Background Several observational studies have reported an association between gut microbiota and male erectile dysfunction (ED). However, it remains unclear whether there is a causal relationship between gut microbiota and male ED. Thus, we aimed to investigate the potential causal relationship between gut microbiota and male ED through Mendelian randomization (MR) analysis. Objective To assess the causal relationship between gut microbiota and male ED, we performed a two-sample MR analysis. Methods We obtained gut microbiota genome-wide association studies (GWAS) data from the MiBioGen consortium and publicly available GWAS data on male ED from the OPEN GWAS database. Subsequently, we performed a two-sample MR analysis to evaluate the causal relationship between gut microbiota and male ED. Finally, we performed sensitivity analysis, including Cochran’s Q test, MR-Egger intercept analysis, MR-PRESSO, and leave-one-out analysis, to assess the level of heterogeneity and horizontal pleiotropy in the results. Results Our MR analysis revealed a negative causal relationship between the genus Ruminococcaceae UCG013 and male ED (OR = 0.761, 95% CI 0.626–0.926), while the family Lachnospiraceae, genus Lachnospiraceae NC2004 group, genus Oscillibacter, and genus Tyzzerella3 may be associated with an increased risk of male ED, with the highest risk observed for family Lachnospiraceae (OR = 1.264, 95% CI 1.063–1.504). Furthermore, sensitivity analysis confirmed the reliability of our positive findings. Conclusion Our MR analysis revealed a causal relationship between gut microbiota and male ED. This may contribute to a better understanding of the potential applications of gut microbiota in the occurrence and treatment of male ED.
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