This latest internet spectacle can be traced back to a year-old Reddit board about the ketogenic diet, where people said they developed malodorous vaginas, and suspected their diet had something to do with it. Some keto dieters were diagnosed with bacterial vaginosis, a common and recurring vaginal infection caused by an imbalance of bacteria in the vagina. Others simply claimed they had discharge and odor, but couldn't figure out why. But is the keto crotch hype warranted, or is it just another internet-induced panic? Well, it's tough to say.
There's limited data about the way that a person's diet affects their vaginal health, period, Caroline Mitchell, MD, director of the vulvovaginal disorders program at Massachusetts General Hospital, told Refinery29. (And there's essentially zero research about the ketogenic diet's specific effects on people's vaginal health.) It's true that your gut microbe and vaginal bacteria are somehow linked, but it's "not a direct, straight line," she said. In other words: eating specific foods won't drastically change your vagina.
That said, research has shown that eating a diet high in dietary fat is associated with an increased risk of bacterial vaginosis (BV). The ketogenic diet consists of eating a lot of fat, a moderate amount of protein, and tiny amount of carbohydrates. In fact, on a true keto diet, fat makes up 55-60% of all macronutrients consumed. While there are more significant lifestyle factors that influence someone's susceptibility to BV (such as number of sexual partners and condom use), it's not that far-fetched to believe that consistently eating a high-fat keto diet could theoretically increase your chances of vaginal issues.
Vaginal infections are certainly not the end of the world, but they aren't something you'd want, and they can be difficult to get rid of. If you're someone who's following the keto diet, and you find that you're coming down with more vaginal infections than usual, then it's worth it to discuss with your Ob/Gyn or healthcare provider. They can help determine if it's your diet or some other factor contributing to it.
Of course, there are a variety of reasons why people are attracted to the keto diet, but it's worth repeating that it's really not for everyone. The keto diet is so restrictive that it typically has to be medically monitored, meaning a doctor oversees it. Beyond keto crotch, some people experience a range of uncomfortable side effects, often called "keto flu," after adopting the diet. And although people claim it's "effective" for weight loss, it labels some pretty important macronutrients as "off-limits," which could harm your relationship to food long-term.
So, if you're not on the ketogenic diet for medical reasons, and are just jumping on the bandwagon, then you have to ask yourself: is it worth a vaginal infection, in addition to the other health issues it could present? On top of everything we know about the keto diet, it seems like "keto crotch" is just one more reason why you should steer clear.