The ketogenic, or “keto,” diet—a high-fat, relatively low-carb lifestyle that has taken the diet world by storm—has been related to weight reduction and other health benefits, but it may also have an unusual impact on your time. Some women on the keto diet experience erratic cycles, while others claim that their menstrual cycle has totally disappeared (called amenorrhea) after taking keto.
In fact, it seems to be right up there with weight loss as one of the major side effects of the diet. Research released in Epilepsia showed that 60 per cent of research participants indicated a lack of weight due to diet, while 45 per cent of female participants have reported menstrual disorder.
“Deficiencies in nutrient levels could lead to the abnormal menstrual cycle, and after the diet that cuts down major macro-nutrients could lead to a gap in the nutrition of a woman,” said registrar of dietitians Crystal C. Karges, MS, RDN and IBCLC.
To see how the keto diet can effect your span of time, we spoke to experts on the subject to make you understand what kind of effect the low-carb and high-fat diet strategy will have on your body. Below are several key points that you would like to bear in mind.
The Reason for a Keto Diet Can Mess With Your Period
What’s giving? It may be the result of a sudden weight loss. “If someone cuts too many calories, the cycle of irregularities can develop,” says Kristen Kizer, RD, of the Houston Methodist Hospital in Texas.
Remember, though, that this can occur in any diet, not just keto, although keto has been shown to result in extreme weight loss. Research published in the journal Endocrine found a low-calorie version of keto for one year, with most research participants losing at least 10% of their original body weight. Keto diet can result in rapid weight loss because it allows the body to burn fat instead of carbohydrates by a mechanism called ketosis.
John Thoppil, MD, a board-certified obstetrician-gynecologist with River Place Obstetrics and Gynecology in Austin, Texas, says low carbohydrate consumption has sometimes been connected with disturbed times, but says much of the data is observational or comes from limited trials. He accepts the shifts in your time are possibly due to weight loss and not to keto directly.
How does the diet of Keto influence the hormones?
Irregular or vanishing cycles can be traced back to hormonal shifts. “To have a normal period, you need to have a pulsatile release of hormones from the brain,” says Dr. Thoppil. “Any kind of stressor—weight loss or a lot of exercise—may affect that pulsatile release that has to happen for this normal hormonal release choreography that allows you to have regular menses.” A report published in the Journal of Obesity and Weight Loss Therapy in September 2018 states that keto has disturbed women’s hormonal systems.
One of the major hormones at stake here is the oestrogen, which is responsible for regulating the menstrual cycle. As weight decreases, so do the amounts of oestrogen, says Luiza Petre, MD, a licenced cardiologist and diet specialist based in New York City. According to a study published in Breast Cancer Science, as women lost an average of 17 pounds, their oestrogen hormone estrone levels decreased by 5.7% and the oestrogen hormone estradiol decreased by almost 10%. The authors of the study state that weight loss due to calorie restriction and exercise substantially reduced oestrogen levels.
Another hormone that appears to be interfering with period regularity is the gonadotropin-releasing hormone (GnRH). GnRH is a signal for the pituitary development of follicle-inducing hormone (FSH) and luteinizing hormone (LH) which are responsible for stimulating ovarian production of oestrogen and progesterone and hence ovulation.
Changes in body structure (such as those resulting in weight loss due to keto diet or other diet) can change GnRH levels, according to an article published in Endotext in March 2016.
Disruption of GnRH induces decreased oestrogen, which may interrupt ovulation and lead to amenorrhea.
How worried should you be if Keto ends up influencing your menstrual cycle?
Decreasing levels of oestrogen can be a cause for concern. “Low oestrogen levels have some side effects that go along with that, [such as] vaginal dryness, but the long-term health concern would be an increased risk of bone loss,” says Dr. Thoppil. According to the Mayo Clinic, osteoporosis is a known amenorrhea condition. In order to protect the bones, he also suggests a natural oestrogen supplement to patients. Estradiol (estrace) is an example of a natural oestrogen supplement.
Of course, low oestrogen levels and missed periods can also affect fertility. But, “If you’re not worried about getting pregnant, then ovulation is not the end of everything, from a pure health point of view [it’s not much to worry about],” says Thoppil. If you have had normal periods previously and proceed to see abnormalities for three to six months, the doctor will be recommended to see you.
How to get your menstrual cycle back to normal in Keto?
Thoppil says that most people have a threshold, a “happy weight,” where they will resume regular periods. He admits that this is very individual and may involve a little trial and error. “The first thing I’d do is try to increase my weight a little and see if that helps,” he says. Perhaps that means raising the calorie consumption by 250 calories a day or toning down the high-intensity exercises. “For some, five pounds would make a difference and give the menses back,” Thoppil says.
Dr. Petre recommends keeping close to the highest number of carbohydrates you can eat each day while preserving ketosis (which is different for all, but typically between 20 and 50 grammes). Or she says to consider ketocycling, which involves keeping your body in ketosis for five days, followed by two days of higher carbohydrate intake.
How long it would take to get back to normal depends on where you set the threshold weight. “It could be as soon as the next month,” Thoppil says. “But the body of everyone is different in how they respond and what they need for adequate nutrition.”
Why Keto Will Make Cycles Return?
Interestingly, much like progress in ketoing may cause the cycle vanish, the opposite can also be true: overweight people who lose weight through ketoing may find cycles returning. “Weight gain often leads to ovulation difficulties,” Thoppil says. “There are probably people who are resuming menses because they are ketogenic.” In fact, he says that there are probably as many people who fall into this camp as those who lose their period.
The Last Word of Caution About Keto and Your Time
Bear in mind that the diet could not be at all to blame. Missed cycles can be a symptom of a significant health problem, such as hormonal dysfunction, developmental anomalies, or polycystic ovarian syndrome (PCOS), according to the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Kizer claims that skipping your cycle—on keto or otherwise—is a legitimate excuse to see your doctor.
