PCOS affects roughly one in ten women of reproductive age and is closely linked to insulin resistance, weight gain, and chronic low-grade inflammation, resulting in irregular cycles, fertility issues, and enhanced cardiometabolic risks. Since modest weight loss can normalize menstrual function and improve fertility, dietary interventions remain vital but often hard to sustain. VLCKD, which triggers nutritional ketosis and reduces insulin and visceral fat, may offer a practical solution.
Following PRISMA guidelines and a PROSPERO-registered protocol, the team searched global databases for RCTs up to July 2025, selecting studies involving adult women with PCOS on a VLCKD. Outcomes assessed included weight, BMI, waist circumference, fat mass, waist-to-hip ratio, key reproductive hormones (free and total testosterone, SHBG, LH, FSH, LH/FSH ratio), and metabolic markers like fasting glucose, insulin, insulin resistance (HOMA-IR), and lipid profiles.
Meta-analyses using random-effects models revealed significant reductions in body weight (~9.6 kg), waist circumference (~7.7 cm), fat body mass (~7.4 kg), and BMI (~3.5 kg/m²). Hormonal shifts indicated decreased free and total testosterone, lowered LH and LH/FSH ratio, and increased SHBG, which collectively suggest reduced hyperandrogenism and enhanced ovulatory potential. Metabolic control improved with lower fasting glucose and insulin levels and reduced insulin resistance. Triglycerides decreased; however, changes in LDL, HDL, and total cholesterol were inconsistent.
Despite moderate evidence certainty and heterogeneous trial designs — including varied caloric intakes and durations (4 to 24 weeks) — results consistently support VLCKD as an effective dietary approach to alleviate PCOS symptoms and improve cardiometabolic health. However, larger, longer-term studies are necessary to ascertain safety, adherence, and benefits across PCOS phenotypes, as well as direct comparisons with other diets.
This pioneering research charts a promising path for managing PCOS through targeted nutritional ketosis, with potential to improve fertility, metabolic function, and quality of life for millions affected worldwide.
REFERENCE: Tosatti, J. A. G., Magalhães, F. M. V., and Gomes, K. B. (2025). Effects of the very low-carbohydrate ketogenic diet in women with Polycystic Ovary Syndrome: a systematic review with meta-analysis of clinical trials. British Journal of Nutrition. DOI: 10.1017/S0007114525105692 https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/effects-of-the-very-lowcarbohydrate-ketogenic-diet-in-women-with-polycystic-ovary-syndrome-a-systematic-review-with-metaanalysis-of-clinical-trials/A99D5670AC6F774E4531D143A4DB6395
Disclaimer: This website is primarily for healthcare professionals. The content here does not replace medical advice and should not be used as medical, diagnostic, endorsement, treatment, or prescription advice. Medical science evolves rapidly, and we strive to keep our information current. If you find any discrepancies, please contact us at corrections@medicaldialogues.in. Read our Correction Policy here. Nothing here should be used as a substitute for medical advice, diagnosis, or treatment. We do not endorse any healthcare advice that contradicts a physician's guidance. Use of this site is subject to our Terms of Use, Privacy Policy, and Advertisement Policy. For more details, read our Full Disclaimer here.
NOTE: Join us in combating medical misinformation. If you encounter a questionable health, medical, or medical education claim, email us at factcheck@medicaldialogues.in for evaluation.