Do you have to be lifelong VLC or LC for PCOS (polycystic ovarian syndrome)?

Answered on August 19, 2014
Created May 04, 2012 at 3:07 PM

I have several friends with PCOS. They were wondering what level of lifelong carbohydrate do they have to stick to? I define VLC (very low carb) as less than or equal to 50 g/day and LC (low carb) as 51-150 g/day.

I know this might be n=1 but I wanted to hear feedback from longtime PCOS patients who have done Paleo long-term (at least several years). Or if you are PCOS and you have Paleo/low-carb-friendly (or at least sympathetic) doctor/health professional - what do they think?

I know for some conditions like cancer, epilepsy, etc. ketogenic is the best way to go - and lifelong! Is this true for PCOS?




on May 04, 2012
at 07:04 PM

I don't know for sure long term, but I think I'm getting better. My last ultrasound came back completely normal, no cysts (OMG! I could hardly believe it). I don't know if I could go high carb all the time at this point, but I failed to defrost meat in time, so dinner last night was just taters, a little butter, and some cheese, and it didn't feel like it messed up my blood sugar at all.

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4 Answers


on May 04, 2012
at 06:07 PM

Caveat: I'm neither a woman nor a doctor.

The plausible mechanism for LC/VLC working to help PCOS is that it induces ketosis and a more fat-burning metabolic orientation. The weight loss engendered (and the burning of excess adipose when fasting, especially) decreases insulin resistance (which feeds into the hormonal cycle). Adipose tissue also tends to aromatize androgens to estrogens, which further inhibit FSH. The increase in LH maintains the unopposed estrogen dominance, creating insulin resistance and hyperglycemia ad infinitum.

Weight loss is one of the primary interventions begun for PCOS in all settings. Since LC/VLC is almost universally effective for loss of excess adipose, it can only help in terms of getting one to a better place. If one could maintain a healthy weight without being LC/VLC, it probably wouldn't hurt to increase the carb intake moderately. Probably of equal importance is the 3:6 balance, which will normalize the pulsatile hypothalamic GnRH secretion that regulates LH/FSH cycling (and thus the estrogen/progesterone cycling that is pathologic in PCOS). Plus, progesterone is easier to make from cholesterol than estrogen, so replacing carb intake with fat intake (including cholesterol intake) should also help the process.

Not exactly what you were asking for, but when I didn't see the pathophysiology begin to appear, I thought it might be useful to throw it out there (albeit very roughly sketched). And at least I got to use the caps-lock a whole lot without looking like I was screaming c:



on May 04, 2012
at 05:37 PM

PCOS and paleo for 24 days, lost 18.6lbs. I had my first menstral cycle unaided by hormones this month. I'm VLC so I did find that it helps my PCOS but I haven't gone long term yet so can't speak to that. I'd venture to say it could vary woman to woman.


on May 04, 2012
at 05:34 PM

I have PCOS, stopped my birth control and I am usually around 80g carbs. Under 100 seems to keep me feeling good. Mind you I haven't been paleo for very long like you were seeking.


on May 04, 2012
at 05:07 PM

Go check out some of Paleo Pepper's stuff on PCOS, like this one Julianne tweeted Taylor today. http://paleopepper.com/2012/03/emerging-from-starvation-why-i-can-no-longer-fast/ Pepper did not find that VLC worked well for her PCOS.

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