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The Important Connection Between Gut Health and Fertility


This Irritable Bowel Syndrome Awareness Month, we are featuring dietitian Judith Johnson's guide on working on gut health to support your reproductive health. Anywhere between 10 and 25% of people suffer from IBS, but only one in three consult a physician. Yet, gut health is integral to reproductive health. Read on.


Guest Post by Judith Johnson, RD


The health of your gut influences the health of every system in your body, including your reproductive system. It influences the proper functioning of your immune system, how you think and feel, and how you synthesize and excrete hormones. It is one of the building blocks of your reproductive health.

Your gut health is your key barometer to systems that might need help – including your reproductive system – and your gut health may even affect your ability to conceive or have a healthy pregnancy. Getting your gut right is the gateway to supporting every other system in your body, including your reproductive system.


How are gut health and reproductive health related? 

  1. Inflammation

Some inflammation is good – it helps to fight off the bad stuff. However, too much inflammation can cause major oxidative damage in cells, the largest of which is a woman’s egg cell. Recent research suggests that women with recurrent pregnancy loss may have abnormal gut permeability, which contributes to inflammatory reactions in the body. The study suggested that the inflammatory reaction caused by leaky gut may contribute to miscarriages.

A healthy gut also helps reduce inflammation, likely in support of reproductive health. Research also suggests that chronic inflammation may affect reproductive health by reducing progesterone levels, leading to implantation failure, the development of autoimmune processes impacting female reproductive health, and the development of anti-sperm antibodies preventing fertilization. The good news is that probiotic supplementation to support gut health has been shown to potentially decrease chronic inflammation and improve immune function.

Celiac Disease is associated with an inappropriate immune response to part of the gluten protein, called gliadin. This immune response causes inflammation, which damages the body’s organs and tissues and leads to the symptoms of celiac disease. A 2016 meta-analysis found that women with unexplained infertility have 3.5 times higher odds of having Celiac Disease and 6% of the women that struggle with unexplained infertility may indeed have Celiac Disease. In fact, unexplained infertility may be one of the first signs of the disease in some women.


  1. Insulin Sensitivity

The health of your gut can also have a profound effect on insulin sensitivity, which, along with blood sugar levels, has an impact on your reproductive health.

Insulin is a hormone that controls glucose metabolism. It is secreted by the pancreas in response to blood glucose levels. If glucose levels are high for too long, the pancreas has to produce too much insulin, which leads to insulin resistance.

Insulin resistance is strongly associated with PCOS (polycystic ovarian syndrome), affecting steroidogenesis in the ovaries, and increases free testosterone levels, which can impact fertility when at unhealthy levels.


  1. Mood & Methylation

Our gut is our second brain: if your gut is not happy, your mood is affected. Your gut is where you produce 90% of your serotonin which we all need to cope with life’s ups and downs.

Your mood can also be an indication that the biochemical process for methylation are compromised. The body is a complex machine, with various gears and switches that need to be all functioning properly to operate optimally. Methylation is a main mechanism that allows the gears to turn, and turns biological switches on and off for a host of systems in the body, including the reproductive system.

Most importantly for fertility, methylation helps regulate hormone activity and your immune system – both key for a solid foundation of reproductive health.


  1. Impaired Estrogen Metabolism

Without a healthy gut microbiome, estrogen metabolism and function becomes impaired. This can lead to a number of health consequences including endometriosis, PCOS, endometrial hyperplasia, and infertility. A 2017 review of the literature concluded that treating the gut microbiome to modulate estrogen levels should be considered as a new future treatment for estrogen-mediated conditions including infertility.



How do I know if my gut needs work?

If you feel the following symptoms, it might be time to do some hard work on cleaning up your gut, and start rebuilding the foundation of your reproductive health:

  • Regularly constipated
  • Bloating after a meal
  • Heartburn before going to bed
  • Hay fever/sinus congestion
  • Stomach pain
  • Regular gas
  • Feeling tired all the time
  • Sleep disturbances
  • You eat a high-sugar diet
  • You’ve had unintentional weight changes


Does lack of gut symptoms mean my gut is okay?

The absence of symptoms may not necessarily indicate good gut health. You might be having regular bowel movements, no cramping, and no gas, but that doesn’t mean your gut is in good shape. You could feel pretty great but have a poorly working digestive system underneath the surface. How do you know?


What are some non-gut symptoms to look out for?

This is often harder to establish without proper tests, but some common non-gut symptoms include:

  • Unexplained infertility
  • Mood changes (including depression/anxiety)
  • Chronic fatigue
  • Trouble focusing
  • Brain fog & diminished memory
  • Headaches (from resorption of cellular toxins back into the body)
  • Chronic yeast infections
  • Frequent colds/flu
  • Constant hunger or cravings, especially for carbohydrates/sugar
  • Skin issues (eczema, acne, rosacea)
  • Symptoms of estrogen dominance or deficiency
  • Joint pain


Is there any way to know my gut is ok? Are there any gut health tests?

If you lack the symptoms above, go with your ‘gut feeling.’ You may be fine. In the absence of symptoms, the only accurate way to check is through proper testing.

Many functional medicine practitioners and nutritionists can help you understand your gut on a deeper level through the use of diagnostic testing, including:

  • Stool testing: This test evaluates the presence of harmful and beneficial microorganisms in the gut, including yeast and bacteria.
  • Food sensitivity testing: This test helps identify what foods you may be sensitive to and which foods may be damaging your gut.
  • Serum antibody testing: You can be tested for specific antibodies, such as transglutaminase and anti-gliadin, to screen for Celiac Disease, a potential cause for unexplained fertility according to research.


How do I fix my gut health?

The good news is that through thoughtful steps, you can repair your gut in order to support your TTC journey. Functional medicine doctors, registered dietitians and other healthcare professionals who specialize in the gut-fertility connection can help guide your journey. Please reach out if you need a referral or have any questions. We are with you.



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