Have You Lost Your Period to a Low Carb or Keto Diet?

Have you lost your period to a keto diet?Every time I tweet my concern about women losing their periods to a low carb or keto diet, I get a lot of angry responses.

“It’s purely anecdotal,” men explain to me. “There is no known mechanism, so it must not really be happening.”

Except it is really happening. Ask anyone who works with young menstruating women. Or not menstruating, as the case may be.

“Does a keto diet stop periods?”

A woman’s hormonal system is different from a man’s in that she needs to do a lot more than just be healthy and make a few hormones. A woman’s hormonal system has to make the life-or-death decision of whether there is likely to be an additional 75,000 calories available to safely complete a pregnancy.

If the hypothalamus perceives signals from the environment that food is scarce (or likely to be scarce), then the hypothalamus will make the very sensible decision to switch off reproduction.

Is carbohydrate availability part of the “signal” to ovulate?

What are the dietary signals that the hypothalamus is waiting for? Well, adequate calorie intake for starters. And almost certainly adequate protein intake. And there is reason to believe that the hypothalamus is also waiting for adequate carbohydrate intake for some women.

There is substantial anecdotal evidence from myself and colleagues that some young women develop amenorrhea (lack of periods) on a low-carb or keto diet, even when there are sufficient calories and protein.

Physiologist Professor Anne Loucks says that, when it comes to maintaining menstrual cycles, the hypothalamus is just as sensitive to carbohydrate availability as it is to total calorie availability. She states that pituitary “LH pulsatility is regulated by brain glucose availability” and “may depend specifically on carbohydrate availability rather than energy availability in women, just as it does in other mammals.”

There are a few things to say at this point.

1) This doesn’t apply to men, 2) it probably doesn’t apply to women over 30 or women who have insulin resistance, and 3) it depends on ancestry. In other words, starch signalling may be more important for women descended from agrarian ancestors.

In her book Fragile Wisdom, evolutionary biologist Grazyna Jasienska builds the case that the hypothalamic-pituitary-ovarian (HPO) axis is calibrated to relatively recent ancestry. She calls it “ovarian set point,” which she defines as the ability to ovulate given a particular energy availability.

Like so many things in women’s health, there is almost no research, but one 2003 clinical trial of the keto diet for teenagers found that 45 percent of the female participants lost their periods within six months.

But what if you have insulin resistance?

If you currently have insulin resistance, you may do well on a low-carb or keto diet. Especially if you’re older than 30. You may even regain the periods you’d lost to a high-carb diet.

But step one to reversing insulin resistance is to cut sugar, not all carbohydrate. That’s because high-dose fructose induces insulin resistance more strongly than any other food. According to Dr Richard Johnson:

“There’s a fair amount of evidence that starch-based foods don’t cause weight gain like sugar-based foods and don’t cause the metabolic syndrome like sugar-based foods. Potatoes, pasta, rice may be relatively safe compared to table sugar. A fructose index may be a better way to assess the risk of carbohydrates related to obesity.”

Quitting sugar is the most effective kind of low-carb diet, so please don’t make the mistake of forgoing potatoes only to binge on Paleo desserts.  Read How high-dose fructose is a major driver of insulin resistance.

Is a low carb or keto diet right for you?

Before you start a keto diet, ask yourself:

  • Do you have insulin resistance? If yes, then you may benefit from a short-term low-carb or keto diet but only until you’ve reversed insulin resistance. If no, then a keto diet is probably not the right approach.
  • Do you suffer stress or insomnia or HPA (hypothalamic-pituitary-adrenal) dysfunction? If yes, then be careful because you might need some starch to calm your nervous system.
  • Did your period go “missing in action” on a keto diet? If yes, then you might want to try reintroducing starch for a minimum of four months to see if you can get your period back.

Share your story.

128 thoughts on “Have You Lost Your Period to a Low Carb or Keto Diet?”

  1. I think this is a big short sighted. Everyone doesn’t have the same reaction to starch vs. sugar. I’ve been on a low-carb diet for almost 10 years and I’ve had two children in that time. I’ve never been able to tolerate starch despite not being diabetic, only insulin-resistant. Carbs affect my mood and my IBS. On low-carb/low-starch, my IBS is non-existent, my mood is stable. When I’ve added on carbs, i’ve only been able to tolerate sugar. From what I’ve read, this is a factor based on the gut biome, which we don’t really understand and have no way of properly testing. For now, I know that I can’t tolerate rice, bread, pasta or anything of the sort. It’s been too much to even have a little from my children’s leftovers. I can however have their leftover ice cream.

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  2. Hi Lara,

    My 17 year old daughter was on a keto diet for 4 months and lost her period for 4 months. She has gotten off the diet for a month and her period has not returned. She eats everything and works out. She even gained 10 pounds getting off the diet. Her estradiol is still low. The rest of her blood work is good. Any suggestions?

    Reply
    • it can take six months for young women to recover their periods from undereating or low-carb and it usually requires 2500 calories per day plus 200 grams starch.

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  3. Hi Lara,

    I suffer from non-diabetic reactive hypoglycemia. I’m tall and lean, no one in my family is diabetic, but my lean mother has had reactive hypo on a couple of occasions. Mine is more severe and much more frequent (more so in luteal phase). Past glucose tolerance test has been within the normal range, but I had elevated fasting insulin and c-peptide on one of the tests I had (another came back normal). I have always been a healthy, balanced eater, low sugar. I am 39 and symptoms have worsened over the past 5 years especially. An endocrinologist recommended I increase my BMI by just eating more, more often (I already eat a lot!). I increased it from 19 to 21, but no improvement, in fact I think hypo got worse.

    My naturopath recently suggested I might want to try low carb and gave me some information on why it might work to stablise my blood sugar. I started a couple of days ago and no hypo so far. How low carb should I go? My aim is to stop the hypo but not lose too much weight, and not negative affect my fertility.

    I have regular cycles and normal hormone levels (and no endo or anything) but was previously diagnosed with unexplained infertility. I’m thinking of trying to conceive again and wondering whether there is connection between non-diabetic reactive hypoglycemia and unexplained infertility?

    I would love to know your thoughts. Most of the information out there is geared for diabetics of people who are overweight, I’m having trouble working out what the best thing is for me, especially given I think I do have a tendency for HPA-axis dysregulation, which I’ve been on herbs for for a while to improve my sleep and clam nervous system.

    Thanks so much,
    Claire

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    • Can anyone help with their own experience in relation to my situation above? Anyone who gets reactive hypo? I have already lost weight since going low carb over two weeks ago (would like to put it back on if possible). Think I ovulated, but I usually get breast swelling post-ovulation and that hasn’t happened so far so I can’t be sure. I haven’t skipped ovulation since going off the pill 6 years ago.

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  4. Hi, thank you for your post! It has shed some light on my situation.

    I’m currently type 2 diabetic but diet controlled, so that means I’m eating pretty low carb. I haven’t had my period since stopping breastfeeding – it’s been about 1.5 years. My endocrinologist said that I need to “eat more of anything”, so that I can gain sufficient weight and get my period back. I don’t want to eat anything because my blood sugars will be really high. I had one slice of sprouted whole wheat toast (paired with egg, avocado and nuts) my sugars were high after.

    What do you suggest? Should I just increase my carb intake with potatoes and rice and not worry about higher blood sugars in order to get my period back? Thanks so much!

    Reply
    • Hi Shelley, I was prediabetic (insulin resistant) with fatty liver (although just slightly overweight) when I decided to try the very low carb/keto – diet and I lost my period immediately. After 3 months of this diet my doctor diagnosed me with “early menopause “. It took me only 10 days of eating carbs with every meal (potatoes, pasta, oats) to get my period back. The keto diet also made me start losing hair, which gave me even a stronger sign, that low carb was the wrong solution for me. 6 Months ago I started what my doctor recommended to me: a diet high in healthy carbs like potatoes, rice, oats etc. and very low in fat, paired with exercise. Obviously, my portions are small and they always include some low fat protein. So far I’ve lost 20 pounds and my blood sugar is normal. I can even exercise on empty stomach now, without becoming hypoglycemic afterwards. My exercise routine is simple: 1 hour every day, 20 min of HIIT or Interval Training followed by 40 min of steady state cardio of low-medium intensity. The theory behind what I’ve been doing is that by exercising every day while eating healthy carbs and keeping fat low (10% of daily cals), I sort of force my body to use carbs as a fuel again. In order to lose the fat from my liver I was also prescribed cholin and l-carnitin. Hope this information is of some help to you. Best wishes!

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      • Thanks for your comment! I’ll try increasing my healthy carb intake as well as exercising more to burn off those carbs. Did you exercise after every meal to burn the carbs?

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    • I’m type 2 diabetic and diet controlled as well. All doctors will disagree with me but from consistently checking my sugars over the years I’ve realized that my blood sugars are highly effected by far more than carbs. My mom is the same way and she had a dr. In the 80s say that to her. Even as a gestational diabetic my readings were always higher after fat vs. carb. More research is needed.

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  5. Hi Lara, I really hope you see this comment.
    I saw here that a lot of people could have PCO’s post pill. And I saw here that you say that insulin resistance causes PCO’s in some people. In my researches, insulin is totally correlated with acne and hormonal imbalance (because can improve the testosterone levels and all that stuffy), which can causes acne, alopecia, hisurtism. Even if I don’t have insulin resistance, an low carb diet or paleo (In Brazil we say low carb), is not going to help me to pass trough this post pill acne? I’m confusing in this question. (I’m not saying cutting all the carbs, but cutting sugar, refined carbs, and prefer to eat vegetables, sweet potato, pumpiking…)
    I don’t know if I have PCO’s (I’m 50% sure that I don’t have or I had an PCO’s post pill) but I notice when once I was dealing with acne that high carb foods was getting this worst.

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  6. Thank. you so much for your work. In March I went on a keto diet and stopped eating much carbs. I did it because I read that keto helped with anxiety and Asperger’s my 10 y o son has those issues.

    Almost immediately, I skipped my period without being pregnant for the first time in my adult life. I know that you say that it takes four months. But It seemed to take only 2 weeks in my case. My last period started on April 2nd and I have not had it again since and it is now May 25th. I know that you recommend gentle carbs such as potatoes and rice. Is there a rule of thumb for the amount? I’m not sure what 150 grams looks like. Should I eat a potato a day or a cup of brown rice a day? Please advise. Thank you and I will spread the word about your work.

    Reply
    • Hi Ama, losing your period can happen that quickly.
      And yes, a potato or a cup of rice with the evening meal should be enough to get your period back.

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  7. I am have been diagnosed with HA, most likely due to the low carb diet I had been following the past 3 years and practicing hot vinyasa yoga 4x’s week … I am working on recovery, quit hot yoga, am eating healthy carbs at each meal. Question is, in your opinion will I have to eat 2100 – 2500 cal/day as a minimum to recover my periods? I can barely eat 1600 – 1800 cals each day and feel like I am stuffing myself? I’ve been graduating upping my carb/calories since June. Thank you, your website is incredibly informative and helpful! Wish I found out about you before I had HA.

    Reply
    • Hey. I got my period back after four months of reintroducing carbs. I didn’t track calories, I just made sure I was eating carbs every day. Take a look on the Strong Sistas channel for more information, they were very helpful to me.

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  8. Feedback on my story: Period recovery after just 2 weeks of “high-carb” (150g-200g/day). Incredibly relieved and happy!

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  9. My period stopped 2 weeks into the keto diet. The typical premenstrual symptoms were there but disappeared couple days after being late.

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  10. This is exactly what happened to me! Felt great on the Keto-diet for a while (carbs below 50g), got my fasting blood sugar levels back to normal in 6 weeks, BUT: no period! After missing 2 more periods I consulted my gynecologist: the ultrasound and blood test revealed menopause-like symptoms (which weren’t there 3 months before the exam) and since I am only 45, my doctor suggested hormone therapy in order to delay the menopause. I totally panicked and started eating bread and sugar again, which made me feel horrible! I decided to test by myself, which carbs make me feel sick and discovered that bread and pasta (main source of carbs in my diet before keto) give me diarrhea, while rice and potatoes seem to work just fine, especially in combination with butter, which seems to prevent a blood sugar spike after the meal. The diet also created a weird shift on my thyroid panel (Hashimoto). I feel depleted and desperately in need of finding a solution! Unfortunately, it is so difficult to find a doctor willing to check all the necessary blood parameters more frequently. I just found this blog today and decided to get off the very low carb diet again, hoping to recover from my amenorrhoea. I also hope to find more answers in your book, Dr. Briden. Thank you so much for sharing all the valuable information with us and thank you Erika, for writing a comment that helped me recognize similarities in my condition.

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  11. I was diagnosed with PCOS and have always been lean. I started down the PCOS information trail which seems to always push low carb. I did that and my ovulation Normalized for two cycles and then got longer and longer over the next three. I got suspicious and added quinoa and brown rice back in and voila! Normal ovulation the next cycle. Low carb doesn’t seem to be a one-size-fits-all solution.

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  12. Your article was very helpful. I have been on a low carbohydrate diet for close to four weeks and have been experiencing hot flushes and now have been experiencing period pains BUT WITH NO PERIODS coming.

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  13. Hi Lara,

    I am grateful to have found your blog! I was on Keto for 2 years and have had spotting before ovulation for those 2 years. All of my Drs have been stumped. I have normal thyroid numbers except for T3, which is showing to be low. The Drs told me to ignore that number and that it could not be part of my spotting. I have not yet been off keto for 3 months, but I am hoping my period will normalize soon. Since I was trying to conceive, my Drs kept trying different low level fertility meds to no success. They all expected them to regulate my period, but nothing has stopped the follicular phase spotting. I also was low on vitamin D recently and have been supplementing for a few months now.

    Have you seen keto causing random spotting during the first part of a period cycle before? I never spot after I confirm ovulation through temping, just during the period before ovulation. If you have any insights I would appreciate your time!

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  14. I lost my period after 2 months on a low carb diet. I am in my late 40s but not in menopause. I have adrenal insufficiency and take Florinef for it. Low carb gave me adrenal symptoms as well. I felt sicker and more fatigued than I have in years. I abandoned low carb and got my period back within days. Low carb was a disaster two other times I tried it but I thought maybe I just didn’t do it right. Never again! I will eat my grains thank you very much. I have celiac and have to eat gluten free grains anyway.

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  15. I am so glad I found this article. I have lost my period and I have been in Keto and IF for just 2 months. I was fairly regular after becoming a mom. And I started keto because I was told it helped with fertility issues. Now that I’ve lost my period I am pretty sure keto is not good (at least for me) for trying to conceive. I suffered AN as a teenager and even then never lost my period. But keto has done it for me. I am not happy about it 🙁

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  16. I’m not sure whether I’m missing my period due to keto because I went on keto for two weeks in early July, but stopped. It’s been two months and I haven’t gotten my period. Can anyone help?

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  17. My period was pretty regular to begin with, but accompanied by excruciating pain and mood swings. That has gotten a lot better since I went keto. I have endometriosis, diagnosed with symptoms but not to the point yet of laparoscopy. I actually have been surprised by my period a few times because the pain and nausea, crying, and increased anxiety just…weren’t there.

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  18. I lost my period on keto. I have previously lost my period twice due to restrictive eating but had been cycling regularly for a year before doing keto. I read that keto helped balance hormones, so I thought that keto might help my short luteal phase. NOPE! I had no period for four months and realized that my missing period coincided with keto. I added back a small amount of carbs (100g per day), and my period returned in less than 30 days. I’m still eating a higher fat diet, but relaxing around carbs has helped my emotional state and social life immensely. I also have more energy and am no longer suffering with aching leg muscles. So much of the keto space is geared towards men, who have a different hormonal system. I believe that my history of HA makes me an unsuitable candidate for a keto diet, and I now understand that the best thing for my health is to fuel my body with a balance of fat, protein AND carbs.

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    • I’m having the same issue. I started keto August 1st. I am currently 10 days late on my period and I’ve been having aching calves in the morning. I’m so happy I found this page.

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    • I also lost my period on keto, also I think Intermittent Fasting is one of the problems. Our bodies perceive it as starvation and therefor shuts down the reproductive system. I also was working out alot in the gym, but I was always working out before, and never missed a period, only on Keto or very low carb. Trying to get it back now, I already had a stress fracture, is that bad for the bones. Good luck to you all getting your period back!

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  19. Thank you so much Lara for keep raising awareness about this issue. I commented last year about the loss of my periods due to keto. I got my periods back adding carbs back however sadly for me it was all too much for my body and I developed CFS/Fibromyalgia due to the diet and stress on my body. Obviously this is an extreme reaction and I don’t want to freak people out! However this is a dangerous diet and I’m passionate about preventing others going down this road. I’m still seeing a lot of positive press coverage about keto and low carb which really alarms me. Please be gentle with your precious bodies girls. xx

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  20. Wow! Thank you for this! All I ever hear is no carbs and sugar but I feel like I’m dying if I don’t have any of those things!

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  21. I started a low carb diet because of migraines. My periods were and continued to be regular and 4 days long, rather on the weak side but normal. My migraines improved a lot and I got pregnant after 2 months of this and had a healthy baby. Since my pregnancy my migraines have returned even stronger and are mostly during my period and after. Periods were regular since resuming for 4 cycles but this month I’m 2 days late. I am no longer doing the low carb diet although I try to avoid wheat and sugar as much as possible. I also started charting my cycles and noticed that my luteal phase is only 8-9 days long. Could this indicate a problem or hormonal imbalance and could this affect my migraines or be remedied by going low carb again?

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  22. Hi Lara,

    What is the mechanism with inadequate / low CHO intake and hypothalamic
    amenorrhoea – i understand how hypo caloric intake will do this but
    why specifically CHOs – is it to do with insulin and leptin – is there
    an signalling affect on the hypothalamus? I also understand that the thyroid interacts / reads insulin levels as if there is not enough insulin levels (i.e. a signal that there is energy coming in for fuel) it will down regulate metabolism.

    warm regards
    Zoe

    Reply
  23. Thank you for this interesting article. When you say we need more starch when on a keto diet, would a resistant starch (which doesn’t effect ketosis) work e.g. Ready powdered potato starch bought from a health food shop?
    I have found slightly more hair loss than usual in the last few months but no effect on my periods at all, which before I started a ketogenic diet 6 months ago, were (and still are) very heavy and last an average of 12 days.
    I was on the combined pill for 11 years and stopped taking it due to the sudden onset of chronic migraines – every single day now for the last 2.5 years (never suffered a migraine before that!). I am trying a keto diet for my migraines, no help yet. I had regular 5-7day periods for the first 8 months following stopping the Pill, but then suddenly they became a regular 12 day period (two weeks on, two-three weeks off)! Very odd. So being on a ketogenic diet doesn’t seem to have any effected my long heavy periods at all.

    Reply
    • Um. So your period is now two weeks on, two weeks off? That is not normal and suggest that you’re having anovulatory cycles. (Cycles in which you do not ovulate.) Which could be because of the ketogenic diet. Please have a read of my new book.
      And no, resistant starch does not seem to be enough for many women.

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  24. I recently tried a form of a low carb diet-it isn’t an inherently high protein diet but it’s a natural consequence that you eat more protein. My period was due two weeks after I started the diet and it’s NEVER late. So far I am 5 days late. I reintroduced carbs two days ago-still no period. Negative pregnancy test? I definitely think it has something to do with the diet

    Reply
    • The high protein is not the problem. It’s the lack of the starch that’s needed to support ovulation. Hair loss often occurs about 3 months into a low-carb diet. And takes a few months to recover.

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  25. Hi! How are you? Hope you’re doing great
    Well, yeah, first of all, I want to ask you an advice … 😬 I’ve got a problem with my periods. Like, umh, I wasn’t into this theme (I wasn’t having my periods) for 5-6 months. I visited a doctor and she said that everything because of the stress (I had an exam period at school). But I’m so scared! I don’t know what to do! She said that two months ago, but I still can’t “find” my periods! 😬😒
    By the way, I also addicted to the theme of the weight loss. But I’m not that crazy, I eat as a normal person, but…
    What should I do? What CAN I do?

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  26. I just had to comment on this article Lara, THANK YOU so much for writing it. I am suffering terribly due to Hypothyroid which started when I started the Ketogenic diet (25g carbs a day) for Migraines. It worked a treat for my migraines but I haven’t had a period in 5 months am piling on weight and just feel tired and sad all the time. After reading your articles on the subject I am in the process of upping my carbs with sweet potato, tapioca and berries. Really hoping I haven’t done my fertility and thyroid any damage and I can get the ‘sweet spot’ for my thyroid and migraines with my diet. Big Hugs Hayley xx

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    • Hayley,

      I saw your post and wanted to recommend a new book called ” The Keto Diet” by Leanne Vogel. She has different variations of the diet to address different womens needs. I was in tears in the intro and it has been very helpful in balancing out what I need .

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      • Falynn, So kind of you to reply! Thank you so much for recommending the book…just ordered it 😊 so glad to hear it helped you, hopefully I’ll get there in the end and manage to get balance xx

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    • Your ovaries and hormones should recover getting back on a few carbs. And you might want to try to figure out if it was ketosis that helped you (it might have been) or being off gluten.

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      • Thanks so much for your guidance Lara, so appreciated! I hadn’t thought of the Gluten 😉 Since my comment I have upped my carbs from 25g to 50g and more recently to 100g, it’s been lovely to have sweet potato and kiwi! YUM!
        I’m probably panicking and being impatient but just wondering in your experience how long usually it takes for hormones to start doing their ‘thing’ again?
        I have seen now that there is alot written out there about the effect of a low carb diet on thyroid and hormones, especially in women of my age….hindsight is a great thing! Hugs H x

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        • Ooh. 100 g is still quite low. You probably want to aim for at least 150 g. It takes a minimum of three or four months to ovulate because of the 100 days to ovulation.

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          • I can’t thank you enough for you guidance Lara, my periods have now officially returned!! I’ve had 2 successful cycles since I increased my carb intake to 100g, I’ve since lowered it a small amount to try to get this balance right with my migraines and fertility. (keeping a close eye though). I feel alot better in general with more berries and sweet potato etc, I felt like I was killing my body before I upped the carbs.
            I just wanted to let you know that all of your time and dedication pays off, you are so generous with all of your knowledge….Thank you it is appreciated. Hugs Hayley xx

          • Hey Lara, I really hope you are doing good? I just wanted to ask a little further advice as sadly my recovery from the damage done by a low carb ketogenic diet didn’t stop with the return of my periods. I have sadly been gradually getting worse and worse muscle and joint aches, fatigue, plus weight gain and PMT, my quality of life isn’t great at the moment 🙁 I’ve had my blood tested by my GP, vitamins and minerals are all good apart from Zinc is a little low. I was wondering about my Thyroid after low carb but my TSH is good, the only hormone tested was estrogen and that was ok. I’m wondering if I should see a hormone and bio identical functional dr here in the UK? I just can’t help but feel some damage was done when going low carb and now despite being really free with carbs my body seems to be struggling to recover. My Dr thinks I may have Chronic Fatigue or ME. On the plus side despite returning good carbs my migraines have been ok! I’m wondering if it was the gluten/wheat removal that helped as you suggested. Any advice would be so appreciated, as it’s abit of a minefield online knowing what to believe! I really value your opinion. Big Love Hayley xx

  27. Hi! I was wondering how fast this diet can affect my period. I just started on it early this week and my period still hasnt arrived. Also this whole month Ive been eating erratically, putting on weight, loosing weight… Could this be the reason my very regular cycle is disrupted? I havent had this late of a period in a long time.

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    • No, a low carb diet wouldn’t affect periods that quickly. If it’s going to stop periods, it usually takes at least four months.

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      • Hi lara..just wondering..ive been doing keto diet for 2 weeks and am due to ovulate and it hasnt happened. Im worried its the diet. Could it affect me this soon. Ive decided because of this to re introduce carbs in form of potatoes etc..feeling a little worried 🙁
        Louise

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        • It would be unusual to stop ovulating so early in the diet. But your cycle could be having a little wobble (late ovulation)

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  28. Hi! I read your post and can really relate to it 100%. I have lost my period for the past year now, and in that year I over-exercised my body, while most likely not getting enough carbs. I am 5’4.5″ and around 111-112 ish, so still in the low-healthy range, but I used to be underweight and am recently weight restored.

    I am wondering what your recommendations on increasing my carbs would be (in terms of what types)? I don’t do gluten well–I get bloated and my gut hurts.

    Additionally, do you think that significantly increasing my carb intake can help bring my periods back? I am also exercising less intensely and just walking daily 5-6 miles.

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  29. Dear Lara,

    I have a serious dilemma and would love your advice. I started a low-carb diet because carbs was causing bloating, inflammation, post-nasal drip, and even sleep apnea for me. Once I stopped eating carbs, all of these symptoms disappeared completely, but instead I lost my period and my hair has not stopped falling for the past 6 months. Now, I can’t decide which diet to choose because both have their pros and cons. What would be your suggestion?

    Thank you so much for writing this article. For the longest time, I thought I was alone in this.

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  30. I am 40. Not in birth control. And have been eating keto diet for 3 weeks. I have been tracking my period for 8 years. Only times I have ever been later than 29 days have been when I was pregnant. I’m on day 30 now. Taken 2 negative pregnancy tests. I suspected it was my diet so I ate some beans last night. Getting ready to eat some carbs today. I don’t like that a diet can change my cycle. Should I worry?

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  31. Hi Lara,

    I know it’s been a little over a year since you’ve written on the effect that low carb diets have on periods but I’d love to know if any new information has come out. I went on a ketogenic diet for two months and during those two months I proceeded to have continuous spotting. Have you heard of this happening to anyone else?

    Thank you,

    Emily

    Reply
  32. I don’t remember what happen with my periods when I tried low carb. What I do remember is that it started my morning anxiety. I went back to eating normal but I still get anxiety most mornings. I regret even trying a low carb. Now I never recommend diets to anyone.

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  33. So I’ve been on the low-carb diet for 10 weeks. My periods are irregular, although always come within 31-50 day range (most likely due to PCOS, although I do not recall doing any specific blood work). I had two periods since going on the diet. During the first one, I was still eating sugar, and it wasn’t much different than the usual. The second period was so much less painful, and also less substantial. The thing that shocked me was that the period was not painful. My periods started at 13, and ever since then they have been impossible to tolerate without spasm-killer or general painkiller. So this was new. I’ve also had acne for the same length of time. Some years it was worse, some years it was better. After I started the low-carb diet, my anxiety dropped tremendously, and I was able to keep better control of my emotions. My acne is less severe, and the cystic acne is not a regular anymore. All of that in 3 months! Out of which, I’ve been under 30g of sugar a day for 4 weeks. My trick, though, is one cheat day a week. During that day, I stuff myself with too much food, and too much carbs. This helps regulate the body’s response to a generally low carb count. I recently started taking Vitex in an attempt to get rid of the last of my acne. All in all, I’d say that increasing my fat intake and chopping down on pasta and bread 6 days a week did wonders for me.

    Reply
  34. You gotta love it when men invalidate the consistent physical experiences of women ?

    I always, and I mean always, have a late period or totally skip one when I go low carb. My menstrual cycle then lengthens significantly the entire time I keep carbs low – usually to between 35 or 50 days (or more!). Cutting out sugar and other refined carbs is fine long term but under 30 g of net carbs per day, my body doesn’t respond well. I’ve read the accounts of so many women with similar experiences.

    So much fasting and low carb research centers around men. Men then proceed to say that ‘people’ respond best to low carb diets and fasting without respecting biological/hormonal differences between men and women. It’s really frustrating.

    Thanks for writing this article. It made my day!

    Reply
  35. Hi I am a 43. I have been doing lchf for 8 months now. My menstruation is gone for about 6 of them. I also started to get hot flusses. I need to get my hormones healthy again… Any suggestions

    Reply
  36. I’m a little late to the party, but everything that you have mentioned here Lara is true for me! I’m new to your blog and you speak such truth.

    I went on a low carb “paleo” diet to try and control my acne – low GI, high protein. The result was hypothalmic amenorrhea – no periods for a year and going down to 8 stone, without meaning to, which on a 5 ft 9 frame is not healthy! As soon as I introduced healthy carbs again with a nutritionist, and increasing portion sizes, I instantly began to put on the weight. Beforehand was getting hypothyroid symptoms and had depression (I also developed osteoporosis). My TSH was almost 4 and after a year, it’s now 2, I’m 9 1/2 stone and have periods again! As well as regular bowel movements.

    I know that cutting out carbs can be a godsend for many women because they need to lose the weight – but this isn’t for everyone and at the moment it’s really being promoted in the media. I’ve realised through trial and error that I need to maintain a high caloric input, and this just isn’t possible with a low carb diet – not to mention the effect a high protein diet has on your bone health.

    Thanks Lara and please don’t stop writing these fascinating articles!

    Reply
  37. Hi again, Lara 🙂
    I felt horrible on low carb + IF. My stress levels went to the roof. I couldn’t sleep and I suspect I stopped ovulating (my periods came every 6-7 weeks). I do way better with all kind of carbs. I actually do better with some (properly prepared) wheat, sugar (specially raw unfiltered honey), and full fat milk. After years of a clean paleo diet with carbs I found out I was undereating: my temperatures were super low and my inmune system sucked. Once I started eating everything, including wheat, sugar & dairy, I felt way better.
    I do believe low carbing is bad for men too, but I think it takes more time for them to develop symptoms. We are lucky to have our monthly report card 😉
    By the way, amazing job with your book, I’m loving it. For the first time in almost 31 years I fully understand what the heck my body is doing every month and how can I help with it.

    Reply
  38. I was diagnosed PCOS at 16 one ovary removed periods every where I’m now 45 also was diagnosed insulin resistance at 16 I did go on to have 3 children I finally found low carb Atkins in my 30 and lost 30 pounds and cycles every 28 days no clots or cramping I fell off the low carb and gained everything back I went and tried the keto diet and bleed for a month straight scared me off well trying it again this time my cycle came a week early and was so light no clots no cramps and just lasted 5 days with just needing a panty liner instead of pads

    Reply
  39. I’m a nutritionist, and I was SHOCKED to find recently that my beloved low carb diet was the slow poison that stole my health. I have suggested a low carb diet to numerous people, and now I wonder how many people I have inadvertently harmed in the long run.

    I was on a low carb diet for three years, including periods of being gluten free. I chose to follow this diet as a sort of prophylactic approach to keep myself from becoming diabetic. I have had three children, and my blood sugar levels raised with each pregnancy no matter how careful I was with my diet and exercise. I never felt different on gluten then I did when off gluten personally (I do make all of my family’s bread using traditional souring methods, though). I noticed my health steadily declining for the last two years, most notably continual fungal overgrowth that could not be resolved no matter what I did, and a basal body temperature drop. I had a fourth pregnancy about a year ago, and suddenly couldn’t sleep at all, and my hair started falling out. I ultimately had a miscarriage at 12 weeks. My basal body temperature was at 97.2 (pre-ovulation) when I read an article about how low carb diets mimic starvation, and it hit me like a bolt that that is when my health had started declining steadily. I still have a stubborn 10 lbs that I haven’t been able to lose, and my pituitary function is off kilter, I was diagnosed with D-MER after the birth of my third child, and now have hyperprolactinemia. I can tell you that when I started adding carbs back in, I felt terrible for about a month, but during that time the fungal problems in my hand cleared up spontaneously. (I know. Sounds totally backward, right?!) I feel energetic now, and my hair is starting to grow back amazingly. My BBT had climbed to 97.9-98.0 (pre-ovulation) within the first month of adding back carbs in full. I’m hoping that eventually the stubborn ten lbs will come off (fingers crossed!), and that I will see a steady climb in my BBT, I am only two months in to this new carbed diet and will be trying vitex to clear up my prolactin problems.

    About sugars, I do have to say there is actually ample evidence that good raw honey is a very healthy food, and dense source of nutrients. I know the word in nutrition these days is that honey is bad, and so is wheat, but in the context of a nutrient dense diet I have changed my mind on these. Whole honey has actually been shown clinically to be protective of many illnesses, including fungal overgrowths.

    Reply
    • I would also like to add that after I added more carbs back in to my diet, my emotions are much more stable. My emotions were all over the map this past year, but it is awesome to say this past month I had only one day of milk PMS symptoms. I am so happy!

      Reply
    • I got your book, and am loving it. I have noticed a lot of my symptoms after reintroducing carbs have mimicked what I experienced after coming off hormonal birth control years ago. I had a stint of lots of acne, and now three months in my hair is falling out. Have you heard of similarities there?

      Reply
        • Gentle carbs, but also spelt, rye, and small amounts of raw honey. I went through a two gluten free periods (both 3+ months), and never felt different. I don’t use wheat, though, I use spelt and rye, and it is always soured or sprouted at home. The acne lasted one cycle and was gone. The hair loss lasted about a week, but was quite intense.

          I tried the Vitex, and after two cycles I felt massively depressed and not at all like myself so I stopped. I have noticed my breasts feeling “full” again now that I’m off it. Bummer, I was really hoping it would be a fit!

          Reply
          • To clarify, I have had two periods since I started taking Vitex. It was not two months before I stopped taking it.

          • I realized this morning that many of my problems are likely related to mercury. I had nine amalgam fillings replaced last year.

          • That could certainly be the case. Just a tip when assessing hair loss as a symptom. There is always a delay, so hair loss that you notice now is the result of something that happened 2-4 months prior. There is also a delay of a few weeks with acne.

          • Thanks for your response. And yes, I assumed it was adding carbs back in as I added them back in at the beginning of January.

  40. Lara, would it be ok to ask you about mixing certain herbs and supplements? I already know what my issues are and what I want to take, I just don’t know if it is all safe to take together. I don’t take any meds and all of my health problems are hormonal in nature, otherwise healthy. Thank you.

    My list is:

    L-theanine
    Berberine
    Goat’s Rue
    Fenugreek
    Evening Primrose Oil
    Multi Vitamin
    Extra Magnesium, D
    Fish Oil
    Probiotics
    Enzymes
    NAC
    DCI, Myo Inositol

    Reply
  41. Lara, I have a burning question, can you tell me what vitamin combinations might help to increase estrogen & progesterone & in what doses? Thank you very much

    Reply
  42. Hi Lara,

    I am 90 percent done with your book and I have learned so much from it. Thank you. One thing I have always been curious about is why my periods skip a day. Like literally, I will bleed on day 1,2,3 skip day 4 then bleed day 5 and 6 and sometime 7. Ever since my first period at the age of 12 I have always had a non bleeding day on day 4. Is that normal? What causes that?

    Thanks,
    Ogo

    Reply
    • Stop and start bleeding like that is common, and can be caused by a relative progesterone deficiency (because progesterone is the hormone that matures the uterine lining and makes it easier to shed).

      Reply
  43. Thanks for this article. I believe this does need more investigation and understanding. I went, unwittingly at first and then deliberately when I saw how lean I was, low carb when I went paleo. I was 34 at a normal weight with regular periods, 1 child and no hormonal birth control. My periods became more irregular and then stopped. I estimate I was eating about 50-100g a day. I have gone up now to nearer 200g a day (so still a fairly moderate intake) and made no other changes – my periods have now been regular for my last 3 cycles. Clearly my body feels it needs carbs in order to reproduce and to be healthy. I’d love to know why but for now I’ll stick to buying kilos of sweet potatoes and squashes a week!

    Reply
  44. Hi Lara,
    Thank you for this post! I have had hypothalamic amenorrhea for 2 1/2 years. It was originally caused by not enough fat or food in general! After a year of having amenorrhea, I was convinced that my digestive troubles were due to bacterial overgrowth, so I went on the GAPS (or FODMAPS) diet. I didn’t eat any carbs other that winter squash for five months. I know for sure that this made my amenorrhea worse and gave me even worse adrenal fatigue. Now I know that carbs are good!! But I definitely feel better eating more fats than carbs. I just cannot eat zero carbs.
    Have you ever written any posts on amenorrhea and the MTHFR gene mutation? They are closely related and it turns out that this is what I have.
    Thanks for the fantastic blog!!

    Reply
  45. Hi Lara,
    I wanted to mention that I started a very low carb paleo diet and even though I was eating gentle carbs such as sweet potatoes and bananas I lost my period for 6 months. I also lost about 3lbs which was a lot for me because I weigh about 119lbs at my regular weight. I believe that the paleo diet caused me to lose my periods. I took a week dose of Provera and I had no withdrawal bleed. Also, all my hormones blood work/ ultrasound came back normal. Once I reintroduced carbs and gained the weight back I tried Provera again and I did bleed. Now I’m hoping my cycle will reset itself and I will ovulate on my own.

    Reply
    • Thanks for sharing your story. I wrote this post for exactly your situation. I expect your period will come back after a few months on starch.

      Reply
  46. Reading this article and the comments really shows that moderation is best. I eat moderate carbs. Too much and I get so hyped up I am nutty and stressed out, too little and I am lethargic. I think the most important thing is listening to your body. If you feel awful, whatever you’re doing probably isn’t working. If a food makes you feel great (hello buttered sweet potatoes!) then it’s working for you.

    Reply
  47. Hi, Lara,

    First of all I would like to thank you for your wonderful blog! You are of great help to many women and I wish there were more health practitioners who make it a point to look at the whole picture and find the real cause of problems and not just prescribe birth control pills (or progestins, or thyroxine).

    Now, I am really glad you wrote this blog post about low carb diets and women’s health. There are a lot of women who seem to do poorly on long-term low-carbing. I have long wondered why this could be – what could be “wrong” with women that’s OK with men? Men seem to do a lot better on low carb, no matter how long they stick to it. Have you thought about what the reason for this could be? It has recently occurred to me it must be iodine deficiency – women tend to be more deficient than men (because breasts need a lot of iodine and only women have them). That’s probably why thyroid diseases affect mostly women. And since iodine has been implicated in ketogenesis (by professor Stephen Cunnane, although I haven’t read his book where he seems to have made that statement), it seems logical to me that this is the “missing piece of the puzzle”: if long-term low carb dieting depletes iodine (assuming iodine is required for ketogenesis) and if women are more deficient than men, that would explain why women fare worse on low carb diets, especially long term. But this is just an idea of mine, not really based on solid evidence.

    What do you think?

    Reply
    • As to “why men do better on a low carb diet compared to women”, I’m not yet 100 percent sure. It’s probably that the female hypothalamus requires a stronger leptin/insulin signal (as I describe in the post). I guess it could be due to an underlying “women’s” deficiency such as iodine.

      I’m really struck by your phrase “What is ‘wrong’ with women that they can’t do low carb the way men can?”. It’s kind of the crux of the matter. Is there something wrong with women? Or something wrong with the diet when prescribed for women?

      Reply
      • Exactly! I am not inclined to think there’s anything wrong with women, other than their increased susceptibility to iodine deficiency (estrogen makes it difficult to absorb iodine, so that’s one more reason why women would be more deficient than men). And since there are traditional populations who eat a very low carb diet and their women do just fine, there must be something missing in our diet (or something excessive for that matter, like halogens) that’s making low carb diets unsuitable for many women. I think this should be researched.

        I have been eating a primal diet for several years – I started decreasing my sugar and grain intake very gradually 6 years ago, then went on to increase my protein and fat intake and further decrease my carb intake, eliminitating pretty much all starches. Sometimes I went really low carb, but mostly just moderately low carb. I managed to drop 62 lbs in 2.5 years and shorten my cycles (I have PCOS and my cycles had been quite long, though I did ovulate every time, so I managed to make them more or less normal). But two years ago I started developing hypothyroid symptoms – slow weight gain, exclusively during autumn and winter months (water weight – I would gain it almost overnight a couple of days before ovulation, but it would stick very stubbornly), sleep problems (for the first time in my life I was experiencing insomnia), my cycles got a little worse (longer follicular phases and shorter luteal phases), dry eyes, dry skin, heavier menstrual bleeding, decreased sweating. It finally dawned on me I must be hypothyroid (had long been in denial), so I am getting tested next week. But I have started including a little starch too in the form of potatoes, rice, bananas, beets. I really hope I can avoid further weight gain and insulin resistance. Type 2 diabetes runs in my family, so I would not like to increase my risk by eating too much carbohydrates. That was why I started researching what could be the problem and stumbled upon iodine.

        Reply
        • Hmmm. I have never heard that estrogen makes it difficult to absorb iodine, and to be honest, I doubt that iodine deficiency is the reason so many women have trouble with a long term low carb diet.

          A couple things to consider:
          1) Our individual need for carbohydrates depends on how well our own ancestors were adapted to famine and carbohydrate intake. It may be true that women in some traditional populations thrived on very low carb, but I struggle to think who that would be. Inuit, perhaps? BUT that does not mean that women of every ancestry will therefore be the same. In fact, turns out the Inuit peoples have quite unique adaptations to their unusual diet.
          2) You did well on a low carb diet when you were insulin resistant. In other words, it was an appropriate intervention for that abnormal physiological state. BUT once your insulin sensitivity improved, THEN the diet was no longer appropriate and started causing havoc with your hormonal system.

          Reply
          • Thank you for your comment, Lara. Yes, it occurred to me I may have solved my insulin resistance problem, so now my body operates in a different mode and has different needs. I hope I can benefit from more carbs now.

          • Hey Lara,
            I read something about inuits needing to eat moose thyroids before attempting to reproduce because the low-carbing had shut down their reproductive function. So also inuit’s diet points in the direction of low-carbing not being good for reproductive health.

  48. Hi Lara,

    Thanks for the wealth of information you provide to women via your website. I purchased your book last week and it arrived tonight. I have not finished reading it yet but I am excited to finish most of it tonight. I have a question about turmeric. Is it good for reducing fibroids? I have read that it is a powerful anti inflammatory as well as good for liver detox but I have also read that curcumin is a phytoestrogen and can mimic the effects of estrogen in the body. For someone who already has a lot of estrogen and because fibroids thrive with estrogen is it counter intuitive to take curcumin for the alleviation of my fibroids? I already take dim and milk thistle as well as decaf green tea and magnesium for help with my fibrods. Thanks in advance for your response.

    Reply
    • Hi Nneka, Turmeric is actually an anti-estrogen. (Like most phytoestrogens.) It blocks estrogen at the receptor, and it also inhibits estrogen production by down-regulating the aromatase enzyme. It is helpful for fibroids, yes. But as I explain in my book, no natural treatment can dramatically reduce fibroids. It can slow their growth though, and soften them somewhat. That’s helpful for many people.

      Reply
  49. Great post, thank you for talking about it!

    I work much, muuuuch better below 30g of carbs, but I assume that’s due to PCOS. My cycle is finally mostly regular, but the best improvement has been the fact that it’s a little bit lighter and completely pain-free. I had no idea life could be so much better and I wish I knew this 15 years ago. (Thank goodness for the internet.)

    That said, I’ve seen in most forums that everyone has a different experience. Some lose their period, some gain it back after some months, and some women get heavier flow. It is really fascinating.

    One thing I’d like to see when women mention their cycle their long-term diet is wether they are also on hormonal birth control or not, and if they are, which kind.

    I sincerely hope the right kind of research questions are being asked, somewhere out there. I don’t like the solution to every hormonal issue you have as a young woman being “oh here, you should be on birth control for that”, without any mention of the influence of your diet. It’s madness.

    Reply
    • Thanks for sharing your experience! It’s helpful to hear from someone for whom low carb is working well. Yes, my experience has been that some PCOS-sufferers do well on low carb diet, even in the longer term.

      And thank you for bringing up hormonal birth control. It’s a very important question indeed. Hormonal birth control forces an artificial bleed and can mask an underlying problem. In a nutshell: Pill bleeds are not periods.

      Pill bleeds are not periods.

      Reply
      • About five years ago (age 21) I began a low carb mostly paleo diet and immediately felt incredible. I leaned out, stopped feeling lethargic and miserable after eating, gained loads of energy, and clarity of mind I hadn’t felt since I was a kid. There was no doubt in my mind at the time that I had found the right way for me to eat, and tending toward a very “all or nothing” obsessive mentality, I quickly worked my way down to eating almost no carbs. No fruit, no starch, not even carrots or winter squash for long periods of time. Selectively reading one-sided material that reinforced my current beliefs (Like Gary Taubes and Michael Eades, etc.), I intellectually convinced myself that I was doing the right thing and Ignored my body. I can be bull-headed (taurus).
        It’s hard to look back and recognize exactly when signs started to show that things were headed downhill, but about three years in I was undeniably in the worst state of health in my life. I was a wreck of nerves, constantly feeling panicy dread. Walking down the street I though everyone was staring at me, or sometimes even following me. I became convinced that even the people who loved me hated me. Social situations were agonizing; I had a hard time making eye contact with people and felt squeamish. My gut was a wreck. I was nauseated all the time. Having always tended toward a slow-moving bowel, for the first time in my life I was having diarrhea all the time. I felt like crying and screaming all the time. My periods had always been irregular but they definitely became worse, sometimes not coming for six or more months (i didn’t track). My PCOS (undiagnosed at the time) symptoms became exponentially worse at this time. Body and facial hair began growing like mad; my love handles grew back, along with significant belly fat for the first time in my life. Typical hypothyroid symptoms also started to pop up or get worse: Lost the outer third of my eyebrows, inability to focus or think clearly, dry skin, hair, eyes, mouth, vagina. I could go on.
        I won’t pretend that I think that there weren’t other factors leading up to that point. I had also just moved to New York City which was a very stressful atmosphere for me, and I now believe I may have been exposed to toxic mold. I do strongly believe, however, that a long-term low carb diet is at least partially to blame. To be fair, though, I do eat more carbs now, and my period is still far from normal.
        Lara, your blog (and book) is a blessing and wonderful resource. Thank you. I wish I had found them sooner. I hope that in reading your advice and the personal experiences of other women will give women pause for thought and a more careful approach in implementing a low cab diet.

        Reply
        • Hi Lindsay, Thank you for the feedback about my book, and thank you for sharing your story with my readers. Little by little, we will all hopefully arrive at a better understanding of what diet really works for people. And of course, it will be different for different people.

          Reply
      • Low-carb has literally been a “quality of life”-saver for me, although I understand that it’s not a universal experience. It did take me about four months for my body to completely adjust, but now everything runs beautifully. And pain-free.

        In my case early treatment with hormonal bc definitely masked the developing PCOS! I started on it as a late teenager after the dermatologist recommended it as an acne treatment, followed by accutane. Fast-forward a decade and the problem still persisted. I then got diagnosed with PCOS and was immediately prescribed Mirena. And that’s when I decided that no, there has to be another way.

        I’m really scared for the generation of young girls today for whom the path to long-term hormonal birth control is absolutely normal. And nobody dares to question it.

        In any case, I was very happy to find your blog. 🙂

        Reply
  50. I am not young (47) and I have tried lowcarb highfat three times over the last few years – each time for about 60 days – each time I lost my period – which had been perfectly normal prior to – each time the low carb experts said 1. I didnt give it enough time 2. I must not be doing it right (the third time I tracked every meal and macro) 3. there must be something unbalanced in my hormones causing an abnormal reaction to low carb (huh?)

    I am very sensitive to sugar (morning glucose goes very high) and processed carbs make my heart race within minutes of eating then – but my cycle and so much more – is so much better when I stay at least above 150 carbs per day

    thanks for this great article
    lisa

    Reply
    • Thanks for sharing your story. You’re right to point out that it can affect older women as much as younger women.

      That is such a common response from low carb experts: “You must be doing it wrong.” That’s one of the reasons I wrote this post.

      Reply
  51. Hello doctor,I am new to this site.I’ v been searching years an answer for my horrible irregular cycle since my childhood. could I mail you about my condition. agin am in little hope after seeing your site.
    thanks.

    Reply
  52. Hello doctor,I am new to this site.I’ v been searching years an answer for my horrible irregular cycle since my childhood. could I mail you about my condition. agin am in little hope after seeing your site.
    thanks.

    Reply
  53. Thank you for putting this out there! I have experienced this in my practice too. In the US most people are insulin resistant. Getting them off of sugar and gluten is so important and beyond that I call it finding your spot on the “carb continuum”. That spot varies at different stages in the healing process, activity level, etc.
    Thank you, I enjoy your posts!

    Reply

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