A significant link between the gut and reproductive health—especially as it relates to fertility education and overall wellness—needs more awareness. The communication between the two pathways affects almost everything happening in the body, and we will specifically talk about its effects on hormone balance and fertility potential

in this article. Whether you are struggling with conception, planning to start a family, or desiring to improve your general health, this blog is a great place to start.

What Does the Gut Do?

The “gut” consists of the entire gastrointestinal (GI) tract running from the mouth to the anus. Within the gut are vital “flora,” or bacteria with several purposes. According to the Columbus OB/GYN, one of the purposes of gut flora is to metabolize estrogen. However, when gut flora is imbalanced, estrogen metabolism can be disrupted, leading to estrogen dominance or deficiency. The gut also impacts insulin sensitivity and testosterone production, and thus affects ovulation. Ultimately, the gut environment is a systemic regulator for reproductive health.

Immunity and Fertility

The immune system relies heavily on the state of the gut–a healthy gut contributes to 70-80% of the immune system function. The gut helps distinguish between dangerous and beneficial substances. The immune cells in the gut have a defense mechanism that simultaneously warns the rest of the body to defend itself. However, when there is a disruption in gut health, inappropriate immune responses can cause inflammation in the reproductive tissues. When this happens, the chance of ovulation is reduced. Implantation of an egg may fail, or recurrent miscarriages can occur. Over time, chronic inflammation of the reproductive tissues can damage sensitive ovarian follicles and lead to infertility. Specific testing to assess hormones and inflammation is an option. Consult your OB/GYN or fertility specialist if you think this may be the cause of your reproductive challenges.

The Cascade of Gut Imbalance

The effect the gut microbiome has on the body is significant. When it is disrupted, this can lead to exacerbations of preexisting conditions such as gestational diabetes, polycystic ovary syndrome (PCOS), and endometriosis. Understanding the role the gut has in contributing to these common conditions is essential.

• Gestational Diabetes (GDM)
  • Gestational diabetes has been shown to affect the metabolic health of the baby. Specifically, gut imbalances in women with GDM is a risk factor for glucose metabolism abnormalities in their child. But if mom takes the necessary steps to correct the gut flora, the baby’s gut may follow. Prebiotic, probiotic, and micronutrient supplementation have been shown to help. Women should also perform consistent, moderate physical activity during pregnancy.
• PCOS
  • Insulin resistance and low-grade inflammation are hallmark signs of PCOS. Altered gut flora is associated with PCOS because there is an increase in intestinal permeability–the allowance of harmful substances to enter the bloodstream from the gut, triggering inflammation. Studies have shown that probiotics and dietary modifications can improve the gut microbiome and PCOS symptoms, like irregular periods. This can lead to an increased chance of conception.
• Endometriosis
  • Endometriosis is an inflammatory condition characterized by pain, excessive bleeding, and infertility. It mainly affects women of reproductive age and occurs when cells like those of the endometrial lining (uterine lining) grow outside the uterus. These areas of overgrowth include the ovaries, bowel, and bladder. Endometriosis can impact digestive health as well. A disruption in gut flora may result in estrogen dominance, stimulating lesion growth and inflammation.

Optimizing Gut Health

Prioritizing gut wellness can greatly benefit reproductive health, whether you are struggling with conception or not. Implementing a diverse diet, full of prebiotic fibers (legumes, whole grains, and various colored vegetables) and fermented foods (yogurt, kefir, sauerkraut, and kimchi) are encouraged. They promote hormone metabolism and restore and strengthen the gut. Evaluating the stressors in your life is also crucial–meditation, yoga, prayer, and cognitive behavioral therapy are great ways to address and remedy stress. You should also avoid gut-disruptors such as alcohol and highly processed foods that contain artificial sweeteners, emulsifiers, and preservatives. Consistent sleep patterns help regulate the body’s natural circadian rhythm, as this also impacts gut function. Finally, adequate fluid intake lubricates the digestive tract, contributing to overall gut health. Making these small changes, one step at a time, will promote balance in the body. Once you have reached optimized gut function, reproductive health will soon follow!