Science and Research

Could COVID-19 Cause Erectile Dysfunction?

December 7, 2020

Since the onset of the novel coronavirus pandemic, we've learned more and more about the immediate health effects of COVID-19. But 12 months in, we're only beginning to understand the long-term effects.

Unfortunately for guys, researchers and doctors are increasingly concerned about COVID-19 causing erectile dysfunction (ED).

In a December 2020 NBC interview, infectious disease expert Dr. Dena Grayson said, "There is some real concern here that men could have long-term issues of erectile dysfunction from this virus because we know that it causes issues in the vasculature."

She's not the first to raise the alarm on covid 19 infection and long term erectile dysfunction, and recent research suggests guys should be aware of the link between COVID and ED.

Erectile Dysfunction and COVID-19

Can the coronavirus cause erectile dysfunction?

As doctors were just beginning to get their hands around how best to treat acute COVID 19 patients in the summer of 2020, a group of scientists published some alarming findings regarding the possible long-term sexual health impacts of COVID:

"Despite being a trivial matter for patients in intensive care units (ICUs), erectile dysfunction (ED) is a likely consequence of COVID-19 for survivors, and considering the high transmissibility of the infection and the higher contagion rates among elderly men, a worrying phenomenon for a large part of affected patients."

COVID-19 may damage a host of bodily functions that impact men's erectile function, with long-lasting effects. The consequences of COVID-19 are likely to extend to sexual and reproductive health due to a variety of connections, and may prove a risk factor for ED.

Mask up guys - here's why sexual dysfunction and covid could be an issue, according to researchers.

The Startling Connection Between Testosterone, Sperm, Covid, and ED

One of the main ways that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19, enters the body is through the ACE2 pathway . That stands for angiotensin-converting enzyme 2, and it's a protein on the surface of many types of cells, including in the heart, lungs, gut, and inside the nose, to name a few. The coronavirus latches onto this enzyme to gain easy entrance to the cell, where it hijacks the cell's normal workings to start replicating itself. The infection begins.

Unfortunately for guys, this protein is also highly expressed on Leydig and Sertoli cells, both of which are in the testicles and involved in producing testosterone and sperm, respectively.


Could this same pathway allow the coronavirus to damage testicular cells and testosterone production? Indeed, an examination of testicular tissue from COVID-19 patients showed a significant reduction in Leydig cells, as well as inflammation and edema. Another report on 31 COVID-19 patients identified that some patients developed hypogonadism and that lower levels of testosterone in the body acted as predictors of poor prognosis in infected men.

What we don't know yet is whether that impact is permanent or temporary. The researchers speculate, however, that lowered testosterone levels might be one of the reasons for the large differences in mortality and hospitalization rates between men and women, and it might also explain why SARS-CoV-2 most commonly infects older men!

While the research is still forthcoming, these scientist write, "It should be acknowledged that the testis is a target for SARS-CoV-2 and the possibility for long-lasting consequences on the endocrine function exists, even for recovered patients."

How COVID-19 Damages the Heart and More

Chances are you already know ED is closely tied to vascular health. Erections, after all, occur with increased blood flow to the penis. Impair blood flow in the body, impair your ability to get an erection: diabetes, hypertension, and cardiovascular disease are all risk factors for ED.

Quality vasculature is necessary for proper erectile function, and COVID-19 is associated with vascular damage. The body's inflammatory response from COVID-19 could very easily damage the penis' fragile vascular bed, and many of the same hyper-inflammation elements associated with COVID are also associated with ED progression.

Coronavirus infection can also affect the heart and make underlying cardiovascular conditions or vascular disease worse. Increases in arrhythmias, blood clots, endothelial dysfunction, and myocarditis have been linked to coronavirus infection.

Patients with underlying conditions are considered some of the most at-risk when it comes to COVID-19. The researchers put it rather bleakly:

"While erection is-of course-a trivial matter for patients in Intensive Care Units, there is reason to suspect that impaired vascular function might persist in COVID-19 survivors and even become a public health issue in the next few months. Moreover, given that erectile function is a predictor of heart disease, investigating whether COVID-19 patients develop ED might also be a good surrogate marker of general cardiovascular function, improving patient care and quality of life."

When it comes to coronavirus and ED, there's genuine cause for concern. Moreover, men make up a disproportionate amount of SARS-CoV2 infected - 58% according to a July paper. Men also make more of those that die, as high as 75% of deaths in certain age groups.

It's Not Just About Infections, Either

A COVID infection isn't the only thing about this virus that's affecting sex lives and erectile function - it's also the unique psychosocial, mental health, and psychological implications of social distancing and long-term lockdowns.

A poll from NBC news in the spring of 2020 found that 47% of those surveyed said the coronavirus outbreak negatively affected their sex lives!

In China, at the height of the COVID-19 outbreak, sexual activity and frequency declined significantly among younger men and women .

The common assumption is that with couples stuck at home with little else to do, we face a baby boom in the next year as couples have more time to act on pent-up sexual desire... or boredom. Not so, say researchers: it turns out more partners are choosing NOT to have kids. More like a COVID baby bust...

Meanwhile, rates of treatment for erectile dysfunction has gone up , at least in the U.K.That could be due to more guys stuck at home and finally seeking the treatment they want, or it could be related to increased ED symptoms.

ED During Covid

Coronavirus? Less motivation? More motivation?

The true long term health effects of the covid 19 pandemic on erectile dysfunction rates - and the precise causes - will be made clear in the coming years, but there's reason enough to stay cautious, at the very least until a covid 19 vaccine gets used widely. Clinical trial data from some of the major vaccines in development could help too, but as this is lower down the priority list, it may be a while before we truly understand the ED-COVID connection.

No matter what, Rex MD is here to help. Get a free virtual consultation when you become a member. Pills as low as $3 each. Get started now.

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