, women with PCOS who were not taking metformin, a common medication for diabetes, achieved a 100% pregnancy rate while on a keto diet. This is notably higher than the pregnancy rates reported in earlier research on the subject.
Other studies justify this connection between the keto diet and fertility. In one article, overweight women with PCOS pursuing fertility treatment followed a keto diet for 12 weeks and saw significant drops in insulin, free testosterone, and body weight.
A more recent review published in 2025 found that very low-carb keto diets were more effective at restoring regular menstrual cycles than other dietary approaches. More consistent cycles indicate healthier ovulation, leading to a greater chance of getting pregnant.
Is the keto diet ideal for everyone with PCOS?
While the research is promising, that doesn’t make it a guaranteed solution that fits every person’s life or needs. While some experience relief from symptoms, others may find the keto diet for PCOS too restrictive or even face health risks if they try it.
For instance, the keto diet’s strict rules are likely not appropriate for people with a history of eating disorders or disordered eating. Those with conditions like pancreatitis, liver disease, or fat-metabolism disorders should avoid it entirely. If you have diabetes and take insulin or certain oral medications, medical supervision is a non-negotiable component of pursuing a keto approach.
Using keto for fertility and PCOS relief is worth considering, but it should be tailored to your health needs and guided by a healthcare provider. Working with a registered dietitian can ensure that you practice keto or any other dietary approach with the necessary balance, oversight, and realistic goals in place.
Want to try the keto diet for PCOS? Do it safely with a Health Loft dietitian
Trying a keto diet for PCOS can sound promising, with research suggesting it may help balance hormones, lower insulin resistance, and even support fertility. However, it can be a highly restrictive way of eating that’s not suitable for everyone. If you’re thinking about giving it a try, it’s best to do so with the guidance of a qualified expert.
Health Loft can connect you with registered dietitians specializing in PCOS who can help you follow a keto approach that’s safe, effective, and tailored to your needs. We’ll work with you to create a PCOS ketogenic plan that supports your health goals while ensuring that your body gets all the nutrients it requires.
We offer convenient one-on-one telehealth sessions, so you don’t have to travel to access expert medical support. Our experts are also in-network with many insurance providers. This means appointments could cost as little as $0 out of pocket.
Make sure you get the right support throughout your journey. Learn how Health Loft can support you along the way.
This article was reviewed by Adrienne DePaul, MS, RDN. It is intended for informational purposes only and does not replace personalized nutritional advice.
