Keto and Menopause: What to Know

2 years ago7 min read
Last updated: Mar 17 2023

You may have heard the rumors about the relationship status of keto and menopause. Yep, it’s complicated.

Keto and Menopause

In this article 📝

  • Is keto good for perimenopause?
  • The lowdown on the keto diet and menopause
  • Keto and menopause: the bottom line

Menopause is defined as the moment 12 months after the credits have rolled on your last period. The build up to this (AKA perimenopause) usually starts in your forties and lasts into your early fifties. In some rare cases, perimenopause can kick into gear in your late thirties.

At this time, your body stops releasing eggs to be fertilized and your reproductive hormones—namely estrogen and progesterone—slow production.

As your body prepares for this major shift to its next chapter, it may give you some rather loud clues as to where it’s at. From hot flashes to digestive issues to mood swings, a diverse set of players can make up your unique team of menopause symptoms. For some women, symptoms are brief and subtle, for others they are intense and long-lasting. There’s just no one way to do this thing.

If menopause is having a bearing on your day-to-day functioning, you may be on the lookout for lifestyle changes that can make it all more manageable. One option that may help is diet. The research is still young, but it looks as though what you eat may help ease some symptoms.

Enter keto. For some who are looking to control symptoms related to menopause, this popular low-carb diet for menopause seems to provide the answer. For those wanting to manage chronic conditions, it also seems to get some glowing reviews.


But the picture is far from a perfect one. In fact, sometimes keto appears to make symptoms worse, and it can even increase certain health risks.

So, is keto a diet that can harm or heal at this time? Let’s take a look at what we currently know about keto and perimenopause.

Is keto good for perimenopause?

The ketogenic diet, AKA keto, is a low carb, high fat, moderate protein diet. It shares some principles with other popular low-carb diets like Atkins, and has proven to have some well-researched medical benefits, such as the treatment of both diabetes and epilepsy.

The diet is based on the premise that there are two different sources of fuel for your body—the one being glucose, which comes from eating carbohydrates, and the other being ketones, which are made by stored fat. If you deprive your body of glucose through cutting back on the carbs, you can reach what is known as a state of ketosis. This is where your body will start burning fat to provide fuel in the form of ketones.

To make ketosis happen, you rapidly decrease your carbs, focus on your fats, and moderate your protein. This Harvard review breaks it down as about 70–80% fat, 5–10% carbs, and 10–20% protein.

The lowdown on the keto diet and menopause

In recent years, keto rose to fame as a tool for weight loss—and it’s definitely getting points in the popularity department. In this survey of registered dieticians, keto ranked as the most popular diet in the US for 2020.

But it’s not without its controversy. As a weight-loss tool, it can be difficult to maintain. Also, it can be heavy on processed, salty foods, and, as this review suggests, it may come with long-term health risks.

And the link between keto and menopause? Well, we’re just not sure. Let’s dive into the details.

How does keto affect menopause?

The research is young, and the effects of keto on menopause are all over the map. We’ll give you the good with the bad.

  • “Keto flu.” Within a week of starting a ketogenic diet, many people experience some negative side effects. It’s well reported—and its effects look uncannily similar to menopause symptoms. Fatigue, nausea, mood swings, constipation.

    The jury is still out on exactly what causes the keto flu. It could be that you’re going through some sort of detox. It could be an immune response. Or perhaps it’s a change to your gut microbiome.

    Whatever is at the heart of it, it’s not ideal if it’s making your menopause symptoms worse. Luckily, the keto flu tends to pass within a few days, so if you’re wanting to battle through it, it’s possible.

  • Weight loss. We gain weight during menopause—likely because ageing is associated with slowing metabolisms. The average weight gain over the menopausal transition is five pounds. So, for some women, keto can be an option for weight loss.

  • Cognitive function. In very early studies, it seems that a keto diet may have a positive effect on memory, attention, and task-switching.

  • Diabetes. Keto may help in the management of type 1 diabetes by balancing insulin levels—but it’s definitely not appropriate for everyone. While a keto diet might help manage diabetes, it also comes with the risk of diabetic ketoacidosis. This happens when your body breaks down fat too quickly and, for those with type 1 diabetes, it can be potentially life-threatening.

  • Cardiovascular response. The effects here are both positive and negative. As this literature review tells us, keto can have a positive effect on cardiovascular risk factors in the short term by helping reduce cholesterol and manage type 2 diabetes. But it’s not all good news. Because of the high fat content of a ketogenic diet, there could be some negative effects here, too.

  • Cancer. There is not enough research to confirm that a keto diet can help stave off or treat cancers—but there is some potential here. In the future, it may be able to be used as a complementary therapy.

  • Bone health. This 2020 study shows a potentially negative link between bone health and a ketogenic diet.

Does keto increase estrogen?

Because menopause causes a decline in your estrogen supply, upping your estrogen intake seems like the right way to balance things out. Hormone Replacement Therapy (HRT) is one option that can be appropriate for some women.

So can keto do the job? There is some evidence to suggest that there’s a link between estrogen and keto—but it might not offer the results you’re after right now. In the subjects of the study—and, granted, they were mice—there was a marked difference in sex responses to the diet. The evidence proposed that higher levels of estrogen may actually make the diet less effective.

So what about other hormonal effects? Is there anything else that’s important to know?

Does keto mess with hormones?

Again, nothing is really confirmed either way here. Recent research suggests that keto may influence a range of endocrine-related illnesses, from migraines to liver disease to PCOS (polycystic ovary syndrome).

And another hormone-related keto intervention? It may help suppress your appetite by influencing ghrelin—the hunger hormone—and this could contribute to long-term weight loss.

Keto and menopause: the bottom line

Keto during menopause may work for you—but it’s worth proceeding with caution. Like any diet, keto is just not for everyone.

And if you’re not so into the keto idea, but still want to explore some dietary interventions to support you through this time, there are other options. For example, a low-fat, vegan diet may have a positive impact. Check out this study. And for more tips on a healthy menopause diet, head here.

Good luck.