There is a lack of controlled data on the ketogenic diet's effects on male and female hormonal systems.

“The real answer is, I don't think anybody knows. And there's not a one-size-fits-all answer because I've seen examples. And I'm aware of science to back up polar opposite conclusions.”

“Unfortunately, I don't think we really have good control data on what does the ketogenic diet do to male hormonal systems, what does the ketogenic diet do to female hormonal systems. But clearly, I think changes are happening. I don't have a way to predict it, at least.”