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Does COVID-19 Cause Long-Term Erectile Dysfunction?

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We will preface this by saying that scientists don’t yet know much about the long-term effects of COVID-19, so much of what we may hear and read is speculative. The impact of COVID-19 also varies greatly from person to person; some people experience few if any symptoms, while others experience severe symptoms, sometimes resulting in death.

There have been no studies directly linking COVID-19 to erectile dysfunction. However, a sturdy published in the medical journal Andrology1 found that men who have tested positive for COVID-19 are more than five times as likely to have erectile dysfunction as those who have not.

A literature search2 suggests several means by which COVID-19 could trigger ED.

Cardio-Vascular Damage

It has been established3 that the COVID-19 virus can cause long-term damage to blood vessels. Since vascular issues are a leading cause of ED, it’s reasonable to suppose that erectile dysfunction could be a long-term effect of COVID-194.

A 2021 study5 demonstrated the presence of the COVID-19 virus in the penis long after the initial infection in humans. The results suggest that widespread endothelial cell dysfunction from COVID-19 infection can contribute to ED.

Testosterone

Testicular damage6 in COVID-19 might induce a state of hypogonadism, leading to decreased levels of testosterone. Low testosterone is linked to erectile dysfunction.

Psychological Factors

COVID-19 has been linked to PTSD7 and depression, both of which psychological causes of ED.

Conclusions

Although there is not yet any direct clinical evidence, there is good reason to suggest that COVID-19 can result in long-term erectile dysfunction in some patients.


References

  1. Sansone, Andrea; Mollaioli, Daniele; Ciocca, Giacomo; Colonnello, Elena; Limoncin, Erika; Balercia, Giancarlo; Jannini, Emmanuele A. “‘Mask up to keep it up’: Preliminary evidence of the association between erectile dysfunction and COVID‐19.” Andrology. March 2021.
    <https://doi.org/10.1111/andr.13003>
  2. Sansone, A; Mollaioli, D; Ciocca, G; Limoncin, E; Colonnello, E; Vena, W; Jannini, E A. “Addressing male sexual and reproductive health in the wake of COVID-19 outbreak.” Journal of Endocrinological Investigation. Jul 2020. 13 : 1–9. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355084/>
  3. Ackermann, Maximilian; Verleden, Stijn E; Kuehnel, Mark; Haverich, Axel; Welte, Tobias; Laenger, Florian; Vanstapel, Arno; Werlein, Christopher; Stark, Helge; Tzankov, Alexandar; Li, William W; Li, Vincent W. “Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19.” The New England Journal of Medicine. Jul 2020. 383:120-128. <https://www.nejm.org/doi/full/10.1056/NEJMoa2015432>
  4. Becker, Richard C. “Anticipating the long-term cardiovascular effects of COVID-19.” Journal of Thrombosis and Thrombolys. Sep 2020. 3 : 1–13. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7467860/>
  5. Kresch, Eliyahu; Achua, Justin; Saltzman, Russell; Khodamoradi, Kajal; Arora, Himanshu; Ibrahim, Emad; Kryvenko, Oleksandr N; Almeida, Vania Wolff; Firdaus, Fakiha; Hare, Joshua M; and Ramasamy, Ranjith. “COVID-19 Endothelial Dysfunction Can Cause Erectile Dysfunction: Histopathological, Immunohistochemical, and Ultrastructural Study of the Human Penis.” World Journal of Men’s Health. May 2021; 39:e22.
    <https://doi.org/10.5534/wjmh.210055>
  6. Rastrelli, G; Di Stasi, V; Inglese, F; Beccaria, M; Garuti, M; Di Costanzo, D; et al. “Low testosterone levels predict clinical adverse outcomes in SARS-CoV-2 pneumonia patients.” Andrology. May 2020 20;10.1111/andr.12821.
    <https://pubmed.ncbi.nlm.nih.gov/32436355/>
  7. Xiao, Shuiyuan; Luo, Dan; Xiao, Yang. “Survivors of COVID-19 are at high risk of posttraumatic stress disorder.” Global Health Research and Policy. Jun 2020. 29 (2020). <https://ghrp.biomedcentral.com/articles/10.1186/s41256-020-00155-2>

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