The Elk rut is a highly ritualized affair that leaves nothing to the imagination. Bull elk bugle to call cows, build and protect their harem from other bulls and perform the rituals associated with the rut (how is that for PG?). The bulls get exhausted over this period as their services are in high demand and they aim to do their best. When they approach cows in their harem they are very affectionate and the cow may accept or reject their affections. When they accept them, well you know.
Here are a bull and cow in mid-mating ritual. And yes I think they will be parents in the spring!