Keto for Women: 14 Tips and Recipes to Help You Get Results

Diets are never a one-size-fits-all endeavor, and keto is no exception. Many turn to ketogenic meal plans for potential benefits like weight loss, but if you’re a woman who hasn’t found success riding the low-carb, high-protein train yet, you’re not alone.

Most of keto’s guidelines are based on research studying only small groups of people or male mice, which means your unique physiology, hormone fluctuations, and other factors haven’t always been taken into account—until now. Inspired by personal experience as well as concerns facing patients in their practices, doctors have started suggesting modifications to help women get the most out of this low-carb lifestyle.

Quick Refresh: Keto Basics

The ketogenic diet promotes high fat, low-carb meals, along with adequate protein. Originally used to treat epilepsy in children, this way of eating has become popularized in recent years because achieving ketosis—a fat-burning metabolic state—is believed to offer certain health benefits as your body learns to burn fat instead of glucose. To drop into ketosis (and stay there) requires reducing carbs to about 50 grams per day or less.

Women and Keto: What the Research Says

It’s a true and somewhat frustrating fact that men tend to lose weight easier than women. One theory as to why is because men—who naturally have more testosterone—are able to burn calories faster due to having greater muscle mass. Women’s bodies, on the other hand, have lower testosterone and higher estrogen levels, leading to slower results when it comes to weight loss.

Women’s metabolisms also slow down in perimenopause, and thyroid hormones can get out of balance more easily with age. All these fluctuations mean that reduced estrogen may lead to increased abdominal fat. Plus, the stress hormone cortisol can trigger blood sugar spikes and lead to stored belly fat as well.

A study at the University of California, Riverside admits that there’s still a lot to learn when it comes to understanding how genes or proteins impact the diet, but suggests that keto doesn’t work as well for women because they metabolize fat differently than men, and “have different genes turned on and off in response to fasting.” Although adopting a keto diet may be an effective strategy to balance insulin—the main hormone involved in weight gain—you have to do it mindfully because keto may also disrupt hormones. Here are three to look out for:

• Cortisol: Going keto trains your body to eliminate fat, not store it. But high stress levels combined with a diet that doesn’t offer the right amount of carbs may burden the body and lead to cortisol spikes. An eight-week study researching stress and diet suggests that when it comes to managing mental and metabolic health, “it may be appropriate to consider carbohydrate intake, and perhaps even increasing intake in the context of a healthy whole food diet.”
• Estrogen: Without enough vegetables (and the fiber that comes along with them), estrogen may become unbalanced. Board-certified obstetrician-gynecologist Dr. John Thoppil explains that “lower estrogen levels have certain side effects that go along with that, [such as] vaginal dryness, but the long-term health concern would be the increased risk of bone loss.”
• Thyroid: Low-carb diets can undermine thyroid health by raising reverse T3 (rT3), an inactive metabolite of T4 that helps slow your metabolism to conserve energy. “The bear in the woods” theory from Dr. Cate Shanahan explains that the sudden change from high carb to low flips a switch. “An abrupt decline in available glucose may trigger an atavistic hibernation reflex, which will trigger the conversion of a thyroid hormone called T4 into something other than the normal T3, namely into the reverse form, rT3. rT3 then gets converted into thyronamines and causes all the symptoms of low thyroid function without significant deficiencies of thyroid hormone showing up on lab tests, leaving people to worry there is something incredibly wrong with their hormonal function.”

How to Adapt Keto for Women’s Health

In her practice as a board-certified physician, functional medicine expert, and author of Women, Food, and Hormones, Dr. Sara Gottfried found that female patients following keto diets were more likely to produce too much cortisol (see above), have menstrual irregularities, and experience thyroid imbalances. Referred to as “lazy keto,” this version of the diet doesn’t include enough fiber and vegetables to feed the gut’s microbiome, and Dr. Gottfried explains that “healthy estrogen balance relies on optimal gut health.” A low-carb diet can also impact sleep in negative ways and can “fall down a hormonal flight of stairs” when ignored, she says.

When following a ketogenic diet, Dr. Gottfried says, “women need to find their own personal carb limit that is not too low that it triggers hormone problems” but still remains low enough to reduce insulin resistance and support fat loss. In her research, Dr. Gottfried found that reducing carbs may help you lose weight in the short-term, but may lead to hormone disruption long-term. From fluctuations in estrogen and cortisol to a slowing metabolism in the perimenopausal years, “if we are not able to manage our refined sugar intake, over time,” she explains, “glucose levels rise in our blood and we have a situation called insulin resistance and fat accumulation. This is one of the biggest factors in weight loss resistance.”

Get Results: Keto Meal Plan for Women

When putting together a keto meal plan, here are a few suggestions that prioritize women’s health while still getting the results you’re after.

• Go slowly. Since a sudden shift to eating a low-carb diet might stress your system in unexpected ways, consider a more gradual approach. You might spend anywhere between 4 to 8 weeks slowly incorporating more low-carb foods into your diet, or eliminating certain foods a week at a time.
• Eat your veggies. Focus on cruciferous vegetables like cauliflower, broccoli, and Brussels sprouts, alliums like onions, leeks, and garlic to help you make glutathione (a plant-based antioxidant), and methylating vegetables like dark leafy greens that help inactivate excess estrogen.
• Prioritize gut health. A 2020 study found that a keto diet “dramatically changed” the proportions of common gut bacteria, especially probiotic Bifidobacteria, which showed the greatest decrease. To support gut health, be sure to get adequate amounts of fiber.
• Eliminate alcohol. Since drinking stresses the liver and limits your fat burning potential, a temporary pause can help give your body a chance to maximize the benefits of going keto.
• Fast with your hormones in mind. Intermittent fasting is a pillar of the keto protocol. Studies have found that it promotes fat loss while retaining muscle mass, but it’s also linked to hormone disruption in women. To reap the benefits, women’s health expert Alisa Vitti has a few suggestions to make it work for you. For example, don’t fast on consecutive days, more than 12 or 13 hours at a time (standard keto diets recommend 16 hours), or when you’re bleeding.
• Try carb-cycling. Author and Bulletproof founder Dave Asprey recommends that women “carb-up” once or twice a week with starchy vegetables. “Cycling in and out of keto each week gives your body the carbs it needs to keep the endocrine system humming along happily.” Registered dietitian Ali Miller gets specific, explaining that most days your total carb intake should be between 30 to 60 grams, but when you carb cycle, you’ll increase to an additional 45 to 60 grams per day, for a total of 75 to 120 grams of carbs during two days of your cycle, ideally on day 19 and 20 (or roughly five days post-ovulation) when leptin—a hormone of satiety and metabolic regulation—is naturally low.

Keto Recipes

It’s easy to stick with your diet goals when flavorful and filling meals are on the menu.

Keto Breakfast Casserole

This make-ahead dish works for a range of diets, including gluten-free, paleo, Whole30®, and of course, keto. Every bite is filled with protein-rich eggs, crispy bacon, savory spices, and veggies like kale, peppers, and spinach.

Keto Chicken Meatballs

Meatballs are another make-ahead essential that make healthy meals easy to pull together. This Japanese-inspired recipe is infused with bok choy, ginger, and scallions, while tender zucchini noodles round out the meal.

Roasted Salmon and Cauliflower Rice Bowl

Cauliflower rice is the gold standard when it comes to diet-friendly swaps. This version uses bold Middle Eastern spices like cumin, allspice, and cinnamon to wake up your taste buds, while roasted salmon adds a generous amount of protein.

Roasted Chicken Thighs with Fennel and Squash

Weeknight chicken, but make it keto. These golden thighs are paired with fragrant fennel and hearty squash for a simple-yet-filling supper. Did we mention you can make the entire dish on a sheet pan?

Keto Artichoke Dip

This warm dip might taste like you’re cheating, but it’s absolutely keto-friendly. This green side (or main event, depending on your mood) is made with frozen spinach, artichoke hearts, Parmesan cheese, and compliant mayo.

Homemade Keto Bread

When you stick to compliant ingredients like almond flour and coconut oil, bread is definitely still on the table. This ketogenic loaf is ready for avocado toast, scrambled eggs, or other favorite toppings.

Mustard Roast Beef

Everyone needs a few no-fuss crowd-pleaser recipes in their back pocket. With a showstopping main (a grass-fed roast) and a few pantry basics (like EVOO, garlic, and tangy mustard), dinner’s practically done. Seriously—your oven does most of the work.

Keto Peanut Butter Cookies

We couldn’t leave out a sweet ending. These seriously satisfying cookies use only five ingredients that are probably already in your pantry: peanut butter, keto-friendly maple syrup, vanilla, almond flour, and an egg.