The Suprising Link Between Erectile Dysfunction and the Gut
The gut-brain-penis axis adds a new perspective on erectile dysfunction.
Posted March 17, 2026 | Reviewed by Devon Frye
Spare a thought for the grad student who has to monitor erections in rats. And yet, that dedication may pay off with better, if weirder, treatments. A new scientific review from China looked into the possibility of using fecal transplants to improve erections—and found that they show potential.
Studies suggest that 40 percent of Chinese men have erectile dysfunction (ED), and that statistic gets worse with age. At this rate, China could have a real depopulation problem on its hands. America is not far behind, with some 20 to 40 percent of men over 40 afflicted by ED.
ED can be caused by both psychological and physical problems. Some of those physical problems include diabetes, hypertension, and obesity. According to the Lancet , over half of the Chinese population is overweight or obese, which may provide some hints for solving their ED problem.
Is Dysbiosis Related to Erectile Dysfunction?
To these issues, you can now add gut dysbiosis, which is a term used to describe a gut microbiome that is out of balance. People with ED tend to have more disease-causing pathogens like Actinomyces starting to dominate, and healthy bacteria, including certain species of Coprococcus and Ruminococcus, becoming depleted.
Perhaps not shockingly, obesity is also related to dysbiosis. In rat experiments, it is easy to induce dysbiosis by feeding a high-fat diet . That leads ED to increase along with overweight.
The idea that diet could cause ED is intriguing, which led some researchers to take an extra step. In order to see if the ED problem is related to gut microbes, they transferred the microbes to other rats. This is called a fecal transplant.
Amazingly, the microbes from ED rats transferred the ED to normal rats. Moreover, transferring healthy microbes to rats with ED helped them to lose weight and gain back erectile function.
Microbiology is full of loose correlations, but fecal transplants are the gold standard for causality. There may be other factors involved, but at least some of the ED story looks to be microbial.
But How Do Tiny Microbes Affect Sexuality and Arousal?
The answer lies in how the microbiome works.
As soon as animals popped on to the planetary scene, they had microbes, simply because the planet is awash in them. And they would devour us all if we didn’t recruit some more benign microbes to work on our side in return for a warm wet home with regular meals.
This is the main appeal of a microbiome: It fights off pathogens before our immune system even knows they are there. Microbes also create healthy fatty acids that our intestines really love from substances we can’t digest, like fiber.
But animals have an immune system that is designed to attack microbes, so how does that work? It’s a tricky balance, but early in our lives our immune system goes into learning mode. It assumes that mother’s milk contains good microbes and therefore gives them a life-long pass. When we are weaned and have an established microbiome, the immune system stiffens into a microbe killer that makes exceptions for these “old friends.”
This locks both the immune system and the microbiome into an interkingdom alliance. Between microbes killing pathogens and the immune system repelling strangers, it is very difficult to change your microbiome. Any microbe looking to make our gut their home faces a daunting gauntlet of defenses.
Changing your diet affects your microbes but mostly rearranges their ratios. That is certainly good enough to improve a dysbiotic gut, but it may not cure it. And thus, the popularity of fecal transplants, which basically replace the entire microbiome.
The Lessons of C. Diff
Fecal transplants are used to deal with a bad side-effect of antibiotics. As well as diet, antibiotics can change your microbiome, but usually not for the better. Most antibiotics are indiscriminate killers, knocking out all but the most resilient microbes.
Among those is the microbe known as C. diff . Because it can encapsulate itself into tough spores, it can survive almost any antibiotic. C. diff is deadly, killing 30,000 people a year, almost all of them from hospital-administered antibiotics.
Since these infections are caused by antibiotics, they are hard to fix with antibiotics. And thus, the first human fecal transplant was attempted in 1958—and it worked to clear the infection. It remains a powerful and singular cure for C. diff .
Getting a New Microbiome
For diseases involving the microbiome, fecal transplants hold a lot of promise. And that extends to ED as well.
Both obesity and diabetes, sometimes lumped together as “diabesity,” cause major disruptions in the microbiome. Low level inflammation caused by the dysbiosis can lead to cellular damage in the cavernosum of the penis, the structure that fills with blood to produce an erection. This, along with other symptoms of dysbiosis like depression , lowers the libido significantly.
Short of fecal transplants to replace a dysbiotic gut with a healthy gut, we have some personal control. We can ameliorate gut problems with diets high in fiber-containing veggies like beans and onions. We can lower the levels of sugar we consume that favor pathogens. We can exercise more, which has an unexpected benefit to our microbiome, and may help with ED.
This research shows one way to make a real impact on our sexual health. It can’t be much fun to do these rat studies—and rat microbes aren’t exactly the same as human microbes, so these results should be interpreted with some caution.
But still, the knowledge gained could help to make us healthier and sexier—so bring them on!
Chen, Junyi, Chenfeng Bu, Xia Li, Lei Wu, and Xingxiang He. “Therapeutic Potential of Fecal Microbiota Transplantation for Male Sexual Dysfunction: Evidence and Clinical Perspectives.” Microbiota Medicine Research n/a, no. n/a (n.d.).
Xu, Zhunan, Shangren Wang, Chunxiang Liu, et al. “The Role of Gut Microbiota in Male Erectile Dysfunction of Rats.” The World Journal of Men’s Health 43, no. 1 (2025): 213–27.
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Scott C. Anderson is a science journalist and coauthor with John Cryan and Ted Dinan of "The Psychobiotic Revolution" from National Geographic.
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This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.