Diet and lifestyle changes, along with proper medications, are the prescribed routes to reducing symptoms of polycystic ovary syndrome (PCOS), a common hormonal condition that causes infertility in women. A new study suggests that following a keto diet can enhance fertility, improve weight loss and lower testosterone levels in PCOS patients.

PCOS is a condition in which ovaries produce excessive quantities of androgens, the type of male sex hormones typically found in small amounts in women.

The name PCOS comes from the multiple cysts formed in the ovaries when ovulation fails to happen. These cysts produce high levels of androgens, which interrupt the menstrual cycle. However, not all women with PCOS may develop cysts. PCOS can also occur due to insulin resistance, a condition in which the body does not process insulin correctly, which results in the overproduction of androgens.

Weight gain, excessive hair, male-pattern baldness, skin tags, enlarged ovaries and missed periods are some of the signs of PCOS. Apart from infertility, PCOS can cause complications such as diabetes, hypertension, problems with the heart and blood vessels and uterine cancer.

Although clinical trials have explored the link between the keto diet and PCOS, the latest study is the first to conduct a systematic review of how the diet affects hormone levels.

"We decided to collate all the available evidence and synthesize the findings to allow for a robust conclusion and impact the clinical scene," said Dr. Karniza Khalid, the lead author of the study.

Researchers evaluated data from seven clinical trials and found significant improvements in weight loss, fertility and testosterone levels in women who followed the ketogenic diet for at least 45 days. The findings were published in the Journal of Endocrine Society.

"PCOS is a complex hormonal condition — hyperandrogenism and reduced insulin sensitivity being the hallmark endocrinological features. Induction of physiological ketosis from the keto diet will reduce the circulating insulin level and IGF-1, further suppressing the stimulus for adrenal and ovarian androgen production, hence limiting the level of circulating free androgen in the blood," Dr. Khalid explained.

The keto diet may not be suitable for all, especially for pregnant women, people with eating disorders and issues affecting the liver, pancreas, thyroid and gall bladder.

"(A) few parameters should come into play when planning: age, baseline BMI, gender, baseline health status — (the) presence of kidney and liver impairments — and gut health," Dr. Khalid said.

The team believes the findings will help endocrinologists, gynecologists and dieticians to carefully plan and customize individual diet recommendations for women with PCOS.