97. Gut Health & Fertility: Is This the Missing Puzzle Piece?

What if your bloating, bowels, or other stomach symptoms were more than just a nuisance—and were actually holding you back from getting pregnant or having regular cycles? On this episode of Cycle Wisdom, Dr. Monica Minjeur explores how gut health can silently sabotage fertility and reproductive hormones. From the gut-immune-hormone axis to the estrobolome, we break down what the science actually says about GI symptoms, inflammation, and their link to conditions like endometriosis, PCOS, and even miscarriage risk.

You'll hear Wendy’s story—a night-shift nurse whose infertility journey turned around after treating gut inflammation—and walk away with practical, hopeful strategies to improve your gut and your cycle. We’ll also explain the role of testing, including looking for bacterial overgrowth and food sensitivities, and how Restorative Reproductive Medicine can help women restore hormonal health from the inside out.

👉 Imagine if your persistent cycle problems or fertility struggles were connected to something no one ever thought to check—your gut.
If you've felt dismissed or overlooked with your symptoms, we want to change that. Book a free discovery call and let’s explore the root causes—together.

Transcript

Monica: 0:02

Welcome back to Cycle Wisdom, where we empower women to restore natural menstrual cycles, to improve health and promote fertility. I'm your host, Dr. Monica Minjeur, and I'm so glad you're listening today. What if your infertility wasn't just about your ovaries, but also about what was going on in your gut? You've likely been told to track your ovulation, test your hormones, and maybe even try medications, but few people are talking about how gut health can quietly undermine your fertility. Today we're digging into the science of everything related to your GI tract, from leaky gut to your gut microbiome, and how this whole system impacts reproductive health and more importantly, what you can do about it. So let's get started with a patient story about a client that I'll call Wendy. Wendy worked at a hospital as an overnight nurse, and although she tried to be as healthy as she could, she did struggle with infertility. After trying to conceive for about 18 months, she went to see her OB doctor. Her OB said that her hormones were fine and there were no structural issues. However, Wendy was also dealing with some chronic GI symptoms, and so when she came to see us, we discussed how that might be playing a role with her fertility concerns. More specifically, she was dealing with chronic bloating, irregular bowel movements and flare ups of her skin. At times, years ago, she had been told that she had IBS or irritable bowel syndrome, and she had learned to live with it. However, after hearing about our clinic, she thought there might be a more of a connection. So we had her start with fertility awareness charting, and completed our full restorative reproductive medicine intake form, which includes evaluation of immune and GI as well as many other assessments. The labs that we did showed that she had elevated inflammatory markers, and there were some additional testing that we did in regards to her GI symptoms that showed bacterial overgrowth in her GI tract. Wendy and I worked together over the course of the next couple of months to develop a treatment plan that included an anti-inflammatory diet, targeted probiotics, medications to treat the bacterial overgrowth and lifestyle changes that she could utilize to help with her stress levels so that it didn't come back to be a problem again. Her symptoms slowly improved, but more importantly, Wendy started to see some significant changes with her menstrual cycle. Ovulation became more consistent. Her luteal phase lengthened out. She had less PMS symptoms and with additional support that we provided with our restorative reproductive medicine techniques, Wendy was able to conceive naturally nine months later. Today, Wendy has a healthy baby girl and she feels healthier, has a regular cycle, and now advocates for other women that she sees to consider their gut health in regards to the fertility conversation. So how common is this and why does this make a difference to consider your gut health? If you've ever had symptoms like PMS or heavy bleeding or unexplained irregular cycles or fertility concerns, and you also are dealing with any sort of gastrointestinal symptoms, your gut microbiome could be the missing link. So let's break it down into a couple different key phrases that many people have heard of but maybe don't fully understand. So the first piece that we wanna talk about is this gut immune hormone access. Now, your gut isn't just about digestion and getting enough calories in, it also plays a critical role in regulating your immune system, the creation of hormones, and most importantly in this situation, inflammation. So your gut microbiome, what that is, is it's a diverse community of bacteria that normally live in our intestines. Everybody has it. There is a piece specifically though of your microbiome that's called your estrobolome, and this is a group of microbes that help to metabolize estrogen. If there is an imbalance in this particular estrobolome, it can lead to either excess estrogen, which can cause endometriosis, PMS, fibroids, irregular bleeding. Or it can cause your estrogen levels to be too low, which can cause short luteal phases or anovulation, or in severe cases, may stop your periods altogether or create a situation that appears to be like primary ovarian insufficiency or early menopause. In addition to this very important section of gut, microbacteria known as the estrobolome, your gut also has about 70% of your immune system that resides in the lining of your gastrointestinal tract. This is known as the gut associated lymphoid tissue or gult. When your gut is inflamed or out of balance, you can have dysregulation of your immune system, and this can trigger many different things. It can trigger autoimmune conditions, things like Hashimoto's. Or lupus or rheumatoid arthritis. It can also trigger chronic inflammation, and this can significantly impair ovulation and implantation. It can also create a disruption of the mucosa that lines the gastrointestinal tract, which can then allow more immune triggers to circulate through your body. Now this piece in particular is oftentimes called leaky gut or intestinal hyperpermeability. Now if you talk to many doctors, they will say that leaky gut is just a fake science, but in medical research it is a very real thing. Your gut lining acts as a filter. It lets nutrients into your bloodstream, but helps to keep larger, more harmful particles out. In a healthy gut, there are tight junctions that hold the cells of the gut wall together and they act like bricks in a wall. However, if you have chronic stress, food intolerance, gut infection, or have been exposed to a high inflammatory diet or certain medications, those tight junctions can loosen, which makes the gut more leaky. So if you have leaky gut, you oftentimes will have undigested food particles, toxins, and bacteria that can slip through that leaky gut and enter into your bloodstream. The immune system then triggers an systemic response because it sees these things as foreign things that should not be in your bloodstream, and it can create inflammation throughout your entire body. Over time, this can disrupt hormone production. It can elevate cortisol or your stress hormone, and it can interfere with implantation and egg quality, especially if we have these inflammatory markers that are now running throughout your entire system. So now you're not just having GI symptoms and bloating and constipation, you're also having inflammation. And in the reproductive system, inflammation acts like background noise. It confuses hormone signals. It disrupts ovulation, and it makes it harder for your body to do what it was designed to do. So what does the research show us about this? There is a study in frontiers and endocrinology in 2019 that actually connected gut dysbiosis with PCOS, suggesting that inflammation and altered gut bacteria contribute to insulin resistance and hormone imbalance. Other studies have shown that women with endometriosis often have altered gut bacteria and increased intestinal permeability leading to this theory of inflammation. As one of the potential causes of endometriosis or perhaps endometriosis is there separately end this gut dysbiosis increases the inflammation on top of the endometriosis. Research in reproductive biology and endocrinology also shows how inflammation tied to gut health may increase miscarriage risk, decrease implantation, and worsen egg quality. So we have the research. We know that there is a link, and although it's not a simple, straightforward blood test that we can do, that identifies this. Digging deep and looking into how we evaluate this and treat this is critically important. So what do we do in restorative reproductive medicine when it comes to looking for clues if there is GI dysfunction? So part of our cornerstone is always taking a very detailed history, including looking for GI symptoms. Things like bloating, constipation, diarrhea, acid reflux, or gas may be clues that say that there's some other underlying gastrointestinal disruption that's going on. Maybe you have signs of food intolerance. We especially focus on gluten, dairy, sugar, and eggs, as well as making sure we're paying attention to processed foods which can increase inflammation. If you have a personal or family history of autoimmune disease, we also wanna consider some sort of gut dysbiosis when it comes to these things because we know that autoimmunity can be an increased risk for gut microbiome health and vice versa. And then we're always considering any signs of systemic inflammation, skin issues, brain fog, joint pain, other things that may indicate that there is inflammation going on on a bigger scale. Oftentimes women think that these things are unrelated to their cycles, or maybe they've been blown off in the past when they've brought up these symptoms, but you would be surprised how many times bloating and PMS show up on the same timeline. In fact, it's one of the things that we encourage all of our women to chart is, along with their fertility, is to chart signs of ovulation. And any symptoms that they have, because this can play a critical role in helping us to determine what the underlying cause is. So once we've done a thorough history and investigation, we discuss testing. Now there are many different tools that we can utilize in order to further evaluate the GI system, but here's a couple of them that we use in our practice. One of them that we definitely consider is helicobacter pylori or h pylori. Now, this is a bacterial overgrowth that can impact both men and women. It also impacts fertility and hormonal health. So it's a common one that we talk about in my practice. H Pylori stimulates chronic inflammation, which over time can disrupt ovulation. It can change the lining of the uterus, and in men, it can contribute to sperm DNA fragmentation or poor sperm quality in men, because the actual DNA breaks up more when it has this inflammation. H Pylori also will disrupt nutrient absorption, so it makes it more difficult for your body to absorb key fertility nutrients like B vitamins, iron, zinc, selenium. And this is especially important in women with unexplained infertility or fatigue or other chronic systemic illnesses. H Pylori also impacts your gut permeability, leading to leaky gut as we discussed earlier. And it can also worsen or even trigger autoimmune conditions, things like thyroid disease or other systemic issues that can become long-term. And most importantly, it influences hormone clearance. If we have that disruption of the gut environment, it can impair estrogen metabolism, which can lead to estrogen dominance. Things like irregular cycles, PMS, or infertility. So h pylori testing is just one of the tools that we utilize. Another tool that we oftentimes will discuss is food sensitivity testing. Now, I will say that this can be somewhat controversial depending upon who you talk to, but there are different tools that we utilize when necessary. Things like IgG food testing, or things like white blood cell reactivity tests, and these can look for either a delayed immune response or for general cellular inflammation. Especially if we have symptoms of chronic GI disease, autoimmune disease, eczema, or other skin related conditions, this food sensitivity testing may help us to identify delayed food triggers. I. Other lab work that we can do includes inflammatory markers of blood work, so things that reveal systemic inflammation like a C-reactive protein or an sedimentation rate. These can help to signify that there may be some inflammation that's happening. And we also would evaluate your vitamin levels. Things like vitamin D, vitamin B, 12, iron. These can oftentimes be depleted with chronic gut issues. Most importantly, we want to overlay what's going on with your cycle charting. Along with your gut symptoms to help give us a more clear picture of how hormones and digestion may be interacting. For example, mucus patterns may be changed if your estrogen levels are too low related to poor microbiome function. Or some women will notice more bloating during their luteal phase when they're having PMS symptoms. All of these things can help clue us into something else that may be going on from a bigger picture. So here's how we really differ from conventional care when it comes to restoring your gut health. First of all, we are not just suppressing symptoms. We're working to restore balance. And depending on what we find, your treatment plan could be really variable. So we're always gonna talk about an anti-inflammatory nutrition plan. So we try to remove any gut irritants that may be playing a role, and in almost all of our patients that are dealing with infertility, we discuss at least a couple months worth of trying to eliminate gluten, dairy, sugar, processed foods, and any other foods that they may be sensitive to. We also want to use a food as medicine approach to help support your gut lining and hormone metabolism so we can talk through what does that look like in order to add in healthy foods that help with your gastrointestinal absorption. We also would utilize targeted supplements and prescription strength medications based on your lab findings. So this may include things like probiotics or digestive enzymes, or in some cases, antibiotics or other herbal medications to help support a better gut health biome. We also would utilize things specifically to your cycle in order to help with hormone support. And so then that's where we're bringing in all of our other techniques from restorative reproductive medicine to help with estrogen detox and utilizing bioidentical progesterone support when needed. And most importantly, we're. Always talking about those lifestyle tools, things like managing your chronic stress, addressing sleep hygiene and movement, and working to improve the gut brain signaling from a daily healthy standpoint. Now if you're looking to hear more in depth, go back and check out episodes number 63 and 64 where I interview Victoria Pet Gray. She's a functional dietician who we work with closely with many of our patients to help. If your GI symptoms are unmanageable or if you wanna bit more focused attention on your GI health. Now if you're looking for a few practical tips to help with your gut and fertility health. In the meantime, while you're awaiting to see us here or working with Victoria, here's a few tips that you can utilize to try and help things out. First, eat slowly and chew thoroughly. This helps with aiding digestion. Focus on whole foods with fiber or fermented foods if tolerated things like kombucha or sauerkraut or pickles, and also work on getting high quality protein. We also want to reduce ultra processed foods that can feed harmful bacteria or increase permeability and try to eliminate overuse of NSAID medications, so things like ibuprofen or naproxen. This can damage the gut lining if you are using them excessively. We also want to practice stress reducing habits, things like deep breathing, getting sunlight, gentle exercise, being outside in nature and watching for cycle changes as your gut health improves. Imagine if your persistent cycle problems, fertility struggles, or hormone imbalances were connected to something. No one ever thought to check your gut. At Radiant Clinic, we help uncover the underlying causes behind fertility and hormone disruption, including things like gut inflammation and microbiome dysfunction. If you've felt dismissed or overlooked with your symptoms, we want to change that. If you're ready to work with our elite team of healthcare professionals, go to our website, radiant clinic.com to schedule a free discovery call and learn more about our package based pricing for comprehensive care. We are currently able to see people for in-person appointments in our Cedar Rapids, Iowa Clinic, or can arrange for a telehealth visit if you live in many different states across the us. Check out our website for current states that we can serve medical clients and let us know if your state is not listed to see if we can still cover you there as we are constantly expanding our reach. Please note that our fertility educators are able to take care of clients no matter where they live. Thank you so much for listening to this episode. Please share this podcast with someone in your life who would benefit from our services. Remember to subscribe to this podcast for more empowering content that I look forward to sharing with you on our next episode of Cycle Wisdom.