Sunday, March 14, 2021

How COVID-19 may cause Erectile Dysfunction in Men?

COVID-19 is real, and COVID-19 brings versatile health related troubles for those who survived. One of the latest studies shed light on another completely undesirable consequence - COVID-19 may be associated with erectile dysfunction (ED). The research points to three factors that can lead to the potential onset of ED in men who have had the virus:

·         Vascular effects. Erectile function is a predictor of heart disease, so we know that the vascular system and reproductive system are connected. We also know that COVID-19 can cause hyperinflammation throughout the body, especially in the heart and surrounding muscles. Blood supply to the penis can become blocked or narrowed as a result of a new or worsened vascular condition caused by the virus.

·         Psychological impact. Sexual activity is closely associated with mental health. The stress, anxiety and depression caused by the virus and pandemic can be linked to sexual dysfunction and poor mood.

·         Overall health deterioration. ED is typically a symptom of an underlying problem. Men with poor health are at greater risk for developing ED and also for having a severe reaction to COVID-19. Since the virus can cause a plethora of health issues, general poor health is cause for concern both for ED and other complications.


Another cause for concern regarding the research is the potential testicular damage that can occur following an infection with COVID-19. It’s too early to tell if the damage is permanent, temporary or if it can affect fertility. Age is also an important aspect to consider, as it’s a risk factor for developing both ED and a severe case of COVID-19.

Roberto is a 39 years old engineer who is married with Anna, a beautiful 29 years old teacher. They were having a perfect life, nice working environment, excellent salary and brand new apartment to build a life together and a common passion for travelling. Roberto had a perfect erectile function in January 2020 and both of them were fully satisfied with their sexual activity.

On the 27th of February he and his wife started to have mild respiratory symptoms. After one week of antibiotic they remained symptomatic and eventually after their notification to the local General Practitioner they underwent nasopharyngeal swab which resulted positive for Sars-Cov-2. Despite the symptoms disappeared after 2 weeks the he and his wife remained positive to the swabs for 57 and 64 days respectively. Both of them were frightened and frustrated during the first month of infection and they did not attempt any sexual intercourse during that period.

During the second month of the infection, since they became completely asymptomatic, they tried to get back to their normal sexual life. Roberto immediately noted a dramatic decrease of his erectile function and surprisingly the intercourse satisfaction and orgasmic function appeared completely worsened. On the other hand, Anna’s sexual desire appeared to be nullified, despite a recent study of Yuksel et al. have demonstrated that women’ (without infection) sexual desire and frequency of sexual intercourse significantly increased during COVID-19 pandemic. They discussed about the situation and they blamed the strict quarantine measures and the stress related to the still positive nasopharyngeal swabs. After few attempts they gave up.

Three months after the infection (roughly one month after the end of the infection) they returned to their “normal” working life, however they realized something was different. Roberto realized his erectile function was not as good as before and the zest of the intimacy was changed. He is slowly recovering but according to him “pre-COVID-19 sexual pleasure is still far”. On the contrary Anna found herself completely recovered.

The story of Roberto and Anna is emblematic of the sexual discomfort that such situation may lead to. Clearly stressful lifestyle is a factor known to impact couple’s sexual relationship, even though no trials have been conducted in such circumstances. Previous studies on sexual health have been conducted during mass disasters such as earthquakes or wars, however such conditions cannot be compared to COVID-19 pandemic since there is no loss of living space and the strict quarantine is an unprecedented measure.

Erectile dysfunction is a complex physiologic and psychologic disorder. A man has to have good nerve function, hormone (testosterone) levels, adequate blood flow, and a willing mind to have normal erections. COVID-19 causes severe physiologic and psychologic stress, which leads to lower testosterone levels and increased stress hormone release.

It is already clear that for the vast majority of patients, COVID-19 manifests as a respiratory illness, which includes difficulty breathing, coughing, and shortness of breath, potentially causing difficulties to get enough oxygen into the bloodstream. And when this happens, it can be harder to get an erection as well—oxygen is required to make nitric oxide, an important molecule in the sequence of steps required to achieve an erection.

Until COVID-19 has been around long enough to study its long-term effects, experts can’t be sure which symptoms are most likely to linger—or who is most at risk for prolonged illness. But there is some hope. Testosterone levels often rebound to their normal levels once a temporary illness has passed. With hormones replaced and blood vessels intact, ED could be a short-term issue.


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