If you’ve spent any time on the journey of trying to conceive you’ve probably heard a lot about hormones… progesterone, estrogen, thyroid panels, cycle tracking.

But there’s another piece of the puzzle that doesn’t get nearly enough attention: your gut.

I had a conversation in this podcast episode with Hannah Aylward, certified holistic health coach and founder of HAN — a team of functional practitioners specializing in gut health — and she opened my eyes to just how deeply the gut influences fertility, hormones, and whole-body healing. Whether you’re dealing with bloating, constipation, food sensitivities, or chronic fatigue alongside your fertility journey, this one’s for you.

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Your Gut “Talks Hormone”

Hannah puts it plainly: “The gut impacts our estrogen, potentially even progesterone production, cortisol, and thyroid hormone.” While the gut isn’t technically an endocrine gland, it communicates directly with the hormonal systems that govern your fertility.

Here’s the key insight she shared that reframed everything for me: hormonal imbalances are usually not the root problem. They’re the result of something else going wrong. More often than not, that something is connected to gut health, liver function, blood sugar, or nervous system dysregulation.

So before jumping straight to hormone support, it’s worth asking: what’s actually driving the imbalance?

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Common Signs Your Gut Needs Attention

Hannah works with women every day who are dealing with what she calls “chronic” digestive issues — not the heavy bloat after a holiday dinner that resolves by morning, but the kind that affects daily life.

Here’s what to look for:

• Chronic Bloating: Feeling bloated after eating healthy food, after every meal, or even waking up bloated. This type of bloating can cause real pain and significant abdominal distention. This is very different from the soft, cushiony feeling of normal fullness.
• Constipation: “I’m always shocked at how many women are dealing with constipation,” Hannah says. We should be moving our bowels at least once daily. If you’re going every four or five days, that means excess estrogen isn’t being excreted efficiently. This can contribute to estrogen dominance and, by extension, hormonal imbalances that affect fertility.
• Diarrhea & Urgency: Running to the bathroom, always noting where the nearest restroom is. This is the other end of the spectrum and equally worth addressing.
• Food Sensitivities: “I don’t know what to eat anymore. Everything makes me feel bad.” If this sounds familiar, Hannah says it’s a strong signal there’s a deeper gut issue at play.
• Other Red Flags:
  • Persistent acne or skin issues that don’t respond to topical treatments
  • Hashimoto’s thyroiditis (there’s almost always a gut component, given the autoimmune and immune connection)
  • Chronic fatigue
  • Reflux and stomach pain
  • Recurring miscarriage or difficulty conceiving

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How Chronic Stress Destroys Digestive Function

This is where it gets really important for women on a fertility journey because stress is almost always part of the picture.

Hannah categorizes stress into three buckets:

1. Mental/emotional stress
2. Physical stress
3. Chemical/environmental stress
   

Any of these — and especially all of them together — raise cortisol levels. Elevated cortisol can do these things to your gut:

• Wears away the gut lining, contributing to what’s often called “leaky gut” (intestinal permeability)
• Triggers systemic inflammation as undigested proteins and pathogens cross the gut barrier
• Shuts down stomach acid production, pancreatic enzyme secretion, and bile flow (the digestive juices needed to actually break down food)
• Suppresses the gut lining’s natural ability to regenerate (it normally repairs every 3–5 days)
• Drives microbial imbalance (dysbiosis)

The nervous system flip that matters most: when we’re in fight-or-flight (sympathetic dominance), digestion is treated as non-essential. Blood flow moves away from GI organs. We can’t absorb nutrients well. The opposite state — rest-and-digest (parasympathetic) — is when our bodies actually process and absorb what we eat.

Hannah’s bottom line: “Stress doesn’t stay stress. It creates imbalances in the gut. And that will only lead to hormonal imbalances as well.”

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The Trauma Layer: What Pregnancy Loss Does to Your Nervous System

I asked Hannah specifically about trauma because for many women reading this, pregnancy loss is part of their story. And what she shared was both validating and important.

When we endure loss, our nervous system doesn’t just process it and move on. It begins to anticipate and brace against the next possible harm. For someone trying to conceive after a miscarriage, this can look like hypervigilance, fear, or a subtle but constant sense of dread even when logically, everything looks okay.

This anticipatory stress keeps the nervous system in that revved-up sympathetic state. Therefore, chronically elevated stress hormones, particularly cortisol, directly suppress progesterone — one of the most critical hormones for sustaining a pregnancy.

“When we can create safety in the body and in the nervous system, it’s only going to better everything,” Hannah says. “Getting out of fight-or-flight is going to be really important to optimal health and to conceiving.”

That doesn’t mean “just relax” or “stop worrying.” It means seeking tools that actually regulate the nervous system: nourishment, support, faith, community, and sometimes professional help.

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What Functional Gut Health Work Actually Looks Like

Hannah’s team at HAN takes a root-cause approach to gut health. Here’s what their process typically includes:

• Functional stool testing to understand exactly what’s going on in the microbiome
• Functional blood work panels and, when needed, hormone panels
• Environmental toxin panels in certain cases
• Targeted nutrition (food-first, always)
• Customized supplement protocols based on individual results
• Nervous system regulation tools — vagal nerve toning, circadian rhythm support, stress resilience work

The goal is to repair the gut barrier, rebalance the microbiome, reduce inflammation, and support the whole-body systems from the inside out.

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A Word for the Woman Who’s Been Told “It’s Just Stress”

If you’ve sat across from a doctor and been told your symptoms are just stress and that it is normal, Hannah’s message is clear:

“If you’re experiencing digestive issues on a daily basis, it’s very likely not just your stress, especially if it’s accompanied by other health issues.”

Chronic bloating, fatigue, food reactions, skin issues, hormonal struggles are signals, not character flaws.

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