Does gut health play a role in conception? Expert interview with Dr. Eva Maria Hoffmann-Gombotz
The fascinating world of microorganisms is invisible to us, yet it has an insanely large impact on us. The human microbiome in particular has been of great interest to researchers for a long time. Recently, the topic of gut health has come up more and more frequently as a significant contributing factor in successful conception. To get to the bottom of this and gain a deeper insight into this exciting topic, we spoke with Dr. Eva Maria Hoffmann-Gombotz, an expert in this field, and received very insightful answers to our questions.
You are an expert in the field of gut health. How did you get into this field? Please tell us a little bit about your background.
I am a microbiologist, I did my PhD at the Medical University of Graz and also worked there for many years in the field of colorectal cancer research. Looking back, I can say that the microbiome has always fascinated me. Especially the questions of what it takes to keep the gut – the center of our health – fit. So I changed fronts. I exchanged the microscope and antibiotic solutions for the microphone and probiotics and switched from the subject of intestinal cancer research to intestinal health.
For almost eight years I have been dealing with the questions: What does our gut need to feel good? And how does a “healthy gut” affect the whole person? That’s what I now lecture, teach and consult about.
What do we mean by the term ‘gut health’?
Hippocrates already said: “Death is in the intestine”. Therefore, it was already known in ancient times that a sick intestine is the root of many diseases. If our intestines are ailing, this is usually associated with a disturbed gut microbiome (intestinal flora). The composition of the intestinal bacterial flora determines how well we can absorb nutrients from our daily food. Whether our body cells are sufficiently supplied with trace elements and vitamins. If and how well our immune system functions. Whether we are able to fight off foreign/disease-causing germs or not.
If this microbial ecosystem gets out of joint, we also lose our balance. We suffer from flatulence, sluggish digestion. Our mood fluctuates. We feel miserable. So when we talk about “gut health,” we’re talking about bacteria. Ideally, in the highest possible density, in the greatest possible diversity. It’s all about an intact protective shield against pathogens and allergens, optimal absorption of nutrients and regular digestion.
How is our health and well-being affected by our gut health?
Each of us has experienced it: if we suffer from a stubborn constipation, we don’t feel like joking around. If we have a gastrointestinal virus, we prefer to withdraw rather than mingle and see other people. We feel lonely, depressed. This is because the intestines and the brain are in constant communication with each other. On the one hand, this works via the vagus nerve, a brain nerve that runs through our entire body. But also via metabolites formed by the intestinal bacteria, which include short-chain fatty acids, such as butyrate. And of course, the bacteria also influence our well-being through the absorption and formation of vitamins. The best food is of little use to us if there is a lack of intestinal bacteria that can utilize it. In addition, the gut is literally a hormone factory.
For us women specifically, how exactly is our gut health related to our well-being?
For us women, a healthy gut is desirable for many reasons. As mentioned, the gut is involved in the production of about twenty hormones. Among them is serotonin. The happiness hormone. If there is a lack of serotonin we feel weak, the gut is sluggish. If there is a lack of the happiness hormone, there is also a lack of melatonin, the sleep hormone. So whether we are in a good mood and well-rested depends not only on the appropriate sleep hygiene but also on the composition of our microbial co-inhabitants. Then we have the aspect of nutrient intake: For our female cycle to function optimally, we need lots of vitamins, minerals and trace elements.
A balanced diet is the cornerstone. But the bacterial flora has the power to knock out the building material. I’m thinking of the B vitamins. I’m thinking of vitamin K. But also vitamin C. In addition, it turns out that women who suffer from PMS (premenstrual syndrome) often have a bacterial imbalance. The intestinal barrier no longer fulfills its protective function (leaky gut), the immune system overreacts and inflammation occurs. A possible consequence: a feeling of tenderness in the breasts, headaches, migraines, tension, depressive mood swings. The list is endless.
What does our gut health have to do with successful conception?
To find out, we need to take a closer look at the connection between the intestinal and vaginal flora. Although the composition of bacteria in a woman’s vagina is quite different from that in the intestine, there is a significant interdependence here. The vaginal flora is characterized by lactobacilli. These are essential for an acidic environment. Under optimal conditions, we find a pH value of 3.8 – 4.5, which is created by the lactic acid production of the lactobacilli. In addition, the bacteria are densely packed here and make it difficult for pathogenic immigrants (E.coli or Gardnerella) to survive and spread.
Stress, antibiotics, sauna visits, changing sexual partners – all of this can lead to a change in the vaginal flora. That’s when women suffer from itching and burning sensations in the intimate area, sometimes they also notice an unpleasant change in discharge. For a healthy vaginal flora, the woman needs sufficient lactobacilli. The gut serves as a reservoir for these bacteria and provides the bacteria for the vagina. That is why a species-rich intestinal flora is indispensable when we speak of a healthy vaginal flora.
And how can conception be influenced by it?
Science shows that there is a connection between lactobacillus colonization and the occurrence of pregnancies. The bacteria are important not only for implantation, but also for maintaining the pregnancy. If the protection provided by lactobacilli is insufficient, pathogenic germs can spread. Each of us has heard of the risks of a “rising” inflammation.
Studies show that women with a lack of lactobacilli in the endomentrial milieu became pregnant less often, or had a tendency to experience miscarriage more often. In addition, and none the less interesting: the health of sperm is also dependent on lactobacilli!
What can women or couples who are trying for a baby do for their gut health?
It is important to ensure sufficient lactobacillus colonization. This applies to both men and women. This is possible through the use of multispecies probiotics. There are good products that are backed by studies. It is important to look for a high bacterial count and a powder formulation when purchasing. In addition to using store-bought synbiotics (probiotic bacteria & prebiotic matrix), I advise including fermented foods in the diet. Let’s think of sauerkraut, yogurt, kefir, miso. Sourdough bread, kimchi. The refrigerator has a lot to offer. But we also have to think about the existing bacteria. They need fiber and roughage to multiply and feel good. The more colors you can include in your meals, the better. The DGE (German Society for Nutrition) recommends a daily dietary fiber consumption of 30 g.
If you’re looking for inspiration look for the Mediterranean diet. This is in many ways the ideal diet for us women! To the disappointment of many, I’m not talking about pizza and pasta here, but instead lots of fruit, vegetables, olive oil, herbs, fish, whole grains, nuts, seeds and, depending on the quantity, red wine. One tip that is most difficult for couples who want to have children to put into practice is stress reduction. After all, wanting a baby and being surprised by your period month after month inevitably causes stress. Talking helps. Taking good care of yourself helps, too.
What I wouldn’t recommend is ending up in front of the TV with a tub of ice cream to eat away your feelings. Sugar damages the intestinal flora. So do convenience foods. Too much processed meat, and alcohol. An excess of animal fat: Unfortunately, too. In addition, the intestine likes exercise. And that’s not only good for digestion, but also for your stress levels and mood. As a yoga teacher, my tip is to cultivate a regular yoga practice. But in reality, anything that gets the body going and quiets the mind is allowed.
What can you do if you've overindulged, such as during the holidays? Is there anything you can do to improve your gut health?
Not being too hard on ourselves. Reaching for the apple more often instead of the cookies. Drink water. Whip up more meals made with vegetables. Start the new year with probiotics. And listen to your gut. In most cases, it already knows what we really need.