The Human Microbiome and Sexual Health: Emerging Links Between Microbial Dysbiosis, Neuroendocrine Regulation, and Sexual Dysfunction

The human microbiome has emerged as a critical regulator of physiological homeostasis, extending its influence beyond gastrointestinal health to include immune function, endocrine regulation, neurological processes, and reproductive biology. Recent advances in microbiome research have highlighted the intricate relationship between microbial communities and sexual health through complex interactions involving the gut–brain axis, neuroendocrine signaling, immune modulation, and local genital microbial ecosystems. Microbial dysbiosis has been increasingly associated with a wide spectrum of sexual disorders, including erectile dysfunction, female sexual dysfunction, infertility, hypoactive sexual desire disorder, chronic pelvic pain, and impaired reproductive outcomes. Accumulating evidence suggests that alterations in microbial diversity may disrupt neurotransmitter synthesis, inflammatory responses, hormonal homeostasis, and vascular function, thereby contributing to psychological and physiological determinants of sexual dysfunction. This review summarizes current knowledge regarding the role of the human microbiome in sexual health, emphasizing the mechanisms through which microbial dysbiosis influences neuroendocrine regulation and sexual function. Particular attention is given to the gut microbiome, vaginal microbiome, seminal microbiome, immune signaling pathways, microbial metabolites, and the gut–brain–sex axis. Emerging therapeutic strategies, including probiotics, psychobiotics, prebiotics, fecal microbiota transplantation, and microbiome-guided precision medicine, are also discussed. Finally, current research gaps and future perspectives are highlighted to facilitate the development of personalized interventions aimed at improving sexual and reproductive health.

کلیدواژه ها:

Human microbiome ، Sexual health ، Gut–brain axis ، Neuroendocrine regulation ، Sexual dysfunction ، Vaginal microbiome ، Psychobiotics