How Having COVID-19 May Affect Men's Sexual Health

Most of us are familiar with the common symptoms of COVID-19: fever, shortness of breath, fatigue and loss of smell or taste. But some research has emerged recently that suggests that COVID-19 might also lead to erectile dysfunction (ED).

One study found that COVID-19 survivors might develop short and long-term sexual and reproductive health issues, including ED. COVID-19 has been detected in the testicle, so it could affect how well your testicles can work. This could affect both sperm production and testosterone production.

Researchers are unsure of the link between COVID-19 and ED. But several factors could lead to the potential onset of ED after COVID-19.

One factor is that the virus causes issues in the body’s blood vessels. The virus causes a high level of inflammation in the body as a defense response. The high level of inflammation can cause small blood clots to form, as well as inflammation of the lining of the blood vessels. These two features combined can disrupt blood flow – one of the most important factors in achieving an erection.

Indirectly, COVID-19 can worsen an already existing heart condition such as heart inflammation or an irregular heartbeat. Medicines to treat these conditions, such as beta-blockers, can cause ED as a side effect.

Possible Effects on the Penis and Testicles

Another hypothesis is that long-term COVID-19 complications may lead to scarring of the erectile tissue.

COVID-19 causes severe physiologic and psychological stress, which leads to lower testosterone levels and increased release of stress hormones. While testosterone levels should return to normal after the illness subsides, loss of testosterone might lead to fibrosis of the penile tissue, which is a more difficult and less reversible condition to treat.

There also is evidence to suggest that the coronavirus has an impact on the testicles. The virus enters cells with the help of a protein that is prevalent in the testicles. The testicles are where the majority of testosterone is made in men, and so COVID-19 may cause decreased testosterone levels in the body.

Lower testosterone levels can contribute to erectile dysfunction, as well as decreased energy, libido and muscle mass. Lower testosterone levels also could exacerbate the body’s inflammatory response, causing heightened damage to the blood vessels.

The Role of Mental Health

Even if you do not have COVID-19, the stress of disrupted routines because of the pandemic can take an unexpected toll on your sexual life.

Being in the right frame of mind is an important part of being able to engage in sexual activity and achieving an erection. Stress, anxiety and depression can be potential causes of erectile dysfunction. As these emotions become heightened during the prolonged pandemic, more men might experience ED as well.

Nannan Thirumavalavan, MD, is a urologist at University Hospitals. 

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If you’re like many men, you don’t pay much attention to your health until something goes wrong. But letting an undiagnosed medical condition go untreated can endanger your best chances for recovery. Your best strategy is to take charge of your health and schedule an annual checkup with a University Hospitals primary care physician. Learn more about Men's Health services at University Hospitals.