Can Covid Cause Erectile Dysfunction?

Even though the COVID-19 crisis brought on by SARS-CoV-2 has ostensibly reduced, it has left behind lingering effects, especially in the people who contracted the virus.

Cases of erectile dysfunction are surfacing more frequently in male Covid and Post-Covid patients. While there is not much on the subject yet, initial research points to covid erectile dysfunction [1].

In the United States alone, 1 out of every 13 persons who contracted the virus experience long covid or post-COVID symptoms that linger for over four weeks and sometimes months following infection.

COVID-19 & the Male Reproductive System: What Do We Know About It?

Research showed that patients in the early stages of a COVID-19 infection exhibited normal or decreased white blood cell counts; some had elevated C-reactive protein levels, and others lower lymphocyte counts [2, 3]. However, more research must be done concerning COVID-19 and its influence on reproductive health.

Covid & the Testes

Some research shows the virus stays in the testes, raising concerns about the possible repercussions of COVID-19 on men’s sexual and reproductive health [4].

In 2021, researchers found that COVID-19 can invade testis tissue in men infected with the virus [5].  According to Ranjith Ramasamy, M.D., one of the researchers, the virus was also found in a patient who underwent a testis biopsy for infertility and had a history of COVID-19.

Even though the patient tested negative and showed no symptoms after contracting COVID-19, the virus was still present in the testes. This first published study revealed the existence of COVID-19 in a recovered patient’s testis tissue, confirming that the virus can remain there long after the initial infection.

Covid & Sperm Count

Research also shows that the COVID-19 virus can decrease men’s sperm count [6]. It also showed that while there were problems with spermatogenesis, the patients could still recover and produce sperm again. However, the sperm showed significant oxidative DNA damage during the recovery phase of spermatogenesis. Researchers concluded conceiving after a COVID-19 infection can be risky for the unborn child.

Another question was whether the virus could be transmitted through sperm. Dr. Jim Hotaling, M.D., M.S., FECSM, demonstrated in his work that the COVID-19 virus does not end up in the sperm [7]. He also stated that while other studies are being conducted around the country, the results have been consistent thus far.

It should be noted, however, that many illnesses can have a short-term effect on sperm count and that any virus that induces a fever could decrease sperm count temporarily [8].

Covid & Erectile Dysfunction

The virus is also suspected of damaging the blood arteries that supply the penis, resulting in erectile dysfunction owing to a lack of blood flow [9]. Dr. Ramasamy saw parallels between this and the organ damage observed in COVID-19 patients, specifically in the lungs, kidneys, and brain. He argues the penis might be similarly damaged and hypothesizes that this could be irreversible.

Covid & Testosterone Levels

Research also shows that patients with COVID-19 had lower levels of testosterone overall. According to one study, active COVID-19 patients had decreased testosterone levels, and the SARS-CoV-2 infection increased the likelihood of hypogonadism [10]. Low sex drive or libido is a symptom of hypogonadism, a medical disorder characterized by inadequate or absent production of sex hormones by the gonads.

A 7-month cohort study this year found that while some recovered patients saw a rise in testosterone levels, it was not the case for half of the study’s participants. In fact, 10% of these individuals had even lower testosterone levels after COVID-19 treatment. The researchers also concluded that the more medical disorders a patient has, the less probable they will regain their testosterone levels.

The Link Between Covid & Erectile Dysfunction

There are many theories surrounding coronavirus and its effects on the male reproductive system. Some claim the difficulty in getting and maintaining an erection may be due to psychological factors brought on by other COVID-19 symptoms, such as feeling exhausted, depressed, and low energy.

The previously stated studies also found reduced testosterone levels in certain COVID-19 patients, which could contribute to erectile dysfunction. While low testosterone levels may not directly cause erectile dysfunction, they are connected to several chronic illnesses that do, including diabetes, obesity, and heart disease.

According to Dr. Ramasamy and his team’s research, endothelial dysfunction brought on by the coronavirus may be a factor in post covid erectile dysfunction. Electron microscopy has revealed the presence of COVID-19 viral components in endothelial cells of damaged organs such as the lung, heart, and kidney. The rich endothelial-lined blood arteries that make up the erectile tissue of the penis also make it susceptible.

These findings are noteworthy, but further research with larger sample sizes and longer durations will help validate them.

Other Causes of Erectile Dysfunction

Men, both young and old, can develop erectile dysfunction after contracting COVID-19. But older men, especially those with underlying medical problems, are at an increased risk of ED.

The following medical conditions can interfere with one’s ability to get an erection [11, 12] :

  • Diabetes
  • Enlarged prostate
  • Heart disease
  • High cholesterol
  • Hypertension (high blood pressure)
  • Low testosterone
  • Multiple sclerosis
  • Obesity
  • Parkinson’s disease
  • Sleep disorders, such as sleep apnea

Age also plays a big role. Men’s testosterone levels naturally decline with age, and a hormone deficiency could cause erectile dysfunction. Older men, in particular, are frequently afflicted by various medical conditions that may impair sexual function.

Furthermore, those with diabetes and high blood pressure risk developing more severe COVID-19 symptoms that could cause low energy, low libido, and poor sexual performance.

What to Do if You Develop Erectile Dysfunction After COVID-19?

If you experience covid erectile dysfunction, including symptoms following an attack of COVID-19, see your doctor or urologist. There are several established therapies for ED, including medications and surgery, that you might want to consider.

There are many ways you can help treat the problem, including eating healthy, working out, reducing stress, and trying natural alternatives for treating ED.

If you want to try natural treatments, check out the following:

  • Horny Goat Weed: An herb used in Chinese medicine that contains icariin, a compound that acts as a PDE5 inhibitor
  • L-Arginine: This substance can increase cGMP and help produce erections
  • Catuaba: This herb can help improve libido and sexual performance
  • Korean Red Ginseng: This can increase artery dilation in the penis and encourage an erection

Can COVID-19 Vaccinations Prevent These Reproductive Problems?

As of yet, there are no definitive studies on the effects of vaccination and erectile dysfunction or other reproductive issues. Nonetheless, these vaccines appear to be effective in protecting patients from coronavirus. While it is still possible to catch Covid, the vaccination can lessen the severity of symptoms, including ED.

Conclusion: Covid Can Impact Men’s Reproductive Health

It’s possible that contracting the COVID-19 virus could lead to erectile dysfunction, low sperm count, and low testosterone levels. More extensive studies, however, are necessary to validate the existing findings, which are limited by small sample sizes and short periods.

References Used

  1. Sansone, A., Mollaioli, D., Limoncin, E., Ciocca, G., Bắc, N. H., Cao, T. N., … & Jannini, E. A. (2022). The sexual long COVID (SLC): erectile dysfunction as a biomarker of systemic complications for COVID-19 long haulers. Sexual medicine reviews, 10(2), 271-285.
  2. Palladino, M. (2021). Complete blood count alterations in COVID-19 patients: A narrative review. Biochemia medica, 31(3), 0-0.
  3. Huang, I., & Pranata, R. (2020). Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis. Journal of intensive care, 8(1), 1-10.
  4. Fathi, M., Vakili, K., Aliaghaei, A., Nematollahi, S., Peirouvi, T., & Shalizar-Jalali, A. (2021). Coronavirus disease and male fertility: a systematic review. Middle East Fertility Society Journal, 26(1), 1-6.
  5. Bradley, B. T., Maioli, H., Johnston, R., Chaudhry, I., Fink, S. L., Xu, H., … & Marshall, D. A. (2020). Histopathology and ultrastructural findings of fatal COVID-19 infections in Washington State: a case series. The Lancet, 396(10247), 320-332.
  6. Gharagozloo, P., Cartagena, S., Moazamian, A., Drevet, J. R., Somkuti, S., & Aitken, R. J. (2022). Rapid impact of COVID-19 infection on semen quality: a case report. Translational Andrology and Urology, 11(1), 110.
  7. Pan, F., Xiao, X., Guo, J., Song, Y., Li, H., Patel, D., … & Hotaling, J. (2020). No evidence of SARS-CoV-2 in 393 semen of males recovering from COVID-19. Fertil Steril, 113(6), 1135-1139.
  8. Andrade-Rocha, F. T. (2013). Temporary impairment of semen quality following recent acute fever. Annals of Clinical & Laboratory Science, 43(1), 94-97.
  9. Kaynar, M., Gomes, A. L. Q., Sokolakis, I., & Gül, M. (2022). Tip of the iceberg: Erectile dysfunction and COVID-19. International Journal of Impotence Research, 34(2), 152-157.
  10. Salonia, A., Pontillo, M., Capogrosso, P., Gregori, S., Carenzi, C., Ferrara, A. M., … & Montorsi, F. (2022). Testosterone in males with COVID‐19: A 7‐month cohort study. Andrology, 10(1), 34-41.
  11. Derby, C. A., Mohr, B. A., Goldstein, I., Feldman, H. A., Johannes, C. B., & McKinlay, J. B. (2000). Modifiable risk factors and erectile dysfunction: can lifestyle changes modify risk?. Urology, 56(2), 302-306.
  12. Goldstein, I. (2000). The mutually reinforcing triad of depressive symptoms, cardiovascular disease, and erectile dysfunction. The American journal of cardiology, 86(2), 41-45.






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