For many women, menopause comes with unpleasant side effects, including weight gain, low energy, and stubborn belly fat. That’s usually why so many menopausal women look at diets like keto for the solution. But when hormones are changing, what works at one stage of life doesn’t always work the same way later on.

So, is keto good for menopause? The honest answer is: it depends. Keto can offer real benefits for some women, but it also comes with risks that are more relevant during menopause than they are earlier in life. Understanding how keto interacts with midlife hormonal changes is key to deciding whether it’s worth trying or whether another approach might work better.

This article breaks down what keto can and can’t do during menopause, why menopause keto is not working for you, and alternatives you can try. 

What is keto? (And why are women eager to try it in menopause?)

Keto, short for the ketogenic diet, is a very low-carbohydrate, high-fat eating pattern designed to shift the body from using glucose (e.g., carbohydrate) as its main fuel source to using fat and ketones instead. 

To do this, there are strict rules about which foods you can eat and foods you can’t eat on keto. Daily carbohydrate intake is typically reduced to around 20–50 grams, fat makes up the majority of the diet, protein is kept moderate.

Women often consider keto and menopause because midlife hormonal changes can cause weight gain, especially around the abdomen, that’s harder to control. As estrogen declines, insulin sensitivity can worsen, and blood sugar swings may become more noticeable. Keto promises more stable blood sugar, reduced appetite, and faster fat loss, which can feel appealing when traditional calorie-cutting diets stop working.

How menopause changes the way your body responds to diets

Menopause is marked by a decline in estrogen, a hormone that plays a role in fat distribution, insulin sensitivity, muscle mass, and appetite regulation. As estrogen drops, many women notice:

• Easier fat gain, especially around the abdomen

• Reduced muscle mass

• Changes in blood sugar control

• Slower metabolic rate

These changes mean aggressive or restrictive diets can backfire more easily. Stress hormones like cortisol also tend to rise more easily during menopause, which matters because very low-carb diets can increase physiological stress in some people.

That’s why the impact of both keto and menopause need to be considered together, not separately.

Proven benefits of keto during menopause

Improved blood sugar control

One of the strongest arguments for keto for menopause is its effect on blood sugar. Very low-carb diets reduce glucose spikes and insulin demand, which can be helpful for women who develop insulin resistance during midlife.

Better blood sugar control may indirectly support weight management and energy stability, especially for women with prediabetes or who respond negatively to a higher carbohydrate intake.

Short-term weight loss

Many women experience initial weight loss on a menopause keto diet, particularly in the first few weeks. Some of this comes from water loss, but fat loss can occur over time as well if calories are controlled. For women who have tried multiple calorie-restricted diets without success, this early momentum can feel motivating.

Reduced appetite for some women

Ketosis can suppress appetite in some individuals by stabilizing blood sugar and increasing satiety (e.g., fullness) hormones. This can make it easier to eat less without constant hunger, which is one reason keto remains popular for weight loss.

Side effects and risks of keto during menopause

Hormonal stress and fatigue

Very low-carb diets can increase cortisol, especially when calories are also low.

Worsening hot flashes and sleep issues

Keto doesn’t reliably improve classic menopause symptoms like hot flashes or night sweats. In some women, it can make them worse, especially if electrolyte intake is inadequate or calorie intake is too low, making it difficult to wind down.

Sleep disruption also occurs in some people, particularly in the early stages of keto adaptation (known as “keto insomnia”). However, most research shows the keto diet improves overall sleep quality in most people over time.

Increased cardiovascular risk if fat quality is poor

Keto diets high in saturated fat can negatively affect cholesterol markers in some women. Postmenopausal women with lower estrogen levels may be more sensitive to increases in LDL cholesterol, as estrogen offers a protective effect for the heart and cholesterol levels. This makes the fat type and quality on a keto diet very important.

This doesn’t mean keto is automatically harmful, but it does mean a careless approach carries more risk during menopause.

What menopause symptoms keto can and can’t help

Symptoms keto may help

• Weight gain related to insulin resistance

• Blood sugar swings

• Energy crashes tied to high-carb diets

Symptoms keto usually does not help

• Hot flashes

• Night sweats

• Mood swings

• Joint pain related to estrogen loss

Keto is a metabolic tool, not a hormone therapy. Expecting it to “fix” all menopause symptoms often leads to disappointment.

How to make keto work better for menopause

If you decide to try keto, the way you do it matters more than the label.

Prioritize unsaturated fats

Instead of relying heavily on saturated-fat-rich foods like butter, cream, and processed meats, switch to healthier fat sources like:

• Olive oil

• Avocado

• Nuts and seeds

• Fatty fish like salmon and tuna

This helps reduce cardiovascular risk while still supporting ketosis. (Try these 5-minute keto meals if you are pressed for time!). 

Eat enough protein

Protein intake becomes even more important during menopause to preserve muscle mass. Many women on keto undereat protein, which can worsen muscle loss and metabolic slowdown. Aim for a clearly defined protein source at every meal. (You can refer to our Menopause Diet Plan for inspiration.) 

Avoid extreme calorie restriction

Keto combined with aggressive calorie cutting and fasting can increase stress hormones and stall progress.  During menopause, consistency beats severity.

Support electrolytes and fiber

Low-carb diets increase sodium and fluid loss, where inadequate electrolytes like sodium can worsen fatigue, headaches, and sleep problems. Including enough sodium, water, and low-carb vegetables helps support adequate energy and digestive health.

Keto alternatives that often work better for menopause

For many women, keto isn’t the most sustainable or symptom-friendly option. Several alternatives have stronger long-term evidence and fewer risks.

Mediterranean diet

The Mediterranean diet emphasizes vegetables, fruit, whole grains, legumes, lean protein, and healthy fats. It’s associated with better heart health, improved metabolic markers, and lower inflammation.

For menopause, this approach often supports weight management without worsening symptoms.

Gentle intermittent fasting

If weight loss is the main goal, a mild fasting window like 12–14 hours can help reduce calorie intake without extreme carbohydrate restriction. Intermittent fasting is often better tolerated during menopause than prolonged fasting or keto.

The plate method

The plate method focuses on balance rather than restriction, which looks like:

• Half the plate is vegetables

• One-quarter is protein

• One quarter is carbohydrates

• Added fats are included in moderation

This approach supports blood sugar control, muscle maintenance, and dietary flexibility.

Bottom line

So, is keto good for menopause? For a small subset of women, yes, particularly those with insulin resistance who approach it carefully. For many others, the risks outweigh the benefits, especially when keto is done aggressively or without attention to fat quality and protein intake.

Menopause is a time when gentler, more balanced strategies often work better than extremes. Whether you choose keto, modify it, or opt for an alternative, the most effective approach is one that supports metabolic health and respects the hormonal changes happening in your body.

It’s wise to consult with a qualified healthcare professional before making major dietary changes during menopause, especially if you have cardiovascular risk factors or metabolic conditions.

Frequently asked questions

Is keto good for a 50-year-old woman?

While keto can help some women with weight loss or blood sugar control, strict carb restriction may worsen fatigue, bone health, and nutrient intake after 50. Many women do better with a moderate-carb, high-protein diet.

Is keto good for a hormonal imbalance?

Keto may improve insulin-related hormone issues, but going too low in carbs can increase stress hormones and disrupt thyroid function in some women. It’s not ideal for everyone, and personalization is key based on your medical history and individual response.

Do you need more carbs during menopause?

Not necessarily, but it’s more about choosing higher-quality carbs. Moderate carb intake from fruits, vegetables, and whole grains can support energy, mood, and hormone balance during menopause.