Thriving Through Change: Navigating Menopause with a Ketogenic Advantage

Elizabeth Priest
6 days ago
9 min read

Menopause is a chapter in a woman's life; like any great story, it can have twists and turns. It is like puberty in reverse!

As we transition from perimenopause to menopause, the brain and the body undergo some dramatic shifts. Contrary to what many conventional docs say, we do need some hormones as we age, just not as much as we do in our childbearing years. As our ovaries slow the production of hormones like estrogen, progesterone, and testosterone, the adrenal glands pick up the hormonal slack. Many women begin to experience some not-so-fun side effects—think hot flashes, weight gain, mood swings, vaginal dryness, reduced libido, fatigue, and a touch of brain fog—these symptoms are often a part of the transition from premenopause to menopause.

While every woman will go through this inevitable mid-life shift, most women find themselves completely unprepared, uneducated, and uncomfortable with menopause. But guess what! The transition to menopause doesn't have to be feared; it doesn't have to be miserable; there are ways to navigate these changes with ease and success!

One factor that can make things more challenging during menopause is insulin resistance. Simply put, this is when your cells become less responsive to insulin, the hormone that helps regulate blood sugar levels. When this happens, your blood sugar levels can rise, leading to your body producing more insulin. Unfortunately, this cycle can worsen those pesky menopausal symptoms.

While addressing health from a functional nutrition perspective is not a one-size-fits-all approach, a ketogenic diet can sometimes be a great tool to combat menopausal symptoms. Research shows that low-carb diets can boost metabolism, balance hormones, and sharpen mental clarity. A ketogenic approach can help tackle insulin resistance and promote healthy hormone levels—after all; those hormones love a good fat source!

In this blog post, I'm discussing how a ketogenic diet might be the secret weapon you need to navigate perimenopause and menopause with ease. The relief and hope that a ketogenic diet can bring are significant, offering a potential solution to the challenges of this life stage.

What are Perimenopause and Menopause?

Menopause is a term to mark the permanent end of menstrual cycles and is defined as when a woman has been without a period for 12 months. Perimenopause is much more convoluted and, for many, difficult to endure. This phase typically lasts 2 to 8 years leading up to the day menopause occurs.

Perimenopause is characterized by declining estrogen and progesterone levels, but these hormones don't decrease in a straight line. Instead, they fluctuate unpredictably and differently between individuals, contributing to irregular periods, sweating, and mood changes. Other key hormonal shifts include:

Cortisol Dysregulation: Increased stress sensitivity can contribute to lowered energy and poor sleep.
Lowered progesterone can lead to difficulty sleeping and increased tension and worry.
Estrogen Decline: This can affect bone density, metabolism, and cardiovascular health.
Insulin Sensitivity Changes: May make weight maintenance and blood sugar balance difficult.

During this time, menstrual cycles may become erratic and irregular. Our supply of eggs in the ovaries slowly diminishes, causing the body to produce and release less estrogen. The pituitary glands in our brains increase the production of the follicle-stimulating hormone (FSH) and luteinizing hormone (LH) until they reach abnormal levels. The pituitary is essentially screaming at the ovaries to produce estrogen, but the ovaries have stopped receiving the message. This communication between the brain and an end organ/ gland is called a feedback loop system.

Menopause officially occurs after 12 consecutive months without a menstrual period and completes the full cycle of transition. But, this does not mean the symptoms related to menopause stop; many women continue to feel the side effects of menopause from perimenopause through post-menopause.

Symptoms of Perimenopause and Menopause

When you first enter perimenopause, the symptoms may be subtle and go by unrecognized. But somewhere along the way, the obvious signs that your body is going through a dramatic hormonal change become too obvious to ignore. The most common symptoms of menopause include:

Weight gain (especially lower abdominal fat)
Trouble losing weight
Hot flashes and night sweats
Mood swings, depression, and anxiety
Insomnia
Extreme fatigue
Thinning hair and dry skin
Vaginal dryness and low libido
Frequent UTI's
Poor memory, trouble concentrating, and brain fog

In the modern world, many women enter perimenopause and menopause, facing a transition that can either be smooth or quite challenging. The side effects experienced during this time can vary from merely annoying to severely disruptive. Many women report these years as some of the most difficult, with feelings of depression and frustration. However, this experience was not always the case, and I don't believe it is how nature intended it to be. It's important to remember that you're not alone in these experiences, and they are a common part of the menopausal journey.

As women's ovaries slow hormone production during menopause, the adrenal glands and fatty tissue become important backup systems for hormonal balance. Unfortunately, lifestyle factors often compromise adrenal health in women by the time they reach age 50, leaving them ill-prepared to manage hormonal balance effectively. And, if a woman has lived a life consuming a highly processed Standard American Diet and has some excess weight, this excess fat tissue, particularly visceral fat (the type of fat around organs), can start to produce hormones and play a role in hormone conversion from estrogens to androgens or even cancer-causing forms of estrogen.

Other factors beyond diet include excess weight, blood sugar and insulin level imbalances, inflammation, poor stress management, and a sedentary lifestyle. All of these aspects need to be taken into account for a smoother transition from being a cycling female through perimenopause and into menopause.

Now, here's where the ketogenic diet comes in. A ketogenic diet is a high-fat, low-carbohydrate diet that shifts your body into a state of ketosis, where you're burning fat for fuel instead of sugar. This can be a game-changer for a couple of reasons.

Keto and Menopause

A ketogenic diet may curtail menopausal symptoms and improve your quality of life because it shifts your body into a perpetual state of nutritional ketosis. When in Nutritional Ketosis, BHB ketone levels are present in the blood, starting at 1.0 mmol/L. When your body is in nutritional ketosis, your body starts running on fat (ketone bodies) instead of sugar (carbohydrates). This shift only happens when the body is deprived of carbohydrates, which allows the liver to convert fat (from food and the body) into ketones and then use those ketones for energy.

When you're in ketosis, your body combats two significant issues associated with menopause: hormonal imbalance, which is responsible for weight gain and mood swings, and insulin resistance, which challenges your health with high blood sugar levels. Here's how.

The Keto Diet Improves Insulin Sensitivity

Insulin is an anabolic hormone produced by the pancreas in response to rising blood glucose levels. Its primary role is to lower blood sugar by increasing cell membrane permeability, allowing glucose to enter cells for energy or storage as glycogen in the liver and muscles. When glycogen stores are full, insulin directs excess glucose into fat cells, converting it to triglycerides, contributing to weight gain and obesity.

When you consume a diet based on the Standard American Diet, your body gets its energy from glucose, primarily through digesting carbohydrates and sweets. Then, the hormone insulin shuttles glucose out of your blood and into your cells for fuel. Insulin resistance occurs when insulin receptor sites become unresponsive to insulin. When elevated blood sugar levels trigger the release of insulin to bring glucose levels down, if the cells are unresponsive or "resistant" to insulin, then the insulin can't shuttle the glucose out of the blood and into the muscle, liver, or fat cell, and the pancreas subsequently increases its production of insulin to compensate.

When glucose levels are chronically elevated and insulin levels are increased, significant detrimental impacts occur, including adrenal and sex-hormonal imbalances.

When we reach perimenopause and menopause, it is expected to see a decline in the amount of sex hormones being produced, but layer on top of that dysregulated blood sugar and insulin resistance, and it makes things even worse.

Studies show a keto diet can lower insulin resistance and increase insulin sensitivity.

Side Note on Estrogen

If you're menopausal or perimenopausal, you'll likely experience low estrogen levels, and unfortunately, low estrogen levels can lead to insulin resistance. Ironically, however, so can high estrogen levels.

In industrialized countries, such as the United States, the most common driving factors behind estrogen dominance include:

Excess body fat (greater than 28%)
Excessive stress, resulting in excess amounts of cortisol, which leads to adrenal exhaustion and can adversely affect overall hormone balance
A low-fiber diet, high in refined carbohydrates and deficient in nutrients and high-quality fats
Impaired immune function
Environmental agents, which include xenobiotics.

Estrogen dominance can be viewed really from three perspectives:

1. Excess estrogen production in the body.

2. Normal estrogen production or even low estrogen production but elevated in relation to other hormones such as progesterone.

3. Estrogen dominance is due to exposure to exogenous estrogen or xenoestrogens (i.e., synthetic hormones), which is a huge consideration and predominates in today's world. Xenoestrogens are estrogen-mimicking chemicals found in our food system, water, personal care products, and even our food storage and cookware.

A high insulin load can further challenge estrogen deficiency or dominance. So, whether estrogen-dominant or deficient, regulating blood sugars and lowering insulin are critical parts of hormonal optimization.

The Keto Diet Can Fulfill Your Appetite

Women in the menopause cycle often have higher levels of ghrelin (aka the "hunger" hormone). Ghrelin alerts your body when you're hungry. But high levels can mean you always feel hungry and never feel satiated. This slippery slope can lead to overeating, extra calories, and creeping weight gain.

A ketogenic diet crushes ghrelin levels, leading to greater appetite suppression. According to research:

Limiting daily carbohydrate intake to 50 grams or less reduced hunger and appetite.
Consuming exogenous ketones helped participants lower ghrelin levels, perceived hunger, and desire to eat.
Replacing carbs with moderate protein also renders a satiating effect, which can help you naturally eat fewer calories while preserving your lean muscle mass.

The Keto Diet Can Help With Weight Management

Along with high ghrelin levels, low estrogen levels lead to weight gain, especially in the lower abdominal area. Tummy fat storage can be more dangerous than the fat on your hips or thighs, specifically if it's "visceral fat," which is fat that fills the spaces between the abdominal organs and in an apron of tissue called the omentum, which is located under the belly muscles and blankets the intestines. Excessive visceral fat increases your risk for heart disease and metabolic syndrome.

The aim of a ketogenic diet is to get into ketosis, the state where your body actively burns your fat stores. The breakdown of fat for energy (lipolysis) boosts your metabolism and transforms your trouble spots into fuel reserves!

The Keto Diet Can Help to Lower Inflammation

The Standard American Diet is full of foods that inspire inflammation. Even some foods that are thought of as healthy can cause inflammation in some people. Chronic inflammation increases your risk of obesity, type 2 diabetes, heart disease, stroke, and more. Inflammation can also improve symptoms such as depression, anxiety, memory loss, and trouble thinking.

A properly dialed-in ketogenic diet is anti-inflammatory and lowers systemic inflammation. It removes inflammatory foods, including refined carbs, sugar, and highly processed vegetable oils. Instead, anti-inflammatory foods high in omega-3 fatty acids and antioxidants fill the menu.

The best part? Ketones protect your body and brain from inflammation. Science says your brain may use beta-hydroxybutyrate (BHB), the main ketone body, more effectively than glucose. Ketones can boost mental performance, attention, and memory and help reduce brain fog.

The Final Word

Is the keto diet good for menopause? The connection between keto and aiding menopause symptoms seems pretty clear. Efficient metabolic processes, including stable blood glucose levels and effective fuel utilization, characterize good metabolic health. Improving metabolic flexibility is essential for health, including hormone balance and endocrine health during perimenopause and menopause.

It is essential to monitor progress with data such as lab testing, looking at glucose, insulin, A1c, triglycerides, a full female adrenal, thyroid, and sex hormone blood panel, and DUTCH testing to assess hormone metabolism. Also, you'll only reap the rewards of a ketogenic diet if you're actually in ketosis. This is why I recommend testing your ketone levels often to make sure you maintain this metabolic state and work with a trained nutritionist for menopause relief.

And remember, it's not a one-size-fits-all approach. What works for one woman might not work for another. The bottom line is that keto can be a powerful tool for managing menopause symptoms by improving insulin sensitivity, balancing hormones, satiating the appetite, promoting weight loss, and reducing inflammation. It's all about enhancing your metabolic flexibility and helping your body better manage energy.