COVID-19, erectile dysfunction

At the onset of the COVID-19 pandemic, familiar symptoms such as diarrhoea and loss of taste and smell had not yet been confirmed; now, they are hallmark signs of the illness.

Although we know much more about the novel coronavirus now than we did months ago, doctors are still discovering new side effects of the infection, including hair loss and lingering fatigue.

The latest discovery? Research points to a surprising link between COVID-19 and erectile dysfunction (ED), that is the inability to obtain and/or maintain an erection for satisfactory sexual function.

A review of research published earlier this year was the first to note a correlation between survivors of COVID-19 and ED, plus evidence of other sexual and reproductive issues in recovered men, both short and long-term.

The virus causes your body to have a very strong immune response which can impact the cardiovascular system, circulation and the heart.

Any major stressor can disrupt your normal hormone function which can, in turn, “completely obliterate the libido”, says Prof. Amin Herati, Director of Male Infertility and Men’s Health at the Brady Urological Institute and Assistant Professor of Urology at the Johns Hopkins University.

Since COVID-19 infiltrates so many different parts of the body, from the skin to the brain, experts say it is no surprise that ED could be a lingering effect, even post-recovery.

Erectile dysfunction has multiple origins

The causes of ED vary widely. Psychologically, there must be arousal; physiologically, the brain and body need to release the proper compounds to initiate an erection; and physically, the penis must be able to become erect.

A lot of things can go wrong along the way. And when COVID-19 starts to replicate in the body, the resulting illness can mess with every piece of this system, from blood vessels to testosterone levels, resulting in ED.

Any major illness that affects the body can cause ED, but COVID-19 has this strong systemic, inflammatory response that really drives the hormones down.

When hormone levels drop, men will notice reduced spontaneous nocturnal and morning erections.

That loss of desire for intercourse and also the diminished spontaneous erection are things that some men have noticed with COVID-19.

What are the long-term effects of COVID-19?

COVID-19 attacks blood vessels, and symptoms caused by this complication of the virus have been well documented over the past few months. Blood clots in the lung, for example, can cause intense breathing issues, while clots closer to the skin’s surface can cause “COVID-19 toes”.

If blood flow is weakened or blocked by COVID-19, ED could be one of the ways that underlying issue presents itself—after all, a healthy erection requires healthy blood flow.

And in a more general sense, weaker overall health caused or aggravated by the virus could also play a role. Men with poor health are at greater risk of developing ED and also for having a severe reaction to COVID-19.

For instance, ED could point to underlying issues with the heart or circulation, especially when combined with COVID-19. If you are barely getting enough blood to other parts of your body because of clotting or a weakened heart, achieving an erection will be difficult.

Impact on mental health Beyond the physical effects, the mental toll of recovering from the virus might play a role in suppressing libido.

There is a very strong association with ED and the psychological effects from COVID-19. We have to be aware of that.

For certain people, recovery is not so simple.

So-called long-haulers or people who have technically recovered from COVID-19 but still experience long-term symptoms or side effects could be particularly at risk of ED caused by psychological distress. Depression, anxiety and fatigue can all destroy the sex drive, leading to reproductive issues.

ED induced by COVID-19 could be a short or long-term issue.

Until COVID-19 has been around long enough to study its long-term effects, experts can not 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. “To my knowledge, there is no data that says that COVID-19 affects the structures of the penis,” Dr. Herati says. With hormones replaced and blood vessels intact, ED could be a short-term issue.

Still, there is no guarantee. I can give you a solid ‘I don’t know’. We don’t know how long these effects will last prospectively, but we have seen them last for three months, six months or even longer.

Like with neurological and cardiovascular symptoms, there simply is not enough research yet to determine how long patients can expect ED to last after COVID-19.

Absolutely get the COVID-19 vaccine

Whether or not COVID-19 directly causes ED, the two conditions are at least correlated other adverse effects such as permanent lung damage, chronic fatigue and even death, however, are confirmed side effects of the illness.)

But it is crucial to note that there is no evidence that the COVID-19 vaccine causes ED. Its side effects are akin to those of the annual flu shots, which is also encouraged by medical experts.

Avoiding ED could be reason enough to seek out the vaccine. This is why men should go get vaccinated. It is worth it.

If you suspect you have ED, talk to your doctor

COVID-19 is a serious illness, and your first step should be addressing serious symptoms and side effects such as shortness of breath or heart problem.

Compared to these complications, ED should hit the bottom of the priority list. (Keep in mind that when you are sick, you might not be in the right mental state to maintain an erection, either.)

But if you have recovered and you are still experiencing ED, it is a good idea to chat with your doctor. They will be able to connect you with a urologist who can help determine the cause of your ED and offer potential solutions.

• The writer is a pharmacognist, Chief Medical Officer and CEO of the Medi Moses Group of Companies