Your Fertility Questions Answered: Hormones, Ovulation, and Timing

Confused about your cycle, ovulation, or the “right time” to conceive? You’re not alone. In this Q&A episode, Dr. Stephanie MacKay answers the questions women ask most about hormones, stress, gut health, and fertility — with clear, compassionate guidance from both a Functional Medicine and Chinese Medicine perspective.

Learn how to recognize true ovulation, understand how stress alters your cycle, and why your gut plays a bigger role in fertility than you might think.

You’ll learn:
• How to tell if you’re ovulating regularly
• How stress impacts hormones and ovulation
• The real difference between PCOS and hormone imbalance
• Why gut health and digestion affect fertility
• When the best time to have sex actually is (and how to make it less stressful)

Your body isn’t broken — it’s communicating. Let’s decode the messages together.

✨ Learn more about Dr. Stephanie’s personalized 6-month Flourish Fertility Program → https://restorefertilityandwellness.practicebetter.io/#/67251fc5017d92d3606d1cb2/bookings

Thanks for tuning in to the Restore Fertility Podcast with Stephanie MacKay. Don’t forget to follow the show so you never miss an episode.
Want more fertility and hormone support? VisitRestoreFertilityAndWellness.com Connect with me on Instagram @RestoreFertilityAndWellness

Transcript

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Welcome to Restore Fertility, the podcast where women's health meets holistic healing. Hosted by Stephanie McKay, fertility and hormone expert. With 20 plus years in alternative medicine, we dive into the root causes behind period problems, hormonal imbalances, and fertility struggles. Combining Eastern wisdom with modern functional medicine, whether you're trying to conceive. Navigating PCOS or simply Craving Hormone Harmony. This podcast is your space for support, education, and empowerment. Join us weekly for expert tips, fertility success, stories, and guidance from someone who truly gets it. Welcome back to Restore Fertility. I'm Dr. Stephanie McKay, doctor of Oriental Medicine and Fertility Specialist. Today we're doing something a little different, a Q and A episode where I answer some of the most common questions women ask me about the hormones, fertility, and timing. Whether you're just starting your journey or have been trying for a while, understanding how your body works is empowering. will cover how to know if you're ovulating, what stress really does to your hormones, the difference between PCOS and general hormone imbalance, how gut health ties into fertility, and of course, when to have sex if you're trying to conceive. Let's dive in. All right, question number one. How do I know if I'm ovulating regularly? This question comes up constantly, and I completely understand why ovulation can feel like a mystery if you're not tracking it. The truth is ovulation is the main event of your cycle. Your period is just the after party. It's the release of an egg, the peak of your fertility window, and the signal that your hormones are dancing in rhythm. Here are a few clues your body gives you around mid cycle. You'll notice cervical mucus becomes clear, slippery, and stretchy like egg whites. That's your body creating the ideal environment for sperm to swim Your basal body temperature will dip right around the time your LH surge is. Then you will notice a slight rise about 0.4 to 0.6 degrees after ovulation confirming that it did happen. You'll also want the temperature to stay higher around that 98 to 98.2 degrees for a good bit, and then it will dip down right before your period or after several days after your ovulation. You might see it rise from the 98 to. Go up to 98.2 to 98.4 and stay strong up there. And that could be a good indication that implantation and growth are happening. You might feel more energetic, social, or confident, and that's the surge of estrogen and testosterone before the egg is released. And if you're tracking with LH test strips, you'll see the urge about 24 to 36 hours before ovulation from a Chinese medicine perspective, ovulation reflects strong kidney yang. That's your spark, your fire. If you're not ovulating regularly, we look for things that might be dimming this fire that could be stress over exercise. Undereating or deep fatigue. My advice is to track your cycle for a few months and notice your own unique rhythm. When you tune in, you'll start seeing that your body has been communicating all along. All you need is a super basic digital thermometer. You take your temperature first thing in the morning before you talk to your partner or go to the restroom. Question number two, can stress really affect my fertility? Absolutely. And not because you're just too stressed. Our bodies often act primal. When we have stress, our body perceives it as a threat. We might need to run or flee, and if we're pregnant, that will slow us down and make us vulnerable. So instinctually our body protects us. Stress changes hormones in measurable ways. When cortisol rises chronically, it steals from progesterone, that hormone. Is a hormone that holds the uterine lining and supports early pregnancy. This phenomenon is called the pregnenolone steel. Think of it like a hormonal traffic jam. Your body diverts resources to make stress hormones instead of the reproductive ones. Physically, you might notice short luteal phases spotting before your period, poor sleep, or feeling wired and tired. What we can do to help is create gentle structure for your day. Try to have meals every three to four hours with no skipping your breakfast. Prioritize restorative movement. Over intense workouts. If you're depleted, support your adrenal health with herbs like ashwagandha, rei, mushrooms, or licorice if you can tolerate them and emotionally find ways to discharge stress, like journaling, walking or breath work. And remember, stress is unavoidable, but we can teach our body to feel safe again. And safety is fertile ground. Okay. Question number three. What's the difference between PCOS and hormonal imbalance? This is such an important distinction. PCOS. Polycystic ovarian syndrome is a collection of symptoms that usually includes irregular ovulation, higher androgen levels, and sometimes cysts on the ovaries. It's not one single cause. It's a pattern. A general hormone imbalance could mean your estrogen, progesterone, or thyroid or off, but you still ovulate. You might have PMS, mood swings, fatigue, or bloating, but not the metabolic picture of PCOS. P. COS often involves insulin resistance. That's when the cells don't respond to insulin efficiently, so the body makes more. And that excess insulin drives the ovaries to produce more androgens like testosterone, which then interfere with ovulation. In Chinese medicine, we call that pattern a phlegm damp accumulation. The system is sluggish, congested, and not moving smoothly, so we focus on restoring flow clearing damp. We wanna strengthen your spleen, which is your digestion, and support the liver's smooth movement of Q. The takeaway. Not every irregular cycle means PCOS. True healing starts with identifying your root pattern, metabolic stress related inflammatory or digestive, and restoring rhythm from there. Question number four, why is gut health such a big deal for hormones? Your gut is like mission control for your hormones. One of the most important roles is estrogen metabolism. There's something called estrobolome, a group of gut bacteria that helps process breakdown and eliminate used estrogen. When our gut is sluggish, that estrogen can recirculate. Which can then lead to symptoms like PMS, bloating, tender breasts, or heavy periods. The gut also controls inflammation and nutrient absorption. Both are vital for ovarian and thyroid function. An Eastern medicine digestion reflects the strength of your spleen sheet. That's your ability to transform food into energy and blood. If your digestion is weak, the body can't make high quality blood and chi, which is very needed for ovulation and implantation. Supporting your gut doesn't mean perfection. It means consistent habits. Eat whole unprocessed foods and enough protein. It's about 30 grams of protein A meal include fiber, rich vegetables, chia seeds, flax seeds, or oats, reduce alcohol. And refined sugar, which can harm your microbiome, and try to chew your food slowly so digestion starts in your mouth. A healthy gut equals efficient hormone clearance, less inflammation, and more energy for your reproductive system. Question number five, when do I actually know the best time to have sex? Timing is one of those topics that causes so much confusion and pressure. Your most fertile days are during the four to five days leading up to ovulation and the day of ovulation itself. That's your fertile window. So sperm can live about three to five days, but the egg can only survive about 12 to 24 hours after it's released. So the goal is to have healthy sperm waiting when the egg drops, watch your cervical mucus when it's clear, slippery, and stretchy. That's your green light. Ovulation usually happens within 24 hours of your LH surge, which you can usually do with test strips. Okay. Practically speaking, intercourse every other day. From day 10 to 16. When you have a typical 28 day cycle, works well for most women. If your cycles are longer or shorter, adjust based on your signs. And one more thing, connection matters. When intimacy becomes mechanical or scheduled, the body senses that tension. The parasympathetic nervous system, which governs rest, digestion, and reproduction thrive on a calm environment. Create an atmosphere of connection. Take a warm bath together, laugh, relax. This helps your body open literally and energetically. Fertility isn't just biology. It's receptivity. Your body is wise and responsive. When you start to see your symptoms, not as problems, but as a communication, everything changes. You'll learn how to work with your cycle, not against it. If this episode resonated and you'd like to go deeper into balancing your hormones, nourishing your fertility, or learning how to track your body's vital signs, visit the link in the show notes and learn more about my Flourish fertility program. Thank you for being here, and I'll see you next time on Restore Fertility.