If you’ve been exploring ways to support your hormonal health—whether for PCOS, fertility, postpartum recovery, or just better energy—you’ve probably come across the ketogenic diet. But can keto actually help balance your hormones? And if so, how should you approach it to work with your body, not against it?

Let’s take a closer look at how keto affects your hormones, what benefits (and risks) to watch for, and how to make it work in a nourishing, sustainable way.

What Is Keto, and Why Does It Matter for Hormones?

Keto is a high-fat, very low-carb diet that puts your body into a state called ketosis. When you’re in ketosis, your body switches from burning sugar (glucose) for energy to burning fat and producing ketones. That shift impacts more than just your metabolism—it also affects insulin, cortisol, estrogen, and appetite-regulating hormones like ghrelin and leptin.

The standard keto ratio is about 70–80% fat, 15–20% protein, and less than 10% carbohydrates (usually fewer than 50 grams a day). While that sounds intense, many women find they feel more stable, focused, and less hungry when they’re in ketosis—especially if they’re dealing with insulin resistance.

How Keto Affects Insulin and Blood Sugar

Insulin plays a central role in hormone regulation. It’s not just about blood sugar—it also affects ovulation and inflammation. If you have insulin resistance (which is common with PCOS or postpartum hormone shifts), your cells don’t respond to insulin, and your body produces more of it.

On a keto diet, insulin levels typically drop. This can be a good thing. In one 12-week study, women with PCOS who followed a ketogenic diet had lower insulin, reduced testosterone, and more regular ovulation (Paoli et al., 2020). Another review showed that within just 45 days, following a keto diet improved LH/FSH ratios (relative levels of two hormones in the bloodstream) and increased SHBG, a protein that helps regulate estrogen and testosterone (Khalid et al., 2023).

This reset in insulin sensitivity can also support more regular cycles, better energy, and a reduced risk of long-term issues like Type 2 diabetes.

How Keto Affects Hunger and Cravings

One surprising benefit of the keto diet is how it changes your appetite. If you’ve ever felt like you’re constantly fighting cravings, it’s likely your hunger hormones were out of sync. Keto tends to reduce ghrelin (the hunger hormone) and increase satiety hormones like GLP-1 and CCK (Sumithran et al., 2013; Gibson et al., 2015).

That means you feel full longer. And, when you're not constantly battling hunger, your energy feels more stable throughout the day. That steadiness can also lead to fewer emotional highs and lows, helping you feel more grounded both physically and mentally.

What About Cortisol and Stress—Especially for Women?

When women begin a ketogenic diet, the body goes through an adjustment phase. It’s common to feel more fatigued, edgy, or wired at first. That’s because cortisol, your primary stress hormone, can rise temporarily as your body shifts from burning carbs to using ketones.

For women, this early “keto flu” may trigger a sharper cortisol response, especially if paired with low calorie intake or over-exercising. Research shows that short-term ketogenic diets can increase resting and post-exercise cortisol levels in the first two weeks of adaptation (Whitaker et al., 2022). However, these effects tend to normalize after about three weeks.

Encouragingly, longer-term studies—of both men and women, show no consistent rise in cortisol with sustained keto diets. In fact, one study found a well-structured keto diet had no negative impact on cortisol levels in women and even supported adrenal balance in those with stress-related conditions (Guarnotta et al., 2023).

Bottom line? A keto diet doesn’t have to be another stressor. When done thoughtfully—with enough calories, rest, and support—it can be a nourishing way to reset your metabolism and support hormone health.

Reproductive Hormones: Estrogen, Progesterone, and Ovulation

Body fat plays a role in estrogen production, so when you reduce fat mass through dietary changes, stored estrogen levels may drop. This is helpful if you’re dealing with estrogen dominance (common in PCOS or postpartum), but it needs to be done gradually. Too-rapid changes can lead to drops in estrogen that may disrupt your cycle.

Keto can also help regulate your LH and FSH levels and lower elevated testosterone, which are often at the root of irregular periods and ovulatory dysfunction in PCOS. In fact, women with PCOS who followed a keto diet for a few months were more likely to resume ovulation and improve fertility outcomes (Endocrine Society, 2023).

You may also notice improvements in skin, PMS symptoms, and even mood stability as your sex hormones rebalance.

When Can a Keto Diet Work for You

You might benefit from a keto diet if you’re navigating:

• PCOS: Especially if insulin resistance and elevated testosterone are part of your picture (Mavropoulos et al., 2005).
  
• Postpartum (after weaning): Keto may help rebalance your cycle and improve energy once breastfeeding ends.
  
• Cycle irregularity linked to metabolic dysfunction: Keto supports insulin sensitivity—an important factor in hormonal regulation and ovulation.
  
  

That said, a keto diet isn’t for everyone. If you’re currently pregnant, breastfeeding, or recovering from an eating disorder, talk to a healthcare provider before starting. A moderate, whole-foods-based approach might be a better fit.

How to Follow a Keto Diet in a Hormone-Supportive Way

Keto diets don’t have to be restrictive or meat-heavy. In fact, it works best when it’s personalized and nutrient-dense. Here’s how to make keto work for your hormones:

• Eat quality fats like olive oil, avocado, pasture-raised ghee, and fatty fish for anti-inflammatory support.
  
• Get enough protein to support ovulation, thyroid function, and muscle repair (especially postpartum).
  
• Prioritize non-starchy veggies like leafy greens, cruciferous veggies, mushrooms, and zucchini for fiber and hormone detox.
  
• Don’t skimp on electrolytes—especially sodium, magnesium, and potassium. These are crucial during the keto transition.
  
• Try cycle syncing: If you still have a menstrual cycle, adding more carbs during the luteal phase can help support progesterone and prevent burnout.
  

How You’ll Know It’s Helping

Every woman’s experience is different, but here are some signs your hormones are responding well to following a keto diet:

• More consistent cycles
  
• Less PMS and cramping
  
• Stable energy and mood throughout the day
  
• Fewer cravings or emotional eating episodes
• Improved skin, especially if you had acne related to PCOS
• Better lab results (insulin, fasting glucose, lipids, SHBG)
  

If your period disappears or you start feeling cold, anxious, or exhausted, that’s a sign to reevaluate. You may need more carbs, calories, or a different approach altogether.

How Chiyo Can Support You

At Chiyo, we take a whole-body approach to hormone health. Our Hormone Balance Program includes keto-friendly, low-glycemic meals made with nutrient-rich ingredients and guidance rooted in both modern nutrition and Traditional Chinese Medicine. For example, one of our hormone-supportive meals might include sesame-ginger braised salmon with sautéed leafy greens and cauliflower rice—a nutrient-dense, anti-inflammatory combination rich in omega-3s, fiber, and essential minerals. It’s the kind of food that supports your metabolism and helps stabilize hormones naturally.

Whether you’re managing PCOS, recovering in postpartum, or just trying to feel better in your skin—following a keto diet might be the missing piece. And we’re here to help you do it in a way that feels nourishing, not punishing.

Explore Chiyo’s Hormone Balance Program to learn how we can support you on your journey.