MICROBIOTA AND SEXUAL HEALTH

Abstract Objectives Sexual problems have a negative impact on quality of life, psychological well-being and relationship satisfaction. In recent years, the connection of the microbiota with various health problems, as well as the connection with sexual health, has been increasingly investigated. The aim of this paper is to show the influence of microbiome imbalance, which is called dysbiosis, on individual phases of the sexual response cycle, starting with sexual desire itself. Methods The UpToDate and PubMed databases were reviewed using the keywords microbiome, probiotic, synbiotic, sexual health, and sexual dysfunction. The inclusion criteria were the availability of complete review articles in English published in the period from 2018 to 2024. Results The connection between microbiota and sexual health is explained by complex communication mechanisms within the organism, including immune, neurological, endocrine and metabolic pathways. Stress, anxiety and depression significantly reduce sexual desire. Obesity in both sexes is associated with a change in the microbiome where the representation of good bacteria (Bifidobacterium and Lactobacillus) is reduced compared to unhealthy (Enterococcus, Clostridium, E.coli, Proteus and Pseudomonas). In men, it is associated with hypogonadism, decreased testosterone concentration, decreased libido, erectile dysfunction, decreased muscle function and lethargy. A lack of testosterone in women also results in reduced sexual desire. Semi-permeable bowel syndrome in women is often associated with changes in the endocrine system and the increasingly prevalent polycystic ovary syndrome. A balanced microbiota affects the balance of neurotransmitters necessary for sexual health. Dopamine is needed for sexual desire and is affected by Bacillus; gamma-aminobutyric acid (GABA) is necessary for calmness and the ability to enjoy sexual intercourse, and L.rhamnosus acts on GABA receptors. Approximately 95% of serotonin originates from intestinal enterochromaphilic cells and intestinal neurons, and this neurotransmitter maintains pleasure in sexual life and affects the possibility of experiencing orgasm. Conclusions Based on the above, it is clear that the imbalance of the microbiota affects all aspects of sexual health. We should consider dysbiosis as a possible cause of sexual dysfunction in diagnosis and treatment. Conflicts of Interest The authors declare that they have no conflict of interest.