Keto Diet and Corresponding Supplements Can Get Disrupted Menstrual Cycles Back on Track

Increasing ketones in the blood through a keto diet or supplements may help to get irregular menstrual cycles back on track or even restart a period that seems to have stopped for good, new research suggests.

In a study comparing weight loss results on low-fat and ketogenic diets with and without the addition of ketone supplements, 11 of 13 premenopausal participants who achieved nutritional ketosis reported at least one change in menstrual frequency, intensity, or both during the intervention. Women on the low-fat diet did not report changes in their periods. All of the women had lost the same relative percentage of weight. Their average age was 34, and all were healthy but overweight.

Keto Diet and its Influence on Menstruation

“Six women hadn’t had a period in over a year and felt their typical cycles were over. And their periods actually resumed with the diet,” said Madison Kackley, lead author of the study and a research scientist and lecturer in human sciences at The Ohio state university. ‘Our hypothesis after these results is that the presence of ketones can help regulate women’s health in terms of endocrine, cognitive and metabolic influences.’ The study was recently published in PLOS ONE.

The ketogenic diet converts fat into ketones, which are used by cells in the body and brain as an alternative to glucose. Dietary supplements also increase ketones in the blood without having to change eating habits. All are designed to put the body into nutritional ketosis – the state of the human body in which it has greater access to ketones as fuel and signaling molecules.

Nineteen women participated in the weight-loss study – seven on a ketogenic diet alone, six on a ketogenic diet combined with ketone salt supplements, and six on a low-fat diet. The researchers provided all of the food for the six-week study. Both interventions resulted in clinically significant weight loss, less body fat, healthier cholesterol levels and better insulin sensitivity. Menstrual history was one of dozens of lifestyle questions researchers asked at biweekly checkups. The participants’ self-reports about their cycles surprised Kackley and her colleagues.

“It’s not a validated survey, but when we checked the answers, we found that most of these women’s cycles did shift. Even for women with normal menstrual cycles, the frequency changed,” Kackley said. ”One of our participants was 33 years old and had never had a period in her life. She got her period for the first time after being in nutritional ketosis for five days.” The two women who reported that their cycles had not changed were taking oral contraceptives. Women who reported changes in their menses were not using contraceptives.

One goal of Kackley’s research program in the future is to explore the findings related to ketone supplementation. While adding keto salts to the diet did not help improve weight or health scores, ketone levels were high in all women on the ketogenic diet—even in the two in whom menstruation did not change. The result suggests an individual effect of added ketones in the blood.

Nutrition, Exercise, and Women’s Health

It was the presence of ketones alone that significantly altered the menstrual cycle. So if we are looking for that signaling effect as opposed to a weight-loss effect, then I think ketone supplementation could indeed play a role in the overall concept of hormone regulation, Kackley said. The researcher is now working to identify the mechanisms that explain this relationship. She has established a new laboratory at The Ohio State University dedicated to exploring the links between diet, exercise, and women’s health.

As part of evaluating and selecting a tool to standardize tracking of research participants’ menstrual cycles in future studies, her team is currently monitoring a pilot group of women for the range of changes that occur between and during periods: muscle strength, fat composition, water retention, energy expenditure, hormone levels, body temperature and more. As far as Kackley knows, this comprehensive data has never been collected before to influence cyclical changes through diet and/or exercise.

She wants to identify interventions that not only help to solve women’s health issues – such as polycystic ovary syndrome, perimenopause and postpartum depression, which her lab is currently studying – but also solve the mystery of menstruation, especially when it is irregular or absent. An estimated 5 to 7% of women of childbearing age each year have no periods for three months.