{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:40:59Z","timestamp":1789432859118,"version":"build-2803163510"},"reference-count":102,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>This review provides a comprehensive synthesis of the link between inflammatory bowel disease (IBD) and male erectile dysfunction (ED), with a distinct emphasis on underlying mechanisms and novel perspectives. We critically evaluate the evidence and then systematically elucidate the \u201cgut-penis axis\u201d detailing how gut-derived signals orchestrate a systemic inflammatory response that culminates in penile vascular dysfunction. A novel aspect of our work is the integration of psychological factors into a cohesive psychoneuroimmunological framework, linking stress, the cholinergic anti-inflammatory pathway, and direct pro-inflammatory neural circuits to ED pathogenesis. Beyond mechanistic insight, we examine the clinical implications of this connection, discussing the potential of anti-inflammatory therapies and the necessity of integrated management strategies that address both intestinal and sexual health. 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