Is 'Keto Crotch' a Real Thing?

Keto flu, keto breath, keto diarrhea—it's no secret the keto diet comes with side effects. Initially used to treat epilepsy in children in 1921, this high-fat, very low-carb diet grew to become a tool for weight loss, according to the National Library of Medicine's StatPearls. And some say another unpleasant side effect of the keto diet exists: "keto crotch," or a foul-smelling vagina.

A quick search online will reveal several keto followers who complain about this particular effect. They say their vagina has a more pungent smell since they've gone keto. But, scientifically speaking, why would a diet high in fat and very low in carbs change the scent of your vagina?

The Science Behind Keto Crotch

Health posed that question to an OB-GYN, who said keto crotch has never been scientifically investigated.

"Nobody knows if this is a real effect of the keto diet," Lauren Streicher, MD, clinical professor of obstetrics and gynecology at Northwestern University, told Health. "Anecdotally, there have been a lot of reports over the years that diet can influence vaginal odor, but it's never been studied."

Yet, science does show that going keto can change the odor of your breath and urine, making both smell like nail polish remover.

That's because your body breaks down fat for energy instead of carbs. This process, the goal of a keto diet, is called ketosis. When in ketosis, your body converts the fatty acids into chemicals called ketones. It then disposes of the ketones through both exhalation and urination.

"One type of ketone, acetone, is an ingredient in some nail polish removers, which is why your breath may smell like this familiar scent," said Cynthia Sass, RD, Health contributing nutrition editor.

How Ketosis Is Measured

The measurement of breath acetones has been used since the 1960s to judge the level of ketosis that occurs in the body, according to a November 2015 article published in Obesity. The more fat your body burns in ketosis, the more ketones, like acetone, your body produces as byproducts.

Another way to measure ketosis is by testing urine for other byproducts, specifically beta-hydroxybutyrate and urine acetoacetate. According to one study published in the journal Nutrition & Metabolism in November 2016, these urine markers are highest in the morning and after dinner.

The release of ketones might also result in keto crotch, but it's never been researched. And it's not like smelly pee will stink up your vagina. "Your urine isn't going to make your vagina smell," confirmed Dr. Streicher.

Potential Side Effects of the Keto Diet

The short-term side effects of a keto diet are better known. The most common ones that can be experienced for up to two years after following the keto diet, according to the National Library of Medicine (NLM), include:

• Nausea
• Vomiting
• Headache
• Fatigue
• Dizziness
• Insomnia
• Difficulties in tolerating exercise
• Constipation

These short-term symptoms usually go away within a few days or weeks. You can lessen these symptoms by drinking plenty of fluids and getting enough electrolytes.

There are also long-term effects of a keto diet. The NLM reports these symptoms:

• Hepatic steatosis (aka fatty liver, which is a buildup of fat in the liver)
• Hypoproteinemia (deficient levels of protein in the blood)
• Kidney stones
• Vitamin deficiencies
• Mineral deficiencies

Causes of Vaginal Odor

Some experts have theorized that the keto diet changes vaginal pH (the balance of bacteria in your vagina), which can alter your vaginal scent. It's true that if your vaginal pH is thrown off, you're at a higher risk for developing bacterial vaginosis (an overgrowth of bacteria in the vagina), which can have a funky odor, said Dr. Streicher. But unfortunately, no research exists showing that diet alone can alter vaginal pH.

Vaginal odor can be caused by these other factors as well:

• Antibiotic use
• Douching
• Yeast infections
• Spermicide
• New sexual partners
• Frequency of sex
• Sexually transmitted infections
• Menstruation
• Changes in hormone levels due to pregnancy
• Breastfeeding
• Menopause

If changes in vaginal odor are accompanied by itching, burning, redness, or swelling, you'll want to see your healthcare provider to nail down the exact cause.

How To Prevent an Unpleasant Vaginal Odor

Like any other body part, your vagina needs to be kept clean. But, it's important not to overdo it by washing excessively or using scented products like perfumes, powders, and deodorant sprays. The soap you use is also important. It's best to avoid scented antibacterial soaps, which can affect the balance of natural bacteria in your vagina. And remember to be gentle when washing this sensitive area.

Wearing breathable fabrics can also help prevent unwanted moisture and scents from building up. Lycra or spandex is not very breathable, so it's better to go for cotton instead.

Keeping the vulvar and vaginal area dry is another way to keep unwanted odors down. If you've been working out or sweating, change out of wet or damp clothing as soon as possible. And if you've been swimming or wading in a river, lake, or chlorinated pool, it can also help to shower or rinse off after you've been in water.

So while plenty of people are sure the keto diet is the cause of their odorous vagina, no science yet supports this. If you follow keto and start noticing that your vagina smells bad, consider checking in with your OB-GYN. "It's never normal for your vagina to have an odor," said Dr. Streicher.