Microecological modulators—new perspectives for treating sex hormone disorders

Sex hormone related disorders, characterized by complex etiology and long-term health risks, pose a significant challenge to global health. Hormone-based therapies are often accompanied by adverse effects and fail to address the underlying pathophysiological mechanisms. The “gut microbiota-sex hormone axis” maintains endocrine homeostasis through diverse pathways, including enzymatic reactions, immune modulation, metabolic regulation, and the microbiome-gut-brain axis. Dysregulation of this axis has been identified as a critical factor in the pathogenesis of sex hormone-related disorders. Probiotics have emerged as a promising adjunctive therapeutic strategy by targeting this axis. Preclinical and clinical studies have demonstrated that specific probiotic strains ameliorate hormonal imbalances, attenuate inflammation, and optimize metabolic parameters, showing positive efficacy in sex hormone-related disorders. This review systematically elaborates the regulatory mechanisms of this bidirectional axis and highlights the application of probiotics and its regulatory roles as targeted interventions in related disorders.