Discovering a new paradigm: Gut microbiota as a central modulator of sexual health

Abstract

The gut microbiota plays a pivotal role in human health, influencing diverse physiological processes, including those related to sexual health. Emerging evidence suggests a bidirectional relationship between the gut microbiota and sexual health, mediated by its impact on systemic inflammation, hormonal regulation, and immune function. A balanced gut microbiota supports optimal levels of sex hormones, such as estrogen and testosterone, which are critical for sexual function and reproductive health. Additionally, gut-derived metabolites such as short-chain fatty acids contribute to maintaining mucosal barrier integrity and regulating immune responses, which are essential for protecting against infections that may impair sexual health. Conversely, dysbiosis, an imbalance in gut microbial composition, has been linked to conditions such as erectile dysfunction, polycystic ovary syndrome, and reduced libido, emphasizing its role in sexual dysfunction. Lifestyle factors, including diet, stress, and antibiotic use, can modulate the gut microbiota and, consequently, sexual health outcomes. Recent therapeutic approaches, such as probiotics, prebiotics, and fecal microbiota transplantation, offer potential for restoring gut balance and improving sexual health. This review highlights the central role of the gut microbiota in sexual health, emphasizing its importance as a target for therapeutic interventions to enhance overall well-being.

Keywords: Gut microbiota; Sexual health; Mental health; Dysbiosis; Gut brain axis; Short-chain fatty acids; Neurotransmitters; Hormonal regulation; Sexual performance anxiety; Diet; Psychobiotics; Psychological therapies

Core Tip: The gut microbiota is crucial for sexual health, influencing hormonal balance, immune function, and the gut-brain axis. A balanced microbiota supports optimal levels of estrogen and testosterone, while dysbiosis contributes to erectile dysfunction, polycystic ovary syndrome and decreased libido. Microbial metabolites, such as short-chain fatty acids, influence neurotransmitters and mood, affecting sexual desire and function. Therapeutic approaches, including probiotics, prebiotics, and fecal microbiota transplantation, show promise in restoring gut balance and improving sexual health. Recognizing this interplay offers new strategies for managing sexual dysfunction and enhancing overall well-being.