Keto crotch: is this new diet dangerous to your vaginal health?

An unpleasant odour 'down there' may be one of the not-so-great side-effects of the Keto diet

13 March 2019 - 00:00 By Sanet Oberholzer
An imbalance in the vaginal pH caused by the Keto diet could trigger a change in the flora of the vagina, which can then create the Keto crotch.
An imbalance in the vaginal pH caused by the Keto diet could trigger a change in the flora of the vagina, which can then create the Keto crotch.
Image: 123RF/Andranik2018

The Keto diet has grown in popularity, with more and more people opting for the low-carb diet to shed off unwanted kilos. However, some women are reporting unwanted side-effects after going on the Keto diet, including the Keto crotch: an intense, unpleasant odour coming from their vagina.

People have been warned of the "Keto flu", "Keto diarrhea" and even "Keto breath" – all side-effects from the change in food you eat and the changes your body undergoes as it enters into ketosis, a process that takes place when your body produces ketone bodies – a fuel the liver produces from stored fat.

As if these side-effects are not enough: enter the Keto crotch. Users started posting about it on Reddit years ago, with one user writing, "I have that not-so-fresh feeling. But it's not just my breath and my pits, it's also my crotch (read: vagina)" and another posting, "Help ladies! Why do I smell down there?!"

Some women on the platform reported that it went away after a week while for others, it continued for months on the diet without ease.

The Keto crotch has left women frantic, self-conscious and worrying about the cause and the effect it may have on their relationships.

With the recent attention the Keto diet has been getting, we thought we would look at what exactly the Keto crotch is, what causes it and if you should be worried if you have it.


Specialist in gynaecology Dr Sumayya Ebrahim says there’s no major research to show any link between Keto crotch and the Keto diet but she adds: "I could understand how the odour in the vagina can change based on your diet."

When anything disrupts the acidic environment of the vagina this results in some bacteria that overgrow. Those bacteria can create an imbalance in the bacterial environment. They then produce what we call amines, or substances, that can favour an odour.

Essentially, it’s an indirect consequence: the imbalance in the pH triggers off a change in the flora of the vagina which can then create an odour.

According to Ebrahim, "Any change in any diet can do that: if you binge on alcohol; if you’re on a starvation diet, if you’re not eating; if you’ve been on recent antibiotics; or if you’ve been very stressed – all those factors. Because the vagina doesn’t exist in isolation, it exists as part of a general whole, the wellbeing of your vagina will reflect the wellbeing of your body."

If the problem is an imbalance in the pH of the vagina, sometimes all that’s required is vaginal probiotics. Possible suggestions from your doctor will be a gel or a capsule that you insert it into your vagina that brings the pH back to normal. "Or, you could just wait long enough for your body to rebalance itself," Ebrahim says.

The other thing that you could theoretically result in Keto crotch is from the amines produced from the Keto diet – similar to what happens when you get Keto breath. "Technically any secretion from your body can have that smell," says Ebrahim.


To allay women’s fears, Ebrahim says the Keto diet is not causing a problem that is going to scar you for life and affect your fertility.

Other times, however, what you think to be Keto crotch can be something completely unrelated. "Each person needs to be assessed individually. I can’t say globally because you’re on a Keto diet you have Keto crotch and that’s where it’s coming from. You could have a completely coincidental reason to have a smell. You could have an STD or you could have something else going on," says Ebrahim.

What you think to be Keto crotch can be something completely unrelated like an STD

The bottom line: if you have any odour down there, don’t think its Keto crotch because you're on the Keto diet. It may well be, but you need to check that it isn't anything else.

Dr Ebrahim encourages women to have anything out of the ordinary checked, especially if there are associated factors, like if you’ve had unprotected sex or you think there could be some kind of other infection.

"Anything associated with pain; abnormal bleeding; an offensive, horrible discharge that is not normal; or anything associated with unprotected intercourse needs to be checked out," she says.