How Your Microbiome Shapes Your Sex Drive

For some, sex drive can turn on and off as abruptly as a light switch. You might be in the mood for intimacy one minute and the next, you wish your partner wouldn’t even look in your direction. What gives?

Well, sexual arousal is complicated, and a handful of factors can affect your desire level on a given day—even ones as unexpected as your gut microbiome. 

The microbial composition of your gut is connected to the hormones that influence physical pleasure during sexual intimacy, as well as the neurotransmitters that make you feel revved up about your partner.

Here’s what the gut-estrogen connection means for your sex drive—and how to use it to your advantage in the bedroom.

If you have ovaries, estrogen is a hormone that supports your metabolism, sleep, energy levels, and libido in a big way.

NOTE: Those with penises have estrogen circulating through their bodies too—though in concentrations that are up to 40 times lower.⁷ For the remainder of this article, we’re going to be focusing on estrogen in those with ovaries.

Integrative gynecologist Tara Scott, M.D. explains that estrogen exists in the following three forms: 

• Estradiol: The main form of estrogen during reproductive years in people with ovaries, estradiol is produced by dedicated cells in the ovaries (called granulosa cells) and acts as a growth hormone for the vaginal lining, cervical glands, endometrium, and other reproductive organs. It also helps maintain an ideal environment for oocytes (essentially immature egg cells) in the ovary and supports pregnancy.⁸
• Estrone: Estrone is primarily produced by your adrenal glands and fatty tissue.
• Estriol: Estriol is mostly created during pregnancy.⁹ 

Regardless of where they’re produced, estrogens travel throughout the body via the bloodstream, either on their own or attached to proteins. Then, they’re processed in the liver, where they’re transformed into an inactive form of estrogen that can be removed from the body (scientifically speaking, they’re “conjugated”). Conjugated estrogens move into the gut to be expelled through urine or poop.¹⁰ 

But not all estrogen is pushed out of the body right from the get-go. This is where the estrobolome—a collection of bacteria in the gut microbiome that regulates estrogen metabolism—comes in. 

These bacteria produce enzymes (e.g., β-glucuronidase) that can reactivate (specifically, “deconjugate”) inactive forms of estrogen so that they’re able to be reabsorbed into the bloodstream. In doing so, they influence how much estrogen is circulating throughout the body.¹⁰ 

This process can have profound impacts on your health, potentially influencing and risk of estrogen-related health concerns such as breast cancer, poor bone density, and cardiovascular disease.^10,11,12

Estrogen supports many of the physiological and psychological changes needed for comfortable, pleasurable sex. Here are a few ways the hormone helps set the mood:

• It maintains the elasticity of the vagina: Estrogen affects the thickness and stretchiness of the vagina, says Dr. Scott. The vagina has “wrinkles” or ridges known as rugae, which give it the ability to expand. When estrogen levels are low, the vaginal wall becomes thin and dry and rugae can be diminished, she explains. This can lead to pain and discomfort during intimacy.¹³

• It enhances vaginal lubrication: Estrogen promotes the production of vaginal mucus and moisture—essential forms of natural lubrication during sexual activity.¹² 

• It influences the psychological component of desire: Estrogen also acts on the hypothalamus and limbic system, influencing the areas of the brain responsible for mood, emotion, and libido.^14,15 Plus, the hormone helps regulate levels of dopamine and serotonin—neurotransmitters that play a role in sexual motivation and pleasure.¹⁶
• It relates to other sex hormones: Estrogen levels are connected to other hormones that affect reproductive health and sexual desire, including testosterone and progesterone.^17,18 For individuals who ovulate, testosterone generally peaks in the middle of the cycle, during ovulation, says Dr. Scott, and may increase desire.¹⁹ Progesterone, on the other hand, peaks during the luteal phase (after ovulation) and may curb libido.^18,20

Having the proper amount of estrogen in your body is key to arousal and sexual satisfaction—and more isn’t necessarily better. “It’s kind of like Goldilocks—too little is not good, and too much is not good,” says Dr. Scott. “It’s just the right amount, and everybody’s set point isn’t the same.”

Estrogen’s ups and downs through life

You’ll see estrogen production rise during puberty and pregnancy (the latter of which helps to support fetal development and prep the body for childbirth) and fluctuate during the menstrual cycle (peaking just before ovulation and dropping after)^.21,22,23,24 Then, it plummets (by 100- to 1000-fold!) in the postpartum period, says Dr. Scott.²⁵ 

During perimenopause (the transitional period into menopause), your estrogen levels go on a rollercoaster ride—they can be high, low, or jump between the two extremes with no clear pattern, says Dr. Scott. When menopause officially hits, the ovaries no longer produce significant amounts of estrogen. This is one reason why vaginal dryness and low sex drive are more common during menopause.²⁶ (If you’re dealing with this, we have some tips that might help.)

Let’s dig deeper into how the gut microbiome plays a role in influencing sex drive and keeping estrogen levels in that “Goldilocks zone”:

• It can reactivate conjugated estrogens

As mentioned earlier, many times, estrogen is “inactivated” by the liver to be excreted when you go to the bathroom. But thanks to the estrobolome in your gut, some estrogens are reactivated and recirculated in the body. The level of circulating estrogen in your body directly impacts your libido. 

• It helps regulate feel-good neurotransmitters.

Having a resilient, diverse gut microbiome may support the neurotransmitters that shape pleasurable sexual experiences.

Many of your gut microbes can either produce or modulate the metabolism of dopamine, serotonin, and noradrenaline—neurotransmitters that are heavily involved in regulating sexual desire and arousal.^27,28 In fact, upward of 90% of serotonin is produced in the gut, so when the gut microbiome is impacted, your levels of the mood-boosting neurotransmitter might be too.²⁹ Serotonin levels that are too high have been shown to reduce libido and may be a cause of sexual dysfunction in people with hypoactive sexual desire disorder (HSSD), research suggests.³⁰

Certain gut bacteria, such as Lactobacillus reuteri, can also upregulate oxytocin.³¹ Also known as the “love hormone,” oxytocin is involved in feelings of happiness and attachment and is released during sexual activity.³² 

• It can influence your mood via the gut-brain axis.

The microbiome is closely linked to stress, anxiety, and depression via the gut-brain axis.³³ Mental health plays a huge role in sexual desire (just think about how difficult it is to get in the mood when you’re stressed), so an imbalanced microbiome may indirectly affect sexual health and satisfaction.³⁴

• Specific gut microbes may actually help turn you on.

For one 2021 study, 24 women who struggled with HSSD had their gut microbiomes analyzed and compared to controls without HSSD. Researchers found that the participants with HSSD tended to have less bacteria in the family Ruminococcaceae and more bacteria in the genus Bifidobacterium and Lactobacillus in their guts. This led them to hypothesize that the more Bifidobacterium and Lactobacillus in one’s gut, the lower their libido.³⁵

In separate research, elevated levels of Bifidobacterium and Lactobacillus were associated with reduced levels of anger, aggressive thoughts, and self-reported feelings of sadness.^36,37 

It’s interesting to consider how these emotions can be a precursor to sex in some (though certainly not all) cases. Think about it: When you’re experiencing intense emotions, even if they’re not necessarily happy, they can snowball into sexual desire and arousal. (Exhibit A: breakup sex.) If you’re not experiencing those more intense feelings of sadness or anger, that so-called “excitation transfer” doesn’t occur, researchers theorize.³⁸ 

Pulling it all together:

While more research still needs to be done on the microbiome-sex connection, there does seem to be a link between gut function and libido. Everyone’s libido is different and if you’re happy with yours, there’s no need to “improve” it to meet made-up societal standards. However, if you do feel the desire to feel more aroused and/or sexually satisfied, tending to your gut microbes may help. Get started by including a variety of plant-based fibers and fermented foods into your diet, sticking with a regular sleep routine to support your gut’s circadian clock, and considering if taking a science-backed probiotic is right for you. 

Beyond tending to your gut health, there are a few other ways to maintain balanced estrogen levels during reproductive years. 

Some of these include the basic health habits you hear about a bunch: Keep up with physical activity, eat a nutrient-rich diet, reduce alcohol consumption, and keep chronic stress to a minimum as much as possible.^39,40,41 

Your body composition also influences your production of estrogen, particularly estrone (which, reminder, is produced by fat tissue). Individuals with higher body fat may have higher estrogen levels.⁴² Oral contraceptives also suppress the production of natural estrogen and decrease free testosterone, which may reduce libido, says Dr. Scott.^43,44

Finally, your environment can impact your sex hormones too. Chemicals such as bisphenol A (BPA), phthalates, and certain pesticides can mimic or interfere with estrogen activity in the body, potentially binding to estrogen receptors and disrupting the hormone’s natural production and metabolism.^45,46,47 This is another reason to keep your plastic use to a minimum when you can (particularly in food packaging and storage) and prioritize a plant-rich, minimally processed diet. 

Sometimes, hormonal health falls out of our control: Health conditions like polycystic ovary syndrome and thyroid dysfunction can both cause estrogen imbalances.^48,49 

Summary:

Your estrogen levels are constantly in flux—but exercising, managing stress, and eating a whole-food, nutrient-rich diet can help keep them at a healthy baseline. Still, Dr. Scott stresses that hormones like estrogen are just one lever impacting sexual desire and comfort. Your physical, mental, and emotional health, your history of sexual experiences and trauma, and your personal “baseline” libido can all influence your sex drive in a non-linear way, she says.

Your gut bacteria play a role in regulating estrogen levels, ultimately influencing the physiological and mental processes that make sex satisfying for all parties. But your hormones are just one piece of the puzzle: The composition of your gut microbiome and its ability to influence mood can also play a role in turning you on or off. Research on the gut microbiome and libido is still evolving, so send this to your partner(s) and continue to watch this space together. 

For more insights on how your microbiota might help set the mood, read up on the mind-boggling world of the vaginal microbiome.

Written by Megan Falk: Experienced health and wellness journalist and editor. Megan is a graduate of Syracuse University’s S.I. Newhouse School of Public Communications, where she earned a bachelor’s degree in Magazine Journalism and a minor in Food Studies. She’s also a certified personal trainer through the American Council on Exercise.
Reviewed by Jennie O’Grady: Senior SciComms Specialist at Seed Health

1. Schober, J. M., & Pfaff, D. (2007). The neurophysiology of sexual arousal. Best Practice & Research. Clinical Endocrinology & Metabolism, 21(3), 445–461. https://doi.org/10.1016/j.beem.2007.04.006
2. Delgado, B. J., & Lopez-Ojeda, W. (2023, June 26). Estrogen. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK538260/
3. Jiang, I., Yong, P. J., Allaire, C., & Bedaiwy, M. A. (2021). Intricate connections between the microbiota and endometriosis. International Journal of Molecular Sciences, 22(11), 5644. https://doi.org/10.3390/ijms22115644
4. Pesantez, G. S. P., & Clayton, A. H. (2021). Treatment of hypoactive sexual desire disorder among women: General considerations and pharmacological options. FOCUS The Journal of Lifelong Learning in Psychiatry, 19(1), 39–45. https://doi.org/10.1176/appi.focus.20200039
5. Kolatorova, L., Vitku, J., Suchopar, J., Hill, M., & Parizek, A. (2022). Progesterone: A steroid with wide range of effects in physiology as well as human medicine. International Journal of Molecular Sciences, 23(14), 7989. https://doi.org/10.3390/ijms23147989
6. Nassar, G. N., & Leslie, S. W. (2023, January 2). Physiology, testosterone. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK526128/
7. Faac, A. G. S. P. N. (n.d.). Medscape Registration. https://emedicine.medscape.com/article/2089003-overview?form=fpf
8. An introduction to biological membranes. (n.d.). ScienceDirect. https://www.sciencedirect.com/book/9780444637727/an-introduction-to-biological-membranes
9. Ali, E. S., Mangold, C., & Peiris, A. N. (2017). Estriol: Emerging clinical benefits. Menopause the Journal of the North American Menopause Society, 24(9), 1081–1085. https://doi.org/10.1097/gme.0000000000000855
10. Kwa, M., Plottel, C. S., Blaser, M. J., & Adams, S. (2016). The intestinal Microbiome and estrogen receptor–positive female breast cancer. JNCI Journal of the National Cancer Institute. https://doi.org/10.1093/jnci/djw029
11. Khosla, S., Oursler, M. J., & Monroe, D. G. (2012). Estrogen and the skeleton. Trends in Endocrinology and Metabolism, 23(11), 576–581. https://doi.org/10.1016/j.tem.2012.03.008
12. Peters, B., Santoro, N., Kaplan, R., & Qi, Q. (2022). Spotlight on the gut microbiome in menopause: Current insights. International Journal of Women’s Health, Volume 14, 1059–1072. https://doi.org/10.2147/ijwh.s340491
13. Whiteside, J., Barber, M., Paraiso, M., & Walters, M. (2005). Vaginal rugae: Measurement and significance. Climacteric, 8(1), 71–75. https://doi.org/10.1080/13697130500042490
14. McEwen, B. S., Akama, K. T., Spencer-Segal, J. L., Milner, T. A., & Waters, E. M. (2012). Estrogen effects on the brain: Actions beyond the hypothalamus via novel mechanisms. Behavioral Neuroscience, 126(1), 4–16. https://doi.org/10.1037/a0026708
15. Baird, A. D., Wilson, S. J., Bladin, P. F., Saling, M. M., & Reutens, D. C. (2006). Neurological control of human sexual behaviour: Insights from lesion studies. Journal of Neurology Neurosurgery & Psychiatry, 78(10), 1042–1049. https://doi.org/10.1136/jnnp.2006.107193
16. Bendis, P. C., Zimmerman, S., Onisiforou, A., Zanos, P., & Georgiou, P. (2024). The impact of estradiol on serotonin, glutamate, and dopamine systems. Frontiers in Neuroscience, 18. https://doi.org/10.3389/fnins.2024.1348551
17. Uloko, M., Rahman, F., Puri, L. I., & Rubin, R. S. (2022). The clinical management of testosterone replacement therapy in postmenopausal women with hypoactive sexual desire disorder: A review. International Journal of Impotence Research, 34(7), 635–641. https://doi.org/10.1038/s41443-022-00613-0
18. Cappelletti, M., & Wallen, K. (2015). Increasing women’s sexual desire: The comparative effectiveness of estrogens and androgens. Hormones and Behavior, 78, 178–193. https://doi.org/10.1016/j.yhbeh.2015.11.003
19. Stern, J., & Casto, K. (2024). Salivary testosterone across the menstrual cycle. Hormones and Behavior, 164, 105608. https://doi.org/10.1016/j.yhbeh.2024.105608
20. Reed, B. G., & Carr, B. R. (2018, August 5). The normal menstrual cycle and the control of ovulation. Endotext – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK279054/
21. Breehl, L., & Caban, O. (2023, March 27). Physiology, puberty. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK534827/
22. Pascual, Z. N., & Langaker, M. D. (2023, May 16). Physiology, pregnancy. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK559304/
23. Tal, R., & Taylor, H. S. (2021, March 18). Endocrinology of pregnancy. Endotext – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK278962/
24. Buckley, S. J. (2015). Executive summary of hormonal physiology of childbearing: Evidence and implications for women, babies, and maternity care. The Journal of Perinatal Education, 24(3), 145–153. https://doi.org/10.1891/1058-1243.24.3.145
25. MacIntyre, D. A., Chandiramani, M., Lee, Y. S., Kindinger, L., Smith, A., Angelopoulos, N., Lehne, B., Arulkumaran, S., Brown, R., Teoh, T. G., Holmes, E., Nicoholson, J. K., Marchesi, J. R., & Bennett, P. R. (2015). The vaginal microbiome during pregnancy and the postpartum period in a European population. Scientific Reports, 5(1). https://doi.org/10.1038/srep08988
26. Santoro, N., Epperson, C. N., & Mathews, S. B. (2015). Menopausal symptoms and their management. Endocrinology and Metabolism Clinics of North America, 44(3), 497–515. https://doi.org/10.1016/j.ecl.2015.05.001
27. Chen, Y., Xu, J., & Chen, Y. (2021). Regulation of neurotransmitters by the gut microbiota and effects on cognition in neurological disorders. Nutrients, 13(6), 2099. https://doi.org/10.3390/nu13062099
28. Strandwitz, P. (2018). Neurotransmitter modulation by the gut microbiota. Brain Research, 1693, 128–133. https://doi.org/10.1016/j.brainres.2018.03.015
29. Martin, C. R., Osadchiy, V., Kalani, A., & Mayer, E. A. (2018). The brain-gut-microbiome axis. Cellular and Molecular Gastroenterology and Hepatology, 6(2), 133–148. https://doi.org/10.1016/j.jcmgh.2018.04.003
30. Croft, H. A. (2017). Understanding the role of serotonin in female hypoactive sexual desire disorder and treatment options. The Journal of Sexual Medicine, 14(12), 1575–1584. https://doi.org/10.1016/j.jsxm.2017.10.068
31. Varian, B. J., Weber, K. T., & Erdman, S. E. (2023). Oxytocin and the microbiome. Comprehensive Psychoneuroendocrinology, 16, 100205. https://doi.org/10.1016/j.cpnec.2023.100205
32. Lee, H., Macbeth, A. H., Pagani, J. H., & Young, W. S. (2009). Oxytocin: The great facilitator of life. Progress in Neurobiology. https://doi.org/10.1016/j.pneurobio.2009.04.001
33. Simpson, C. A., Diaz-Arteche, C., Eliby, D., Schwartz, O. S., Simmons, J. G., & Cowan, C. S. (2020). The gut microbiota in anxiety and depression – A systematic review. Clinical Psychology Review, 83, 101943. https://doi.org/10.1016/j.cpr.2020.101943
34. Atlantis, E., & Sullivan, T. (2012). Bidirectional association between depression and sexual dysfunction: A systematic review and meta-analysis. The Journal of Sexual Medicine, 9(6), 1497–1507. https://doi.org/10.1111/j.1743-6109.2012.02709.x
35. Li, G., Li, W., Song, B., Wang, C., Shen, Q., Li, B., Tang, D., Xu, C., Geng, H., Gao, Y., Wang, G., Wu, H., Zhang, Z., Xu, X., Zhou, P., Wei, Z., He, X., & Cao, Y. (2021). Differences in the gut microbiome of women with and without hypoactive sexual desire disorder: Case control study. Journal of Medical Internet Research, 23(2), e25342. https://doi.org/10.2196/25342
36. Messaoudi, M., Lalonde, R., Violle, N., Javelot, H., Desor, D., Nejdi, A., Bisson, J., Rougeot, C., Pichelin, M., Cazaubiel, M., & Cazaubiel, J. (2010). Assessment of psychotropic-like properties of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in rats and human subjects. British Journal of Nutrition, 105(5), 755–764. https://doi.org/10.1017/s0007114510004319
37. Steenbergen, L., Sellaro, R., Van Hemert, S., Bosch, J. A., & Colzato, L. S. (2015). A randomized controlled trial to test the effect of multispecies probiotics on cognitive reactivity to sad mood. Brain Behavior and Immunity, 48, 258–264. https://doi.org/10.1016/j.bbi.2015.04.003
38. APA Dictionary of Psychology. (n.d.). https://dictionary.apa.org/excitation-transfer-theory
39. Ennour-Idrissi, K., Maunsell, E., & Diorio, C. (2015). Effect of physical activity on sex hormones in women: A systematic review and meta-analysis of randomized controlled trials. Breast Cancer Research, 17(1). https://doi.org/10.1186/s13058-015-0647-3
40. Wiggs, A. G., Chandler, J. K., Aktas, A., Sumner, S. J., & Stewart, D. A. (2021). The effects of diet and exercise on endogenous estrogens and subsequent breast cancer risk in postmenopausal women. Frontiers in Endocrinology, 12. https://doi.org/10.3389/fendo.2021.732255
41. Albert, K. M., & Newhouse, P. A. (2019). Estrogen, stress, and depression: Cognitive and biological interactions. Annual Review of Clinical Psychology, 15(1), 399–423. https://doi.org/10.1146/annurev-clinpsy-050718-095557
42. Mair, K. M., Gaw, R., & MacLean, M. R. (2020). Obesity, estrogens and adipose tissue dysfunction – Implications for pulmonary arterial hypertension. Pulmonary Circulation, 10(3), 1–21. https://doi.org/10.1177/2045894020952023
43. Fleischman, D. S., Navarrete, C. D., & Fessler, D. M. (2010). Oral contraceptives suppress ovarian hormone production. Psychological Science, 21(5), 750–752. https://doi.org/10.1177/0956797610368062
44. Bennink, H. J. C., Zimmerman, Y., Laan, E., Termeer, H. M., Appels, N., Albert, A., Fauser, B. C., Thijssen, J. H., & Van Lunsen, R. H. (2016). Maintaining physiological testosterone levels by adding dehydroepiandrosterone to combined oral contraceptives: I. Endocrine effects. Contraception, 96(5), 322–329. https://doi.org/10.1016/j.contraception.2016.06.022
45. Cimmino, I., Fiory, F., Perruolo, G., Miele, C., Beguinot, F., Formisano, P., & Oriente, F. (2020). Potential mechanisms of bisphenol A (BPA) contributing to human disease. International Journal of Molecular Sciences, 21(16), 5761. https://doi.org/10.3390/ijms21165761
46. Hlisníková, H., Petrovičová, I., Kolena, B., Šidlovská, M., & Sirotkin, A. (2020). Effects and mechanisms of phthalates’ action on reproductive processes and reproductive health: A literature review. International Journal of Environmental Research and Public Health, 17(18), 6811. https://doi.org/10.3390/ijerph17186811
47. Gea, M., Zhang, C., Tota, R., Gilardi, G., Di Nardo, G., & Schilirò, T. (2022). Assessment of five pesticides as endocrine-disrupting chemicals: Effects on estrogen receptors and aromatase. International Journal of Environmental Research and Public Health, 19(4), 1959. https://doi.org/10.3390/ijerph19041959
48. Yang, J., & Chen, C. (2024). Hormonal changes in PCOS. Journal of Endocrinology, 261(1). https://doi.org/10.1530/joe-23-0342
49. Saran, S., Gupta, B. S., Philip, R., Singh, K. S., Bende, S. A., Agroiya, P., & Agrawal, P. (2015). Effect of hypothyroidism on female reproductive hormones. Indian Journal of Endocrinology and Metabolism, 20(1), 108. https://doi.org/10.4103/2230-8210.172245