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Ketosis and Hormone Changes

woman ketosis hormonesWhile working as a nurse with Dr. Robert Atkins, I adopted a low carb diet. My goal was to avoid my genetic tendency for developing obesity and type 2 diabetes.

I had the tools at hand to monitor urinary and breath ketones frequently. After months I noticed that a few days before my period, ketones would drop or even disappear. This coincided with mild PMS symptoms including weight gain and the re-emergence of hunger and cravings. Ketones would return by the 2nd day or so of my menses.

I began to mention this to my patients who wanted to monitor urinary ketones. I didn’t want them getting discouraged if they experienced the same. Many would return and tell me they noticed the drop in ketones as well. They appreciated having advanced warning.

We also observed that with low-carb regimen, PMS symptoms over time would decrease, sometimes to the point that a woman would be surprised when she began her flow. At the start of the plan others would mention that the first period would in some way be worse before getting better. To my knowledge this has not been studied.

What I learned is that any hormone changes in women can increase insulin resistance, which makes the body produce more insulin to get the same insulin benefit. At puberty and menarche when girls need to gain body fat they become more insulin resistant. I have been a carb addict but my cravings increased significantly at this time as did my weight.

Hormones also fluctuate during the menstrual cycle. During pregnancy, peri-menopause, and menopause there are significant hormone changes accompanied by increased insulin resistance.

This change of life stage (peri-menopause) for me was difficult. I lost ketones but still gained weight on my maintenance plan (my strategy was to adopt a 20 gram carbohydrate level and stay there to minimize weight gain). I believe that this is one reason why women can have such difficulty during peri-menopause and menopause managing weight even when doing everything right. I also believe these hormone fluctuations can cause more havoc if one is genetically prone to diabetes. This is all the more reason to adopt a low carb lifestyle now, to decrease carbohydrate intolerance during those normal hormonal life changes.

 

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17 Comments

  1. Avatar

    This article and these posts have been so reassuring! I am 40 and I’ve always good luck with low carb diets. I have been doing keto for about a month now and I’ve lost about 12 lbs. But then my period started and all of the sudden my ketone meter keeps showing “lo” I am so glad to hear that it’s not something I’m doing!

    Reply
  2. Avatar

    I am 47 and per menopausal. Several months ago I came off keto after losing 46 pounds. I missed 3 periods during that time. After returning to a normal diet started getting pretty severe hot flashes. I’ve since gone back on keto the hot flashes are gone haven’t had a period since October. But I’m noticing dramatic drops in urine ketone levels.the highest I’ve gone is moderate and then sometimes there’s no trace but I’m not eating alot of carbs. Weight loss is slow to non existent. Any suggestions let me know.

    Reply
    • Jacqueline Eberstein RN

      This can be the process with sporadic periods until your period stops.
      Be sure you have your annual GYN visit.
      Be patient with wt loss as you transition. Hormones can be erratic which can make wt loss more difficult. It I also easier to gain weight so don’t give up. Measure inches rather than following the scale.

      Reply
  3. Avatar

    I have been doing keto for about 2 weeks now. I am 54 and have not had a period in 8 months, yesterday it showed up. What is going on? Will it go away?

    Reply
    • Jacqueline Eberstein RN

      One is considered post-menopausal when there is no menses for at least a year. It is not unusual for a women to have a few scattered periods before it ceases completely. Each woman has her own pattern.

      Reply
  4. Avatar

    Does anyone have any breast pain due to the affect the low carb diet has on your hormones?

    Reply
    • Avatar

      Me right now

      Reply
  5. Avatar

    I can attest to the fact that the first cycle may be bad. Actually, that’s why I’m here. Due to an ablation, I barely have a period if at all. I also have had no symptoms of a cycle lately. I started Keto about a month ago. A few days ago, I was tired, sore, not recovering from working out, angry, and hungry. I even started to have a panic attack while trying to organize Christmas junk. Yesterday, I started a light period. Apparently, I was PMSing again and didn’t know it to recognize it for what it was. I have probably been going through menopause and didn’t realize it. I do realize the benefits of increased hormone levels are significant, but I’m not looking forward to PMS again. I hope you are correct and it improves.

    Reply
  6. Avatar

    I would like to add my anecdotal observations to this subject.

    I’m on the Keto diet, staying under 25 net grams of carbs per day. The Keto diet was suggested to me as a way of controlling migraines which for me are much worse before and after my period. I’m 47, pre-menopausal and have had chronic migraines for around 4 years now.

    So far so good. My migraine days are down from 15 to 2 per month. However, I have noticed, like you, that my ketone levels (via Ketostix) are ‘trace’ in the days leading up to my period.

    I intend next cycle to decrease carbs further (<10 gram net) and increase my intake of MCT oil and see if that has an effect on my ketone levels as well as my pms symptoms including migraines/headaches.

    I will be sure to report back if I have any success

    Reply
    • Avatar

      Tanya, I know this post is a year old, but did you ever experiment with this, and if so, how did it affect or not affect things?

      Reply
  7. Avatar

    Thanks so much for all this great information. My question is about the effect of hormone therapy with fat loss? I have been prescribed Estrace cream it’s low dose I use this weekly instead for the 3x a week prescribed. Any advice would be helpful.

    Thanks again

    Reply
    • Jacqueline Eberstein RN

      April,

      I can’t give you specific information as there is no one size fits all when it comes to hormones. Peri-menopause and menopause are complex with many hormone interactions. Women’s needs even change over time as they go through the transition. Some women have an easier time than others.

      If symptoms are affecting quality of life then some form of HRT is indicated. Many times only estrogen is given when some progesterone may also be needed. Low testosterone levels in woman are often not even measured or addressed. Low T can make weight loss more difficult.

      Thyroid function commonly gets upset during this time and needs to be fully evaluated with more than just a TSH or T4 level. Adrenal stress plays a role as does high cortisol.

      People with too much body fat can have insulin resistance which gets worse with hormone changes. That’s why the HEAL low carb approach is so important to address insulin resistance and to decrease the risk of type 2 diabetes that is more likely as we age.

      Hope this information is helpful.

      Reply
      • Avatar

        Thank you so much for your reply.

        Reply
  8. Avatar

    Thanks for this affirmation, especially regarding insulin resistance and hormonal changes. I have been on the low carb WOE since May of this year and have lost 34 pounds with 66 pounds to go. I also joined a running group and completed a 5k in July. I walk run 6-9 miles a week. Sunday my fasting BS was 111. When I returned from a 2.5 mile walk/run my BS was 117!!???. I was mystified. I am 51. My last period was in August. Hot flashes are flashing and I am craving more carbs and sometimes giving in. I know I have to stay the course, but it is a daily battle. I feel I need to ask for prayer. Diabetes and heart disease are prevalent in my family. I had gestational diabetes at 41 and my a1c was 7.5 in May. Last check it was 6.0. Following up with my PCP at end of the month.

    Reply
    • Jacqueline Eberstein RN

      Marilyn, You are off to a good start. Diabetes can be put into remission so keep it up and focus on getting healthier not just watching the scale. When hormones change things can be more difficult but it will get better and you will adjust to low carb and create a healthier life for yourself as you age. Good luck.

      Reply
  9. Avatar

    I think low carb has been a great way for me to handle peri-menopause; I was having no luck with a “regular” diet. My cravings (chocolate, carbs) were out of control and my weight was edging ever higher. My brother discovered low carb high fat this year, after trying Paleo a few years ago. He helped me find a better way to eat.
    I decided to jump-start ketosis with a 36 hour fast. The first week was still difficult, especially exercising, but I’ve stuck with it and I feel so much better. My appetite has dropped in response to high fat. Various aches and pains have cleared up. I have an occasional hot flash but I don’t feel overwhelmed by symptoms. Cooking is so easy and I actually save money on groceries because I don’t buy as much food. Now that I’m near my goal weight I will need to figure out what is required for maintenance.
    Thank you for these articles!

    Reply
    • Jacqueline Eberstein RN

      Thanks, Monica. I’m pleased you’re having such success. Hopefully your experience will encourage other women.

      Reply

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