Does Keto Cause Menopause?

Keto and menopause - two words women may not associate when they make the transition that ends most of the estrogen production, menstrual cycles, and reproductive years. But keto and menopause are getting a lot of attention now as the ketogenic or keto diet has become a popular eating style. "The keto diet has been around for a long time and there are certain advantages for women going through menopause. But there are also many disadvantages," says Dr. Michael Tahery, obstetrician and urogynecologist from Los Angeles.

What is the Keto Diet?
A keto diet is a restrictive eating style that changes the type of fuel your body uses. Diet starves the body for glucose, the main source of energy that comes from carbohydrates. Legumes, bread, pasta, cereal, starchy vegetables like potatoes, dairy products, and sweets are usually not on the menu.
Without glucose, the liver converts stored fat into chemicals called ketone bodies, which are then used as energy by the brain and body.
To fuel ketosis, the body needs more fat, which is why a classic keto diet includes:
- 90% of calories from fat (especially saturated fat such as red meat, whipped cream and butter).
- 6% of calories from protein (too much protein throws a wrench into ketosis).
- 4% of the calories from carbohydrates.

[Read: We Interviewed People On The Keto Diet. Here's what they say.]
Modified keto diets typically contain less fat, more protein, and often more carbohydrates than a classic keto diet. The proportions vary widely, depending on the diet:
- 70% to 87% of the calories from fat.
- 10% to 15% of calories from protein.
- 3% to 15% of the calories from carbohydrates.
"Both the classic keto diet and the modified keto diet are far from how most people normally eat. The majority of our calories - around 45% to 65% - usually come from carbohydrates. These diets lower the carbohydrates to around." 10% and limit them to so many food groups that it becomes almost impossible to follow this eating pattern long term, "says Liz Weinandy, the lead ambulatory dietitian at Ohio State University's Wexner Medical Center.
Keto and Menopause: Benefits
Some people turn to keto during menopause to manage physical changes and menopausal symptoms. Without estrogen, for example, the metabolism slows down and the body redistributes fat. "The weight builds up in the abdomen even when there has been no weight gain," notes Tahery.
Declining estrogen levels also cause menopausal symptoms that can last up to seven years, including:
- Hot flashes and night sweats.
- mood swings.
- tiredness.
- Difficult sleep.
- Fuzzy thinking.
Vaginal dryness.
In theory, the high fat ketogenic diet can reduce some menopausal symptoms. "Fat is a precursor to estrone, a weak type of estrogen made by fat cells," says Tahery. "The more fat you consume, the more estrogen you have in your system. It can lead to fewer hot flashes, mood swings, and fatigue."
Keto can help you:
- Lose weight, which reduces your risk of heart disease, joint problems and cancer.
- Reduce blood sugar levels and reduce the risk of type 2 diabetes.
- Improve insulin sensitivity and make this hormone that carries glucose to cells more effective.
However, it's important to note that the benefits of keto and menopause are only short-term. For example, weight loss can be the result of fluid loss when the body's sugar stores are depleted. "The keto diet acts as a diuretic," says Weinandy.
You can regain weight once you get off the diet if you are not exercising or reducing the amount of calories you are consuming.
[READ: 10 Strategies for Coping with Libido Loss and Other Menopausal Symptoms.]

Keto and hot flashes
Keto for menopause can sometimes backfire. "In some people, it can cause even more menopausal symptoms," Tahery says.
Keto hot flashes and other menopausal symptoms that worsen on a keto diet may be the result of the diet's diuretic effects. "You urinate frequently and lose electrolytes at the same time - sodium, potassium, and calcium," Weinandy says. "The change in electrolytes can cause fatigue, pain, and discomfort known as 'keto flu' within the first two or three days after dieting."
Is It Possible To Avoid Keto Hot Flashes? "If you drink plenty of fluids and increase your carbohydrate intake, the keto flu goes away. However, if you stay on the diet, it is possible that it will get worse and not go away," Tahery says.

[READ: Eat Healthy Carbohydrates.]

Keto and Menopause: Risks
In addition to discomfort, the keto diet and menopause can pose health risks. Three of the biggest are:
- heart disease. "Estrogen has a protective effect. It helps with good HDL cholesterol, prevents the body from making bad LDL cholesterol, and has been shown to increase blood flow to the heart," Tahery says. "But you lose that protection after menopause. A keto diet with all that (saturated) fat increases your LDL and your risk of heart problems."
- cancer. The consumption of saturated fat (especially red meat) is linked to an increased risk of developing cancer. "The more fat you consume and the more estrone your fat cells produce, the higher the risk of cancer," Tahery said.
- osteopenia and osteoporosis. A keto diet contributes to the early and later stages of bone thinning. "The diet is typically too low in calcium and other nutrients in fruits and vegetables that promote bone health, such as magnesium and vitamin C," says Weinandy.
A keto diet can also cause or contribute to:
- constipation.
- Very low blood sugar.
- Overworked kidneys or kidney stones.
- Nutritional deficiencies (including calcium, vitamin D, vitamin C, magnesium, and other beneficial phytonutrients from plants).
What you should do
If you're looking to speed up your post menopausal weight loss, Tahery says it's probably okay to try a short-term ketogenic diet.
But he and Weinandy recommend you:
- Just try the modified keto diet (not the classic version).
- Consult a doctor or nutritionist.
- Eat only lean protein, plenty of fresh vegetables and some fruit.
"Focus more on unsaturated fat," says Weinandy. "Have a good source of fat with every meal. Ideally, it should be a vegetable and heart-healthy fat such as avocado, olives, walnuts, olive or safflower oil."
If you are considering a keto diet as a solution to keto hot flashes or other menopausal symptoms, Tahery says the diet isn't a safe bet. "I don't recommend the keto diet for treating menopausal symptoms. The best solution is exercise, maybe hormone replacement, reduced alcohol and caffeine intake, more sleep, even acupuncture. It needs to be individualized, especially in a high-risk person," he says. "But in my 25 years of practicing, strict diets don't work."

Heidi Godman reports on health for US News, with an emphasis on middle and older ages. Her work has been featured in dozens of publications, including the Harvard Health Letter (where she serves as editor-in-chief), the Chicago Tribune, Baltimore Sun, Orlando Sentinel, and the Cleveland Clinic Heart Advisor.

Heidi worked for more than 20 years as a TV news anchor and health reporter for the ABC subsidiary WWSB and for more than five years as the presenter of a daily health talk radio show at WSRQ-FM. Heidi has interviewed surgeons in operating rooms, scientists in laboratories, and patients at all stages of treatment. She has received numerous awards for outstanding health reports and was the first television station in the country to be named a Journalist by the American Academy of Neurology. Heidi holds a degree in journalism from West Virginia University.

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