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Review
. 2025 Jun 11;15(6):390.
doi: 10.3390/metabo15060390.

Gut Microbiome Dysbiosis and Its Impact on Reproductive Health: Mechanisms and Clinical Applications

Efthalia Moustakli  1   2 , Sofoklis Stavros  3 , Periklis Katopodis  1 , Anastasios Potiris  3 , Peter Drakakis  3 , Stefanos Dafopoulos  4 , Athanasios Zachariou  5 , Konstantinos Dafopoulos  6 , Konstantinos Zikopoulos  7 , Athanasios Zikopoulos  3
Affiliations
Review

Gut Microbiome Dysbiosis and Its Impact on Reproductive Health: Mechanisms and Clinical Applications

Efthalia Moustakli et al. Metabolites. .

Abstract

The human gut microbiome is integral to maintaining systemic physiological balance, with accumulating evidence emphasizing its critical role in reproductive health. This review investigates the bidirectional interactions between the gut microbiota and the female reproductive system, mediated by neuroendocrine, immune, and metabolic pathways, constituting the gut-reproductive axis. Dysbiosis, characterized by microbial imbalance, has been linked to reproductive disorders such as polycystic ovary syndrome (PCOS), endometriosis, infertility, impaired spermatogenesis, and pregnancy complications. These associations can be explained by immunological dysregulation, systemic inflammation, altered sex hormone metabolism, and hypothalamic-pituitary-gonadal (HPG) axis disturbances. This review aims to clarify the molecular and cellular mechanisms underpinning gut-reproductive interactions and to evaluate the feasibility of microbiome-targeted therapies as clinical interventions for improving reproductive outcomes.

Keywords: fertility; gut microbiota; hormone; immune system; inflammation; microbiota–gonadal axis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Illustration of factors influencing gut microbiota and their impact on female (vaginal microbiome) and male (testicular function) reproductive health. Positive influences (solid lines) like probiotics, omega-3, and healthy diet promote gut symbiosis, while negative factors (dashed lines) like obesity, stress, and medications contribute to dysbiosis. The image highlights the gut–reproductive axis and its modulation by lifestyle and metabolic conditions.
Figure 2
Figure 2
PRISMA flow diagram summarizing the literature selection process.
Figure 3
Figure 3
Factors influencing genital microbiota.
See this image and copyright information in PMC

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