Why COVID-19 may cause erectile dysfunction: ‘If men are really ill, nothing works that well'

COVID-19 can lead to a variety of long-term health problems — from shortness of breath and fatigue to muscle pain and memory problems — because of the damage the virus inflicts on the lungs, heart and brain. But the virus may cause another problem, too: erectile dysfunction.

“Even if you have a mild infection, we now know that people can have long-term health effects from this virus, [such as] neurological complications,” infectious disease expert Dena Grayson, MD, told NBC Chicago. “There is some real concern here that men could have long-term issues of erectile dysfunction from this virus because we know that it causes issues in the vasculature.”

Grayson added that “the vast majority of people do seem to recover from this virus, but as time goes on and more and more people are infected, we’re going to unfortunately see more and more of these long-term negative consequences of infection.”

Erectile dysfunction is complex and can be caused by both physical and psychological problems, including heart disease, high blood pressure and diabetes, as well as stress, anxiety and depression, according to the Mayo Clinic.

There is a "plausible link" between COVID-19 and erectile dysfunction, one doctor notes. (Photo: Getty Images)
Doctors say there could be links between between COVID-19 and erectile dysfunction. (Photo: Getty Images)

As far as whether COVID-19 can cause erectile dysfunction, Michael Eisenberg, MD, a male sexual function specialist at Stanford University Medical Center, calls the risk “theoretical,” telling Yahoo Life, “I haven't seen any direct reports of that. But it certainly doesn't surprise me.”

Eisenberg explains that “we’re still relatively early in our understanding of COVID-19. Certainly, there’s an association between health and erectile function. Patients who have been hospitalized with different illnesses, they do report erectile function in decline right afterwards.” Eisenberg adds: “If men are really ill, nothing works that well, including erections.”

Dr. Mohit Khera, a professor of urology at Baylor College of Medicine, tells Yahoo Life that there is a “plausible link” between the virus and erectile dysfunction. “COVID can have a direct and even indirect effect on erectile dysfunction,” Khera says.

In addition, a July 2020 study on COVID-19 and erectile dysfunction suggests that the virus “might exacerbate cardiovascular conditions; therefore, further increasing the risk of ED,” noting that “COVID-19 survivors might develop sexual and reproductive health issues.”

Khera says that patients who are more likely to suffer severe complications “are patients who have comorbid conditions like obesity, diabetes and metabolic syndrome. Those are the same risk factors of erectile dysfunction.”

How COVID might cause erectile dysfunction

COVID-19 triggers an attack on the lining of the blood vessels called the endothelium. “Pro-inflammatory cytokines are released, and they injure the lining of the blood vessels,” Khera says. “It’s the same lining of the blood vessels of the heart, so we’re seeing a lot of heart attacks with COVID.” But the attack “affects all blood vessels,” which can affect blood flow, including to the penile tissues.

In addition, pro-inflammatory cytokines can injure testicular function, according to Khera. “Many men are found to have lower testosterone levels after COVID,” he says. “Testosterone is responsible for sex drive.”

The psychological toll of having COVID-19 can also affect sexual function. COVID-19 patients have a higher risk of developing depression or an anxiety disorder. “Men who are stressed have a much more difficult time” with erectile function, and “depression contributes to erectile dysfunction,” Khera says.

Eisenberg says that erectile dysfunction in general is “very common,” affecting about 30 million American men. Along with following public health recommendations, including physical distancing, wearing masks and washing hands often to help prevent a COVID-19 infection, Eisenberg says that making healthy lifestyle choices and managing any existing health conditions can help prevent erectile dysfunction.

“Everything that’s good for your heart is good for your penis,” Eisenberg says. “So a good diet and exercise,” as well as reducing stress, not smoking, and maintaining a healthy weight, helps.

For the latest coronavirus news and updates, follow along at https://news.yahoo.com/coronavirus. According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC’s and WHO’s resource guides.

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