🎧 Episode 17: Trying to Conceive? How Gut Health, Hormones & Inflammation Affect Fertility with Katie Chapman
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Introduction
In this episode of The WOVA Circle Fertility Podcast, we explore the powerful connection between gut health, hormones, and fertility—and why symptoms that many of us have normalized may be telling us something important about our overall health.
Registered dietitian nutritionist Katie Chapmon explains how the gut microbiome influences everything from estrogen metabolism and stress resilience to thyroid function and reproductive health. We discuss why painful periods, bloating, fatigue, and digestive symptoms shouldn't always be dismissed, and how everyday habits like sleep, nutrition, and stress management can shape fertility outcomes over time.
Whether you're trying to conceive, navigating hormonal symptoms, or simply looking to better understand your body, this conversation offers practical, whole-body strategies to support both your fertility and long-term health.
What You'll Learn in This Episode
How the gut microbiome influences hormones, fertility, and inflammation
The connection between stress, cortisol, the HPA axis, and reproductive health
Why symptoms such as painful periods, heavy bleeding, headaches, and mood changes deserve attention
What hormonal resilience means and how to support it throughout your life
Why your body can compensate for years before symptoms appear—and why they often show up later
The most impactful lifestyle changes you can make today to support fertility, including sleep, stress management, and nutrition
Why brightly colored foods can play an important role in supporting overall health and reducing inflammation
What to know about GLP-1 medications when trying to conceive
Why PCOS was renamed PMOS (Polyendocrine Metabolic Ovarian Syndrome) and what this means for understanding the condition
How IBS, thyroid dysfunction, and endometriosis may affect whole-body health and fertility
Why it's never too late to make meaningful changes that support your reproductive and metabolic health
⏱ Listen time: 37 minutes
🎧 Format: Video & Audio
📍 Best for: Individuals and couples trying to conceive, those navigating hormonal or digestive symptoms, and anyone interested in understanding how gut health, metabolism, and whole-body wellness influence fertility.
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👉 Learn More About Gabie’s Story
Podcast Transcript:
Introduction
Katie, who I'm meeting today, is a registered dietitian nutritionist with a background in digestive dysfunction, supportive supplementation, hormonal health, and bariatric surgery. Today, we're going to explore how the gut connects to hormones, energy, and overall health, and why it matters far beyond digestion.
We'll also unpack common conditions like IBS (irritable bowel syndrome), thyroid imbalance, and endometriosis, and look at some of the newer conversations around things like GLP-1 medications and PCOS with the new name, PMOS.
The goal is to make sure that you get a sense of how all these symptoms connect in a way that feels practical and understandable.
Welcome, Katie.
Katie: Thank you so much. I'm very, very excited to talk to you about all these things today.
Understanding the Gut Microbiome
Gabie: When we talk about the gut microbiome, also oftentimes referred to as microbiota or microflora, what are we actually referring to? Explain it in simple terms.
Katie: Yeah. So we have a whole little environment within our gut that is filled with bacteria and other organisms. What they do and what their function is, is a few different things. One, they help to digest our food and make it into a workable way that our body can use. They also can help with hormone breakdown, and I know we'll get into that connection in a bit.
They also help with creating signals called neurotransmitters, so signals that work with the brain. That's why oftentimes we hear that the gut is called the second brain. It's because those two are connected.
Those little bacteria, and I'll say other organisms, help to actually create those signals with the brain. Those are kind of the main functions of that microbiome or microflora. You'll hear it called many, many different things.
The Gut-Hormone Connection
Gabie: Why does the health of the gut microbiome matter specifically when it comes to hormonal balance? You talked about the brain and gut connection, so moving to hormones, which is also connected to the brain and the...
Katie: Yeah. Hormones are messengers within the body. When I'm talking hormones, we can think of them as a lot of different messengers, but specifically I'll talk much more about our sex hormones. Think of our major players like progesterone, estrogen, and testosterone.
I'll do two parts with this. Part of what that microbiome does, or why that gut is important in this whole process, is that it is a detoxification highway. Like I mentioned before, those bacteria help with hormone breakdown and recycling.
We have a part of our microbiome that is called the estrobolome. Fancy little term there. Those microbes, or those bacteria, their focus is to help break down estrogen and either partially utilize it to go back into that cycle or that cyclical nature that we need, or help take it out to the trash.
We have that process that is really important in terms of the health of our hormones and our gut. That's kind of part one.
Hormones, Stress, and the HPA Axis
Then you mentioned our gut and our brain and our hormones. The other part of that is that our hormones can be highly, highly affected by what's going on in our brain. We have what we call our HPA axis. That means our hypothalamus and our pituitary, which are in our brain, and then our adrenal gland.
Our adrenal gland helps to not only produce some of our hormones—I'm thinking precursors, or what turns into testosterone—it also influences estrogen and progesterone. That adrenal part of the picture, its main feature is to help our stress response.
So HPA is how we perceive stress, and that adrenal gland is the communication not only for cortisol, but also our communication to our hormones.
It's a whole... I'm trying to hopefully simplify this complex system. If I talk through hormones, I always say to think of them as messengers.
If we're looking at how we're perceiving stress, our body has both internal and external stressors. External is what we think about—work and life and those things. Then we also have internal stressors. That could be nutrients. Is our body getting too much or too little? Are we getting too much or too little sleep or movement? Too much or too little can be perceived by our body as a stress response.
Then it starts that whole process of brain to hormones. If I bring it back to the gut, that gut part could also hear, "Oh hey, we're not doing so well," and that can start that response with our hormones, too, and vice versa.
Menstrual Cycles: What's Common Isn't Always Normal
Gabie: I can see all of this can affect the menstrual cycle as well.
Katie: Absolutely. That's where, definitely, if I work with people or walk through looking at this with someone, we want to take a look at what's happening gut-wise. I would not be a good practitioner if I didn't say, "Hey, let's talk a little bit about how that looks."
I'm trying to put the pieces together. If your menstrual cycle is off, let's get down and dirty a little bit with that. Why is that off? What's going on there, and what is the domino that's making that happen? That could be a part of these other systems that we don't always think of.
Usually, when we think of the menstrual cycle, we're just thinking of our reproductive hormones or our reproductive organs. We have some other things that could be happening within our body, too.
Gabie: What are some common symptoms to look out for in your menstrual cycle? What is not normal, even though it's common?
Katie: Yeah. What I tend to look at in terms of the menstrual cycle is length. Do we have consistency in our cycle? We always say 28 days oftentimes, but I'm looking at whether there's consistency in yours. Whether that's 30 days and that might be where you live, I'm looking for some consistency with that.
I'm also looking at PMS symptoms. If we have really extreme or bad cramping that is making someone down for the count, that's telling me something about their hormonal system and potentially the communication within that.
If someone has really heavy bleeding or a lot of clotting, that tells me a bit more about these systems. I also take a look if someone has a marked mood shift. Let's say they're saying, "After my period every month, I feel completely low and depressed."
That's a symptom or a signal for me that we need to take a look at something a little bit further.
Whenever I'm walking through this or thinking through this with someone, there might be things that you're exactly right about. Someone might say, "Hey, this has been my normal for a long time, but it really throws me off."
Or, "I know around my period I'm going to get a headache, and then I'm out of commission for some days."
If that's really taking over your quality of life, then we can look at this a little bit further to start making some heads or tails around it, so it's less impactful on someone's quality of life.
What Is Hormonal Resilience?
Gabie: Makes sense. You often talk about hormonal resilience. What does that mean in practice?
Katie: Yeah. I love the word resilience because what we want is for someone to feel confident that they know where things are coming up for them.
Resilience is not only knowing, "Yep, my period is this amount of time. My second day is a little rocky." That way they're more resilient within their life because they can very much plan for that and not have something take them down for the count for a while.
I think the other thing, too, with resiliency is that if things are thrown off in life, it doesn't throw everything off. They're not saying, "Okay, I know my period's going to be really bad," or, "My gosh, my stress response is going to make sure that this period for the next two months is going to be really hard for me."
You want resilience to be that things can weather the storm a bit better because life will still happen. If we're having a stronger response within our body, a stronger pathway, or even a stronger understanding, our body can go, "Hey, I can weather the storm a little bit better."
Building Hormone Health in Your 20s and Beyond
Gabie: In your view, what are some of the key habits that you develop in your 20s that can shape hormone health long term, even in your 30s and 40s?
Katie: Oh my goodness. Such an important question because we don't always think about our future selves.
I think through some of my major players in all of this. I definitely think through nutrition. If I really break it down, am I getting in my protein needs? Am I getting my fiber needs? Am I getting in those bright colors that are going to help me with inflammation overall that can extend throughout the body?
I also look at sleep and sleep cycles. That's actually one of those things that, like I talked about before, can really ramp up that internal stress response, which then becomes a domino effect later.
I can also say, speaking about that stress response, having some really great stress relief habits that you can bring out from that tool belt when your stress levels go up or down is key, especially as we move into our 40s and 50s.
Then I think my other major players are fluid intake and activity. Do we have something activity-wise that's going to help not only our stress response, but also bone health, blood sugar, insulin resistance—all of these things that can be really far-reaching when it comes to hormones?
Hormones can be a bit complicated there.
Gabie: When you're in your 20s, oftentimes if there's nothing concerning, if there are no symptoms, you usually don't really think about all these things. But wouldn't you say that symptoms sometimes develop later, even if there's something going on underneath, but it doesn't show up until later? Is that accurate?
Katie: No, absolutely. Or it could be something that, in our 20s, our bodies are like, "Okay, no problem."
Bodies are amazing because they adapt. They are all about keeping someone moving and going. In our 20s, our bodies are like, "Hey, I can adjust. I can do things. I can keep them energized." They can get very little sleep, but we've still got this adaptability.
That might not show up in our 20s in terms of ill effects because that's really their goal.
Over time, though, we have this chronic part. If chronically we've been using our body to adapt, whether that's through our 30s, 40s, or 50s, all of a sudden it's like, "You know what? I've been doing this for a while, and holy cow, I can't do it as well or as efficiently anymore."
That's essentially what our bodies are doing and why we can see that difference or see where something may pop up later.
I think if I had to run all the time, over time my legs would be like, "Oh man, I can't do this. I'm getting tired."
I have to think of it that same way. If we're taxing our bodies for some time, eventually they're just going to go, "I can't do this as well." It's as simple as that.
It's Never Too Late to Make Changes
Gabie: I like what you said, that our bodies are so amazing and they adapt. So let's say we're in our 30s or 40s and we're looking for ways to boost our fertility and improve our chances. Obviously, we cannot go back into our 20s and fix all of the things we probably should not have done. But hey, everybody does a lot of different things. It's life. We learn, we grow.
What can you do now that is impactful? It's not too late. You still have time to make changes. What changes would be the most impactful?
Sleep, Stress, and the Bookends of Your Day
Katie: Yeah. I probably would say the two most important—well, let's say two and a half because I'm going to put two together—are sleep and stress. That is one that I can see is key, key, key because your stress response and your cortisol rule your circadian rhythm.
We have a little bit of natural cortisol that's released every day, and that's what tells our body to wake up and then to go to sleep at night. That's why I put both of those together.
I often tell everyone, "Look at the bookends of your day." In the morning, be like, "Okay, this is how my day is going to go." If that is immediately waking up, being anxious, and looking at your phone, that's how your day is going to go, and that's a lot.
We want to take a moment—15 minutes. Don't look at your phone. Journal, whatever works for you. Think, "Okay, this is how my day is going to go."
At the end of the day, your other bookend, you're telling your body, "Hey, I'm relaxing to go to sleep because I need that rest, and I need that reboot of my body."
Look at that last hour and ask yourself, what are you doing? Pick three things. I'm having a cup of tea, I'm washing my face, I'm brushing my teeth, and I'm reading a book. Stay off your electronics.
That's one major part.
Eating the Rainbow: Bright Colors and Inflammation
Then I think of the nutrient part. The main thing that I look at is I want people to focus on color—focus on bright colors—because that tells us much more about the nutrients that are going in there. It also tells us more about our anti-inflammatories.
I know that word is thrown around a lot, but think of inflammation as this puffy little coat that our body puts on to protect itself. We know that with a puffy coat, we can't make a lot of moves, right? We can't move our arm very well if we have a big puffy coat on.
Our body's like, "Okay, if we're on a fertility journey and we want to get pregnant, if that puffy coat is on, I really need to protect myself right now, and so I'm not going to throw a baby into that mix of protection. Something's going on."
The more bright colors we include, the more anti-inflammatory that can be.
Gabie: Give me examples of bright-colored foods.
Katie: Yeah. What I'm mainly looking at is, yes, your protein's important. Yes, we have our whole grains and our carbohydrates. But if I'm looking at my fruits and vegetables, if I'm looking at a green, I want something that's deep green versus just a light green.
I want something that's a rich red or a purple. I'm always thinking of berries. They're such powerhouses of anti-inflammatories.
I'm thinking about that richness versus just a light little red or a light little purple. I want richness. I think of purple cabbage that's really rich in comparison to maybe another cabbage that's a light green and doesn't have that purple to it.
I'm looking for something that gives me a really rich, saturated, or deeper color. I always think of jewel tones. I try to make things light and easy to remember, so I think jewel tones.
Gabie: That reminds me—my husband goes to Costco and oftentimes he comes back home with lettuce, and it's so light. I keep saying, "This is not the lettuce I want to eat." It should be a lot more green.
You're thinking of kale and spinach, and there's red chard, green chard, and all kinds of different varieties there.
Talking about stress and sleep, I was also thinking I feel all these things because when I'm under stress, I tend to not eat. I have friends who do the opposite—they actually end up eating more. When I don't sleep enough, which I think is normal, I start craving very sugary foods. I can definitely see the connection there.
Katie: Sure. So many things are interconnected and far-reaching. Sometimes, when I'm working with someone, I'm just like, "Okay, let's break this down and let's focus on this."
I know as a dietitian, a lot of times people think, "Okay, just food." But if I don't say something about sleep or we don't look at that, again, it's far-reaching.
We really need to look at how all of these things integrate together.
GLP-1 Medications and Fertility
Gabie: Agree. Okay, let me tackle a few modern trends. Let's talk about GLP-1 medications. What do you think about those types of medications, especially for people who are trying to conceive—men, women, anyone with ovaries or testes?
Katie: Yeah. I can absolutely say that they can be useful depending upon the person.
They help with inflammation. They also help with blood sugar response, which can affect the quality of egg and the quality of sperm. Depending on the person and what's going on in their overall picture, they can be useful.
But you'll want to work with someone who really knows the ins and outs of GLP-1 medications—which type, how much, and what that looks like—because on the flip side, they do change things in terms of motility. We think about microbiome changes and motility of the digestive tract. I'm also thinking through hunger and fullness signals.
A lot of times I have people who are like, "Oh, I didn't feel hungry, so I didn't eat." Then we're going to miss out on key nutrients that could make that sperm and that egg.
That's why I say I'm not against them, but it takes working with a professional who knows what they're doing in this area to really be able to navigate them in a helpful way.
PCOS Becomes PMOS: What's Changed?
Gabie: PCOS was recently renamed PMOS. Let's talk about this because it's a hot topic right now.
Polyendocrine Metabolic Ovarian Syndrome. I was looking at this yesterday. I love this name, but I'm not an expert on PCOS or PMOS, and I'd really like to hear what you think about this name. Does it really reflect the true meaning of this condition, or is there still something missing?
Katie: I think it's a much better reflection of this condition.
If you think of it before as polycystic syndrome, I'm just like, okay, not everyone produces cysts. It is a far-reaching metabolic condition. I know when people hear metabolism, they think of weight, but metabolic is literally how someone's body breaks things down, utilizes it, and communicates throughout the body.
It's much more of this background signaling of what is happening within tissues and within certain cells. I could really go into the weeds on this, but it's complicated, so I'm not.
I think PMOS is really looking at endocrine function. If I break that down, it's what's going on endocrine-wise. That's much more of the signaling of how your body is utilizing fuel, blood sugar, et cetera, which leads into metabolic function or metabolism.
It's a much more layered and better meaning for this than simply asking whether someone has cysts or not and whether there are several of them because some people have this condition, but cysts aren't true for them.
Gabie: Yeah, I like it better.
Understanding IBS and the Gut-Brain Connection
Can we tackle a few conditions—IBS, thyroid health, and endometriosis? They're all very common.
Let's start with IBS, irritable bowel syndrome. Can you talk about the symptoms and things to look out for that are really alarming and that we need to pay attention to?
Katie: IBS is kind of a blanket term for a lot of things that can be part of this condition. Typically, it's much more brain-gut related, and vice versa, so there's usually an anxiety or depression component to it. Someone might say, "Oh, I get anxious and then I have symptoms."
Typically, it's diarrhea, constipation, or sometimes it's mixed. That's what I tend to look at when someone has IBS.
Symptom-wise, you think about quick changes in bowel movements and changes in motility within someone's digestive tract. It also can come along with pain and bloating.
IBS covers a lot of areas, and it's a really common one. What I also want to look at is the microbiome because sometimes that signaling can help or hinder that condition.
Gabie: So it's not just a digestive thing, but digestion definitely has a lot to do with it—and stress.
Katie: Yeah, that's why I say it's an important gut-brain connection.
Gabie: Is there a test that you can do to see if you have IBS?
Katie: Not really. There's not an IBS test. Typically, it's a rule-out diagnosis. It's not this digestive condition, and it's not that digestive condition, and it's not this one, so it's IBS.
That's why I say it's very much an overarching diagnosis because you eliminate other things and then it falls into that category. There can be a lot more to it than that.
Gabie: I assume in this case there's really no one treatment. It's a very individualized approach.
Katie: Absolutely. I mentioned the gut-brain axis, but if I'm looking at the microbiome, I might want to think through that as well. It depends if someone's more constipated, has diarrhea, or has mixed symptoms.
There's not one approach because you're looking at all of the symptoms that someone has.
Why Thyroid Imbalances Are Sometimes Missed
Gabie: Moving to thyroid health, why is thyroid imbalance sometimes missed or even under-recognized in practice, even when symptoms can be present?
Katie: Sometimes people can have what we call subclinical thyroid issues. The test that's typically utilized is TSH, which is thyroid-stimulating hormone, and that one doesn't always show lower levels of dysfunction.
Just think of the thyroid as a gland, and we have hormones—again, messengers.
When it's subclinical, I think of that term as low-key. It's not, "Oh my gosh, it's clear as day." But low-key, some of those messengers are off. That's why it's oftentimes missed because it's not much more prominent or glaring.
Symptoms can be fatigue or things that could be related to other issues. That's why it's missed oftentimes. You do need to ask some questions, get into the weeds a little bit, and look further at some of those lower-key hormone pathways, which isn't always done.
Gabie: So not just testing for TSH, but also antibodies. There are other markers that you can test that would help.
Katie: T3, T4, reverse T3, antibodies—there's a lot that you can take a look at that would be much more comprehensive. That's not always done in every setting.
Endometriosis: Challenges in Diagnosis and What's Next
Gabie: My last question is around endometriosis because it's quite often seen in people struggling to conceive. I hear from experts that over 50% of unexplained infertility is oftentimes due to endometriosis. It's also often hard to detect. It can take years—seven or even ten years.
A new blood test came out, the Endomet test. What do you think about this test? Do you really think it's going to give us a lot more information earlier on?
Katie: There hasn't typically been a test for endometriosis. You go by symptoms, and then it's almost like you do a procedure to see if there's endometrial tissue, and that's when you get diagnosed.
All of that time, you have the pain and the other discrepancies. It makes it a really impactful condition, but one that is really hard to give that "yes, exactly this and that" answer for.
I definitely work with people who have endometriosis, and there are things that we can do to improve that pathway and improve symptoms. There are things that we can do besides surgery, if that's not warranted or where someone really wants to go at that time.
I'm looking forward to seeing how testing evolves. That's where I think I could give a better opinion. Right now, I feel like it's just a little too early, and I haven't seen enough to say, "Oh yeah, this is it."
It's such a complicated condition that oftentimes also brings the gut health piece into it, too. That's why I'm always excited to see the newness of, "Ooh, we've got something. Let's see what's really happening here."
We're really trying to move things forward.
Closing Thoughts
Gabie: Thank you so much. This was an amazing conversation. I really enjoyed it.
Katie: Oh my gosh, thank you. As I said, I can geek out on these things all day. It can be complicated, but I really try and hope to simplify it so it doesn't feel so overwhelming because understanding your body and what's going on makes it so much easier to move forward and say, "Oh, I can do this about that," or, "Now I get what's going on."
Gabie: Thank you. I appreciate it.
Katie: Thank you. Thanks so much.
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