Q&A: Can COVID-19 cause erectile dysfunction? | Expert Opinion

More than 850,000 Pennsylvanians have tested positive for COVID-19, and while the vast majority of those infected are recovering, long-term effects of the disease are still largely unknown. While pulmonary, cardiac and neurologic complications from COVID-19 are widely recognized, one of the less publicized reported repercussions of infection has been on male sexual health, specifically erectile dysfunction (ED).

More men are experiencing and seeking medical care for sexual dysfunction during the pandemic, with the greatest increase seen in younger men in their 40s and 50s.

A July study published in the Journal of Endocrinological Investigation examined the effects of COVID-19 on male sexual and reproductive health. The study identified a correlation between COVID-19 and ED, likely caused by many factors, ranging from physiological changes to changes in the way we interact with others.

One of the hallmarks of a COVID-19 infection is an exaggerated inflammatory response. The resulting storm of pro-inflammatory signals, called cytokines, causes inflammation of the lining of blood vessels. The hyperinflammatory state triggered by COVID-19 infection can cause vascular damage, ultimately disrupting blood flow — the key component of getting and maintaining an erection.

ED has long been recognized as an excellent marker for physiological well-being. Specifically, ED functions as the “canary in a coal mine” for cardiovascular disease, often predating symptomatic heart disease up to several years in advance. People with preexisting medical conditions are at higher risk for serious COVID-19 infection, but the converse is also true: COVID-19 infection can worsen preexisting medical conditions, such as heart disease and diabetes.

In addition, many of the medications used to treat common heart conditions can have a negative effect on erectile dysfunction. The decline in overall health in COVID-19 survivors and the medications used to manage this can both result in ED.

Also, mental and emotional health plays a large role in men’s sexual health. Being in the right mindset is a vital component of achieving an erection and having a satisfactory sexual experience. There is no doubt that there has been a negative mental and emotional toll from the pandemic regardless of personal COVID-19 infection. The impact of social isolation, worry for family and self during the pandemic, and economic toll from quarantine is demonstrated with increasing rates of stress, anxiety and depression. All of these feelings can be detrimental to sexual function.

With COVID-19 having such a sweeping effect on our daily lives, finding ways to improve quality of life has become more important than ever. ED is more common than most men realize — it is recognized in more than 50% of men over the age of 50 — and may be occurring at even higher rates during the pandemic.

If you are experiencing ED, you should speak to your doctor or urologist to be evaluated and discuss treatment options. And remember that one of the best ways to lower your risk of long-term complications from COVID-19 is to prevent infection in the first place by getting vaccinated when you can, observing social distancing, masking, and using good hand hygiene.

Joceline S. Fuchs is a board-certified urologist with MidLantic Urology in Abington.