Gut microbiota composition and metabolic characteristics in patients with premature ejaculation

Premature ejaculation (PE) is a prevalent male sexual disorder with an incompletely understood pathogenesis and limited effective therapeutic strategies. Intestinal microbiota dysbiosis may contribute to PE pathogenesis and progression by affecting intestinal barrier integrity, autonomic nervous system activity, immune regulation, metabolic processes, and neuroendocrine signaling pathways. Metabolomic analyses and metagenomic sequencing were performed to compare the intestinal microbiota profiles between patients with PE and healthy controls, investigate the association between PE and gut microbiota, and identify potential therapeutic targets. Comprehensive analysis revealed distinct microbial signatures between PE and control groups. The PE group exhibited significantly reduced relative abundances of Bifidobacteriaceae bacterium, Blautia, Coprobacillus, Ruminococcus sp. ctHOG1, Siphoviridae , and Alistipes . Metabolomic profiling identified 150 upregulated and 73 downregulated metabolites between the two groups. Kyoto encyclopedia of genes and genomes pathway enrichment analysis indicated significant enrichment of the peroxisome proliferator-activated receptor and the transient receptor potential signaling pathways in the PE group. These results provide novel insights into the pathophysiological mechanism of PE. This study characterized distinct gut microbiota features in patients with PE compared with healthy controls and investigated microbiota-associated pathways contributing to PE through integrated metabolomics analysis. The findings advance our understanding of PE pathogenesis and identify potential therapeutic targets.