Menopause is a biological process marked by the cessation of menses and a natural decline in reproductive hormones in women. It can be accompanied by symptoms like hot flashes, sleep problems, and mood changes (1).

Modifying your diet under the guidance of a healthcare professional is a simple strategy that may help balance your hormone levels and alleviate certain symptoms of menopause.

In particular, the ketogenic diet is a high fat, very low carb diet that’s often recommended to provide relief from menopause symptoms.

However, it may also be associated with several side effects and not a great fit for everyone.

This article reviews how the ketogenic diet may affect menopausal women.

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Possible benefits

The ketogenic diet may be associated with several benefits, specifically during menopause.

Improves insulin sensitivity

Menopause can cause several changes in hormone levels.

In addition to altering levels of sex hormones like estrogen and progesterone, menopause can decrease insulin sensitivity, which can impair your body’s ability to use insulin effectively (2).

Insulin is a hormone that’s responsible for transporting sugar from your bloodstream into your cells, where it can be used as fuel (3).

Some research suggests that the ketogenic diet may improve insulin sensitivity to promote better blood sugar control (4).

One study found that following a ketogenic diet for 12 weeks improved insulin levels and insulin sensitivity in women with endometrial or ovarian cancer (5).

However, it’s unclear whether the diet would offer similar health benefits for menopausal women without these types of cancer.

Another review reported that reducing carb consumption may decrease insulin levels and improve hormonal imbalances, which could be especially beneficial during menopause (6).

What’s more, studies suggest that insulin resistance may be linked to a higher risk of hot flashes, which are a common side effect of menopause (7, 8).

May prevent weight gain

Weight gain is a symptom of menopause that’s often attributed to alterations in hormone levels and a slower metabolism.

In addition to experiencing a decrease in calorie needs during menopause, some women undergo height loss, which could contribute to an increase in body mass index (BMI) (9).

Although research on the ketogenic diet specifically is limited, some studies have found that decreasing carb intake may help prevent weight gain associated with menopause.

For example, one study in over 88,000 women found that following a low carb diet was linked to a decreased risk of postmenopausal weight gain.

Conversely, following a low fat diet was tied to an increased risk of weight gain among participants (10).

However, it’s important to note that the reduced-carb diets included in this study contained significantly more carbs than a standard ketogenic dietary pattern.

Could help combat cravings

Many women experience increased hunger and cravings during the transition into menopause (11).

Several studies have found that the ketogenic diet may decrease hunger and appetite, which could be especially beneficial during menopause (12).

According to one 95-person study that included 55 women, following the ketogenic diet for 9 weeks increased levels of glucagon-like peptide 1 (GLP-1), which is a hormone that regulates appetite. Interestingly, this increase was observed in the female participants (13).

Similarly, another small study noted that a low calorie ketogenic diet decreased appetite and levels of ghrelin, a hormone that stimulates appetite (14).

However, more studies are needed to evaluate how the ketogenic diet may affect cravings and appetite in menopausal women specifically.

summary

Some research suggests that the ketogenic diet may improve insulin sensitivity, prevent weight gain, and decrease appetite and cravings.

Potential side effects

While the ketogenic diet may offer several benefits for women during menopause, there are some side effects to consider.

Menopause is associated with an increased risk of heart disease (15).

Some studies have associated the keto diet with increased LDL (bad) cholesterol and endothelial dysfunction, which involves a narrowing of the blood vessels on the surface of the heart. Both of these may further increase heart disease risk in menopausal women.

Also, in one small study in healthy women in their 20s, following a ketogenic diet for 3 weeks was associated with a 39% increase in LDL (bad) cholesterol (16).

Though all participants had normal LDL levels at the start of the study, after 3 weeks on the ketogenic diet, 59% had LDL levels higher than the target for the prevention of cardiovascular disease (16).

What’s more, studies including people with high cholesterol, overweight, and obesity have shown decreased blood vessel health after following a ketogenic diet (17, 18).

In one meta-analysis investigating the impact of low carb diets on blood vessel health, researchers found a 1% decrease in flow-mediated dilation, a test of blood vessel health, following at least 3 weeks on a low carb diet (17).

This reduction of flow-mediated dilation is associated with a 13% increased risk of future cardiovascular events like heart attack or stroke (19).

However, some studies have found low carb diets improve other cardiovascular risk factors by decreasing body weight, body mass index (BMI), percent body fat, blood pressure, and triglyceride levels, particularly in individuals with overweight or obesity (20).

Additionally, restricting your carb intake to the low levels required of a ketogenic diet may make it difficult to meet your recommended intakes for certain nutrients.

In one study on the nutritional quality of the ketogenic diet, participants did not meet recommended daily allowances and adequate intakes for calcium, folate, magnesium, manganese, potassium, thiamin, and vitamins D and E (21).

Several studies show people following a ketogenic diet tend to consume less fiber (21, 22, 23).

Fiber is beneficial for gut health, weight management, and immune function, protects against cardiovascular disease, and decreases your risk of type 2 diabetes and certain types of cancers (24).

Research also shows that ketogenic diets tend to contain more saturated fat, which is associated with increased LDL (bad) cholesterol (21, 22, 23).

However, consumption of some other micronutrients, such as vitamins A, B12, C, D, and K, as well as choline and selenium, may increase on a ketogenic diet (21, 22).

The ketogenic diet can also cause the keto flu, which is a term used to describe the set of symptoms that occur as your body transitions into ketosis, a metabolic state in which your body burns fat for fuel instead of sugar.

The keto flu could worsen certain symptoms of menopause, including fatigue, hair loss, sleep problems, and mood changes (25, 26).

Still, keto flu symptoms typically resolve within a few days to a few weeks and can be minimized by staying hydrated and getting plenty of electrolytes (25).

Keep in mind that there’s currently a lack of research on the potential health effects of following a ketogenic diet for long time periods.

Finally, although the diet may result in temporary weight loss, many people often regain some weight back once they resume a normal diet (27).

Be sure to consult a healthcare professional before making any changes to your diet to prevent any adverse effects on your health and ensure that you’re meeting your nutritional needs.

summary

The keto diet may increase LDL (bad) cholesterol and endothelial dysfunction, both of which may raise your heart disease risk. Also, following a keto diet may lead to micronutrient deficiencies, decreased fiber intake, and increased saturated fat intake.

The bottom line

The ketogenic diet may offer benefits for women during menopause, including increased insulin sensitivity, decreased weight gain, and reduced cravings.

However, it may increase certain risk factors for cardiovascular disease and restrict the intake of several important nutrients. What’s more, the keto flu may temporarily worsen symptoms of menopause during your body’s transition into ketosis.

Though the ketogenic diet may work for some women during menopause, keep in mind that it’s not a one-size-fits-all solution for everyone.

Be sure to speak with your healthcare provider, set realistic expectations, listen to your body, and experiment to find what works for you.