We’ve heard of keto breath and keto flu, but now there’s another possible side effect from the popular diet that’s taken the Internet by storm: Keto crotch. The latest Internet sensation can be traced back to a Reddit board about the ketogenic diet, where a number of women had complained about suffering from vaginal odor after starting the diet.
“I’ve been on the diet for about a month and a half now and I’ve noticed that my vaginal odors have gotten MUCH stronger,” wrote one user. Another wrote, “I’m glad this was posted because I just changed my underwear AGAIN today because I smelled gross. At least I know I’m in ketosis, I guess.”
So to explore what the heck this is and what it might mean for our keto-lovers and their vaginas, we talked to some experts.
So can ketosis cause a change in your vaginal odor?
The ketogenic diet is a high-fat, moderate-protein, and low-carb diet with approximately 80% of your calories from fat, 15% from protein, and only 5% from carbohydrates, which, as a result, induces ketosis in your body. “Ketosis, which is the breaking of fat for fuel, produces a ketotic state,” says Dr. Jessica Shepherd, OB/GYN. “However, if the production of it is in excess it can create vaginal scents that are more pungent.”
The reason for this possibility is that food has been proven to affect our odors and body secretions. “There are certain foods and spices that can process in our bodies through the bloodstream, lungs, sweat, and vaginal secretions and also cause intense smells in the body, including the genital area,” Shepherd says.
In fact, according to Dr. Will Cole, a functional medicine practitioner and author of Ketotarian, any changes to your diet can shift your microbiome, or bacteria of your skin and gut. “When you go off of sugar, it can cause some some ‘die-off’ or detox type responses for people with bacterial or yeast overgrowth,” he says. While he admits that there is “little to no solid research about the so-called keto crotch” and thinks the phenomenon is “largely overly dramatized to get clicks,” Cole says, similar to keto breath, due to a shift of the microbiome, the smell coming from the vagina could change by switching from high-carb diet to a higher healthy fat diet.
Is it normal for vagina pH levels to be affected by the food we eat?
“Normally the body is able to maintain the pH vaginally, however, with certain diets and conditions such as diabetes, it may change the vaginal pH,” says Shepherd. “This pH imbalance can cause bad bacteria growth, which in turn can cause irritation, odor, and infections such as bacterial vaginosis.”
However, according to Dr. Aastha Kalra, a Westchester, NY-based physician who suggests a ketogenic or low-carb diet for her weight loss and diabetes reversal program, there is limited evidence on how diet might affect vaginal pH. She cites a 2014 study that showed that essential fatty acids could possibly help decrease vaginal atrophy (vaginal dryness) but did not suggest any odor. “Personally, I have not encountered anyone complain about change in vaginal odor,” she says. “In fact, most women say that they have less vaginal infections or yeast or bladder infections [since being on the keto diet].”
Kalra believes keto crotch is “reflective of misinformation and there is no science to it.” If Kalra encountered a patient who claimed to have it, she would “advise them to evaluate other issues that might have caused it,” she says. “It could be hygiene, menstrual cycle, menstrual products, or clothing.”
Cole has a slightly different take. He says that if you do suspect that your vaginal odor has changed as a result of the keto diet, the biggest thing you can do is allowing the area to breathe by wearing looser clothing. “But remember, this is your body’s natural response to your shift in your microbiome and should go away on its own after time.”
However, the rule of thumb should always be to visit your family doctor first. “I would suggest someone see their physician to see if there is a vaginal infection because the odor could possibly be the result of other medical conditions,” says Shepherd.
While the “keto crotch” issue has circulated through the headlines, the experts we talked to say the literature and science just doesn’t support it. At least, not yet.
A version of this story was published April 2019.