March 5, 2024

GUT-BRAIN-VAGINA (and libido) CONNECTION (for men too ;)

Is the gut connected to our LIBIDO?? This article will discuss the gut-brain-vagina (and libido) connection and how gut modulation can positively impact sexual health, for men and women. So let’s dive in!

The natural place to turn when thinking about balancing hormones and improving libido is probably your OB/GYNE. Afterall, we have been taught in our society to see certain doctors for certain body systems. I talk a lot about the gut health because it is so important. I also talk a lot about how the gut is central to health and every system in the body is connected. So through this article I want to discuss the gut-brain-vagina (and libido) connection and how gut modulation can positively impact sexual health, for men and women. So let’s dive in!

How does the gut impact vaginal health, fertility and sex drive?

In functional medicine, we view the body as one system working together. The gut is not only central in the body but is central to health, even hormone health. The gut synthesizes nearly 90% of our happy hormones – serotonin, GABA, glutamate, dopamine and through tryptophan metabolism comes melatonin.

What about oxytocin, our love hormone? Yep this is produced in the gut as well. Oxytocin is produced in the intestinal enterocytes and its release is stimulate by our gut bacteria1. Looking for stronger orgasms and increased libido? Look no further!

Wait, there’s more…

The gut is where a big chunk of our immune system sits – nearly 70%. So when the gut is off a person is more prone to anxiety, depression, insomnia, and frequent illness. When someone is over stressed, not sleeping, sick all the time and is not producing happy hormones that person is not likely to have a healthy libido and frequently, as seen in practice, has difficulties conceiving and presents with hormonal imbalance. This is due to a negative feedback loop in the adrenal-hypothalamic-pituitary axis. Let’s keep reading…

How does the gut microbiome affect our hormones?

Estrogens and progesterone:

Our microbiome richness and diversity is associated with greater hormone production3. The deconjugation or detoxification of our hormones is also influenced by our microbiome. Human studies have shown3 that elevated levels of beta glucuronidase (an enzyme produced by certain gut bacteria) prevent detoxification and elimination of our hormones, namely estrogens, resulting in higher levels of these hormones and associated symptoms of estrogen dominance – heavy, painful menstrual flow, moodiness, and breast tenderness. Beta glucuronidase activity also prevents the removal of other toxins (xenoestrogens, BPA, PFA’s, heavy metals, phalates, mold and mycotoxins) which contribute to continued gut microbiome alterations when left untreated.

Progesterone levels are also affected by our microbiome. Dysbiosis in the microbiome leads to increased intestinal permeability and subsequent immune activation through leakage of toxins, food particles, and bacteria into our systemic circulation. This constant immune activation puts us into fight-or-flight all the time requiring constant cortisol release. This can result in a cortisol steal leading to deficient hormone production overall – testosterone, estrogen, and progesterone. Progesterone is our relaxation hormone. Reduced progesterone levels means disrupted sleep which means more stress and anxiety and reduced libido. We become so tired we can’t sleep let alone think about sex.

Testosterone production:

Does the gut microbiome affect testosterone production? Testosterone is our memory, muscle, energy and confidence hormone and frequently associated with libido. Studies have shown that bringing back homeostasis to the microbiome results in elevated levels of serum testosterone and offers protection from the development of type 1 diabetes. In fact, fecal microbiota transfer from adult male mice to immature female mice resulted in elevated testosterone production in the females plus reduced autoimmune disease development and protection against type 1 diabetes5.

PCOS (polycystic ovarian syndrome):

PCOS is a condition affecting a large portion of our female population and is a leading cause for infertility. PCOS leads to hormonal imbalance and frequently androgen dominance symptoms with hirsutism, weight gain, and acne being some outward symptoms. Those with PCOS have irregular periods, usually without ovulation, leading to infertility. Typical treatments for PCOS include birth control pills to regulate periods and drugs like clomiphene, metformin and gonadotropin therapy to help with fertility. But could the microbiome be a better strategy for treatment of PCOS? …

Studies have shown that those with PCOS have reduced diversity of their microbiome and higher gut permeability leading to endotoxin release into the systemic circulation activating immune responses which interferes with insulin receptor function, increases serum insulin levels and then stimulates the ovaries to produce higher androgens that affect normal follicular development and fertility4. Treating the microbiome sounds like an alternate, long-term plan for success 🙂

Ovarian cancer:

As mentioned early, bacteria that produce the enzyme beta glucuronidase alter the deconjugation of estrogens increasing the amount of active estrogen in circulation. This is a risk factor for the development of ovarian cancer as well as other cancers. Of equal importance, is the reduced ability for overall detoxification allowing for toxin overload and increased cellular dysfunction. This can lead to many types of cancer. To read more on the gut-cancer connection read my article titled “Is cancer a freeloader.”

Chronic vaginal yeast infections, bacterial vaginosis, and urinary tract infections (UTI):

If the vaginal microbiome is off, and this is evidenced by frequent yeast infections, UTI’s, or bacterial vaginosis, there is a feedback loop from the gut and the vagina through the vagus nerve to the brain that tells the brain to turn down reproduction because the body needs to get in balance first. If we start by treating the brain we can actually make things worse because gut imbalance causes altered nutrient absorption and distribution which leads to more inflammation in the gut, less happy hormone production, decreased detoxification, and subsequently medication intolerance.

This gets really complicated, but in summary if the gut is off, the brain is off, and subsequently so is reproduction and libido. Chronic stress also decreases immune function, is inflammatory, throws off the microbiome balance further, and increases rates of yeast infections.

So how do we fix this negative loop of vaginal infections, decreased libido and anxiety/depression/insomnia?

Get your gut right! As evidenced above, the gut microbial balance is very important to hormonal production, detoxification and distribution as well as controlling inflammation, neurotransmitter production and subsequent brain function. When the gut is in balance the body is less inflamed and able to produce neurotransmitters that make us feel calm, safe, and confident which is needed for a healthy libido, better sleep, and allows us to shift into a less stressed state easily.

Remember…stress comes from external triggers (finances, friends, family, work, etc) and from internal inflammation (diet, infections, toxins). It is important to recognize and identify external stress triggers as well as treat internal stress triggers.

Toxins and infections are a huge focus in my practice. Toxins and infections will keep the gut microbiome imbalanced and the person subsequently stuck. It is imperative to identify internal toxin and infection load to ultimately regain homeostasis in the body, and the microbiome, to allow for healing. This study shows that when the body is in balance the rate of toxins in vs toxins out is manageable by our microbiome -“Healthy intestinal microbiota demethylates MeHg and promotes excretion through feces1.” When the microbiome is imbalanced the toxins are not cleared resulting in systemic dysfunction.

If we can keep the vagina healthy, then the urinary tract will be healthy. The vagina stays healthy because the gut is healthy, so diet is essential too. Stress, antibiotics, poor diet, toxins and infections can throw off your gut microbiome which will throw off your vaginal microbiome and your hormones. The vaginal tissue needs to be thick and healthy so it can maintain its own microbiome preventing UTI’s and yeast infections and boosting libido and fertility.

If you struggle with infertility, low libido or hormonal imbalance schedule a FREE consultation today 🙂


  1. Coe, G.L., Krout, I.N., Munro-Ehrlich, M. et al. Assessing the role of the gut microbiome in methylmercury demethylation and elimination in humans and gnotobiotic mice. Arch Toxicol 97, 2399–2418 (2023).

2. Danhof HA, Lee J, Thapa A, Britton RA, Di Rienzi SC. Microbial stimulation of oxytocin release from the intestinal epithelium via secretin signaling. bioRxiv [Preprint]. 2023 Mar 9:2023.03.09.531917. doi: 10.1101/2023.03.09.531917. Update in: Gut Microbes. 2023 Dec;15(2):2256043. PMID: 36945649; PMCID: PMC10028957.

3. He S, Li H, Yu Z, Zhang F, Liang S, Liu H, Chen H, Lü M. The Gut Microbiome and Sex Hormone-Related Diseases. Front Microbiol. 2021 Sep 28;12:711137. doi: 10.3389/fmicb.2021.711137. PMID: 34650525; PMCID: PMC8506209.

4. Lindheim L., Bashir M., Munzker J., Trummer C., Zachhuber V., Leber B., et al.. (2017). Alterations in gut microbiome composition and barrier function are associated with reproductive and metabolic defects in women with polycystic ovary syndrome (PCOS): A pilot study. PLoS One 12:e0168390. doi: 10.1371/journal.pone.0168390

5. Markle JG, Frank DN, Mortin-Toth S, Robertson CE, Feazel LM, Rolle-Kampczyk U, von Bergen M, McCoy KD, Macpherson AJ, Danska JS. Sex differences in the gut microbiome drive hormone-dependent regulation of autoimmunity. Science. 2013 Mar 1;339(6123):1084-8. doi: 10.1126/science.1233521. Epub 2013 Jan 17. PMID: 23328391.

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