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The Role of Gut Health In the Fertility Equation

Whether you are looking to support fertility, regulate your cycles or improve premenstrual symptoms, we very often need to look at supporting your gut health! 

What happens in the gut, doesn’t stay in the gut. Your digestive health has direct and indirect influences on your fertility and reproductive functioning.

When referencing the “gut” we are discussing the gastrointestinal system as a whole. This includes the mouth, stomach, small and large intestines and anus, as well as salivary glands, the liver, gallbladder, and pancreas. Each of which serves a critical role in the digestive process. When digestion is subpar it can lead to nutrient deficiencies, infections, inflammation or impaired detoxification. 

The other aspect of gut health is the health of the gut microbiota. The gut microbiome is composed of an ecosystem of microorganisms including bacteria, fungi, parasites and viruses. More research is emerging to suggest that imbalances in the gut microbiota can lead to reproductive pathologies such as endometriosis, PCOS, gynecological cancers, and infertility.

If you have concerns about your fertility, whether you are planning to become pregnant or not, we recommend paying attention to the intricate relationships between your gut and reproductive health. This also very much applies to male fertility, for this article however we will be focusing on the female gut-fertility connection for this article. 

Let’s dive in.

Digestive Capacity

Poor digestive capacity is one very common way we see gut health impacting fertile health in our clients. 

First, digestive capacity refers to your body’s ability to break down protein, carbohydrates and fats, as well as absorb nutrients. Stomach acid, pancreatic enzymes and bile are all required to digest and absorb the foods you eat. If you aren’t properly absorbing amino acids or vitamins and minerals, it could lead to deficiencies. Many women come to us eating a nutrient dense diet, however their lab work reflects holes in their nutrition status because their digestive capacity isn’t what it could be. Sometimes these women are even supplementing vitamins and minerals and we still see those gaps! One common example being Vitamin B12 deficiencies. Stomach acid facilitates the binding of B12 with intrinsic factor so this important nutrient can then be absorbed in the intestines . If stomach acid is lacking, absorption of B vitamins can be impaired. When it comes to fertility and supporting both ovulation and a healthy pregnancy, Vitamin B12 is one (of many) key players.   

Nutrient deficiencies impair your body’s ability to produce hormones and carry out various functions, reproduction included. 

In addition, stomach acid serves as your first line of defense against pathogens and infections. If stomach acid is low, it can lead you vulnerable to infections that throw off the balance of your gut microbiome. 

Infections & Dysbiosis

Imbalances to the gut microbiota occur when there is an overgrowth of pathogenic bacteria or not enough beneficial bacteria- or both. We will refer to this as dysbiosis.  Commensal or “good” bacteria serves an important role in immune health, metabolism, intestinal barrier function and more. We naturally have some pathogenic bacteria present in our microbiome, however when healthy it is in low amounts and doesn’t cause issues. As with any other system, balance is the key and the body is generally good at maintaining homeostasis. However, when bacteria in the gut becomes overgrown, or there are deficiencies in the “good guys” it can impact how you feel as well as your fertility. 

Let’s take the example of the estrobolome. The estrobolome is a collection of gut bacteria in your gut microbiome that help you metabolize estrogen.  By producing an enzyme called beta-glucuronidase, estrogen can be broken down and excreted or reabsorbed into circulation. If too much estrogen is reabsorbed, such as when the gut microbiome is imbalanced, this can lead to symptoms of estrogen dominance. Headaches, irregular periods, breast tenderness and cyclical acne are a few of many signs and symptoms of estrogen levels being too high and not appropriately exiting the body. Constipation (potentially caused by dysbiosis) is another way one can become estrogen dominant, as estrogen (and other chemicals and hormones) is not being effectively detoxed out of the body. 

H. Pylori, Parasites, C. Diff and Candida are some examples of infections that can be developed or acquired. These may develop for various reasons, some in our control and some not, however it is in our control to not let imbalances linger because they can and will impact fertile health and overall well being. If the body is fighting one of these infections it may disrupt your cycle or make getting pregnant a challenge. In addition, in cases such as H. Pylori, we can see stomach acid levels become low which as mentioned previously can hinder nutrient status and your reproductive health. 

Improving the health of your gut microbiome can mutually improve your fertility and restore hormonal balance. 


If there is dysbiosis or infections present in the gut, it is creating a state of inflammation throughout the body. Intestinal permeability is almost often present when there is GI distress as well, and a sign of a disturbed intestinal barrier. When this occurs, the body is left vulnerable to microorganisms, toxins and undigested food particles leaking into the bloodstream and affecting hormonal and reproductive systems. The immune system and nervous system can also be negatively impacted, both of which have close ties to reproductive health . Nothing in the body works in isolation!

Speaking of the immune system, a healthy intestinal barrier and microbiome are imperative for a balanced immune function. We know that autoimmune conditions can directly affect fertility, and a dysregulated immune system can make it difficult to achieve and maintain a pregnancy. 

Chronic inflammation can lead to or further exacerbate hormonal imbalances. Inflammation is a chronic stressor, one of the many which can impact your reproductive health and fertility by disrupting or halting ovulation.  

Cortisol, commonly known as the “stress hormone,” is released in response to inflammation and has anti-inflammatory effects acutely. However, when stress and inflammation become chronic, long term effects of cortisol release may influence the production and balance of reproductive hormones, as well as other hormonal axis that directly influence reproduction and fertility like the thyroid . Heavy periods, mood swings, irregular menstrual cycles or even amenorrhea can all be side effects of disrupted hormones induced by chronic inflammation and stress. 

What to Do About It?

If you suspect your gut health is not up to par, we suggest diving deeper whether you are experiencing fertility challenges or not. You may be catching an infection or imbalanced in the early stages, before you notice systemic symptoms! We also hope this article helps further paint the picture that the body, like the gut, is a dynamic ecosystem. Ideally all parts are working in harmony. If not, that is our goal. 

To start making improvements to your gut health we would suggest downloading our free guide: Prerequisites for a Gut Protocol as this is where we start our clients as well. A diet rich in fiber and diverse in nutrients is also overlooked when it comes to gut health and fertility. You can download our Foods to Add for Gut Health list HERE

If you need guidance to assess your gut health, or if you’re curious if your hormonal symptoms of infertility could be tied to your digestive health, reach out!

Through our comprehensive intake process we can guide you in the proper direction, and get started with nutrition and lifestyle interventions, creating an integrative plan to help you optimize your health. 



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