Sex and Your Gut

By Nicole Cain, ND, MA

Inflammation is one of the body’s most powerful processes, possessing both the potential for both healing and disorder. Among its most significant activities¹ is its influence on the trillions of microbes contained deep in the gastrointestinal tract, referred to as the gut microbiota.

Your gut microbiota impacts sexual health by regulating hormones and neurotransmitters². It is a fact that our gut bugs and sex drive co-evolved³. Recent research identifies a few channels through which inflammation impacts your sexual health, and that knowledge offers strategies to leverage the power of the gut in your sexual satisfaction.

Inflammation, Mood, and Desire

Sexual desire naturally fluctuates over time, with highs and lows corresponding with life circumstances, sexual partner, phase of life, hormone and neurotransmitter composition, and as it turns out, levels of inflammation.

A 2019 article published in the journal Current Sexual Health Reports explored the relationship between inflammation, female sexual desire, and arousal. One of their findings⁴ was that there is an inverse relationship between inflammation and sexual desire in women. As such, researchers suggested anti-inflammatory interventions as a potential treatment for improving sexual desire and arousal. In essence, women with lower levels of inflammation appear to experience more feelings of wanting, wishing, or desiring sexual activity, as compared to women who experience long term inflammation.

Source: Nicole Cain

One proposed mechanism by which inflammation may reduce sexual desire is its effect on amygdala activation. In a 2018 study⁵ published in the journal Brain, Behavior, and Immunity, researchers studied inflammatory biomarkers such as C-reactive protein (CRP) and the predominance of anxiety, depression, and post-traumatic stress disorder (PTSD)symptoms. Authors suggest that increased inflammation levels correlate with reduced amygdala connectivity with the prefrontal cortex, resulting in greater levels of fear and depression, which has been associated with lowered sexual desire.⁶

A 2021 publication⁷ reported that disturbances in gut microorganisms are closely related to the level of human sexual desire. Study participants who suffered from hypoactive sexual desire had similar microbial signatures, which contrasted with the microbial signatures of those who did not struggle with sexual desire.

Considering the influence of inflammation on mood and desire, the link between gut metabolite signatures on sexual desire, and the potential mechanisms by which gut microbes may mediate sexual desire, a viable treatment approach may be the use of gut-brain targeted probiotics or psychobiotics.⁸

Inflammation, Pleasure, and Performance

Another factor in the relationship between inflammation and sexual health is the effect of inflammation on the sex organs themselves.

Painful sexual intercourse in women—referred to as dyspareunia—is a common problem affecting upwards of 28% of the population in a lifetime.⁹ And you guessed it: one of the underlying causes of dyspareunia is inflammation, which may also be associated with pathogenic alterations of the vaginal microbiota.

In a 2022 study reported in the journal Frontiers in Cellular and Infection Microbiology,¹⁰ researchers reported an association between a highly diverse vaginal microbiota and female reproductive tract health. “Probiotics play an important role in maintaining the health of the female reproductive tract, alleviating gynecological diseases, and enhancing the local immunity of the vagina,” the researchers stated.

There is also a very strong link between sexual health, performance, and inflammation in men. Erectile impairment carries profound psychological consequences and may interfere with a man’s overall well-being, self-esteem, and relationships. Conservative estimates from Boston Medical School of Medicine suggest that between 10-20 million men are affected.¹¹

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According to a 2020 article in the journal Current Pharmaceutical Design,¹² “chronic low-grade inflammation is a critical component of erectile dysfunction (ED) pathogenesis,” with shifts in inflammatory markers cytokines, chemokines, and adhesion molecules being observed in men with erectile dysfunction. The authors asserted that the established data suggests anti-inflammatory agents as a therapeutic role in the prevention and treatment of ED.

An additional 2021 publication in the journal Translational Andrology and Urology¹³ identified a correlation between gut microbiota diversity and erectile dysfunction. The investigators found that microbial community structure and diversity was reduced in men with ED. They observed that the microbiome can positively and negatively regulate sex hormone levels; in examining the effects of probiotic supplementation in participants, they found improved sexual function via enhanced sex hormone levels. The authors also asserted that normal erectile function depends on normal functioning of blood vessels in the penis and that inflammation and reduced microbial diversity is associated with increased inflammation and vascular pathology.

Conclusion

Elevated inflammation appears to be associated with lowered sexual satisfaction and in both men and women. Microbial diversity appears to be associated with improved sexual health, performance, satisfaction, and desire.