COVID and sexual dysfunction: Here’s what we know and don’t

Via Peters

A medical worker holds a coronavirus test kit and nasal collection equipment. Experts from around the country say erectile dysfunction and sexual health issues could be a side effect of long COVID-19.

A medical worker holds a coronavirus test kit and nasal collection equipment. Experts from around the country say erectile dysfunction and sexual health issues could be a side effect of long COVID-19.

Getty Images/iStockphoto

COVID-19 survivors all over the world have continued to grapple with side effects of the disease long after their initial recovery. The experiences of COVID-19 long-haulers are still being studied, and scientific knowledge of the long-term impacts of the disease is still developing.

But on top of well-known side effects of long COVID-19, like brain fog and fatigue, some people might experience another surprising condition.

“I’ve seen patients with sexual dysfunction with long COVID,” Dr. Loretta Que, a pulmonologist with Duke Health and a professor of medicine, said during a media briefing on March 9. “It’s not a strange abnormality, but it’s odd for me because I’m a lung doctor and they presented with sexual dysfunction and pain.”

“I think that can be shocking for some patients,” said Dr. Coral Giovacchini, a pulmonologist and critical care specialist with Duke Health and an assistant professor of medicine, during the briefing.

The phenomenon has been observed by other experts, too — a University of Florida Health study published online on Nov. 30 found that men with COVID-19 are “more than three times more likely to be diagnosed with erectile dysfunction, or ED, than those who are not sickened by the coronavirus,” according to a news release on the findings.” The study looked at 1,066,108 patients: 9,554 had erectile dysfunction, 3,098 male patients had COVID-19, and 146 had both.

And in a narrative review published last month in the International Journal of Impotence Research, researchers also concluded that erectile dysfunction could develop after COVID-19 infection due to the numerous ways the virus affects the body.

But there’s still a lot that researchers don’t know about sexual dysfunction and other effects of long COVID-19. Here’s what they can — and can’t — confirm so far.

Why it happens

Some experts believe that erectile dysfunction could be caused by the “long-term effects on the brain, heart and other organ systems,” Abraar Karan, an infectious disease fellow at Stanford Medicine, said in a March 11 news release.

According to Karan, recent data has indicated there’s a correlation between COVID-19 infection and brain inflammation or vascular effects. Those long-lasting problems could have a ripple effect on a person’s health by causing other issues, like erectile dysfunction.

“It’s concerning that some people no longer consider infection to be a big deal,” Karan said.

The narrative review came to similar conclusions, saying erectile dysfunction could be one of many “multi-organ dysfunction-driven clinical conditions” that emerges after the body is infected with COVID-19.

However, some experts also speculate that erectile dysfunction can be directly caused by COVID-19 itself, not just the inflammation or fever that occurs throughout the body during infection.

A study conducted on monkeys by researchers at Northwestern Medicine revealed that “multiple tissues of the male genital tract can be infected with SARS-CoV-2,” the university said in a March 1 news release.

Researchers who studied rhesus macaques that had COVID-19 found that “the prostate, vasculature of testicles, penis and testicles were all infected with the virus,” the release said.

What we still don’t know

As with many of the physical conditions people experience after their initial recovery from COVID-19, scientists are unsure how long people might struggle with erectile dysfunction or the long-term impacts that COVID-19 could have on fertility overall.

“We don’t have any long-term studies and we need studies to identify if this post-COVID ED is going to be short lived or it’s a permanent condition,” Amarnath Rambhatla, director of Men’s Health at the Henry Ford Hospital Vattikuti Urology Institute, told WDIV.

It’s also not clear how many people may have experienced erectile dysfunction or other reproductive issues as a result of COVID-19, though “clinical studies suggest 10% to 20% of SARS-CoV-2-infected men have symptoms related to male genital tract dysfunction,” Northwestern Medicine said in the news release.

What can be done

Vaccination isn’t guaranteed to prevent long COVID-19 and the conditions that could come with it, but it greatly reduces the risk of severe illness or death, experts say.

“The numbers are way lower, so (there’s a) marked reduction in these numbers of patients that are presenting and … seem to be different than what we see with those who have not been vaccinated,” Que said in the Duke media briefing. “When I look at their lung findings on a CT scan or chest X-ray or lung-function studies, they are not as affected as those who have not been vaccinated.”

Because of this, researchers say the possible correlation between COVID-19 and erectile dysfunction or other sexual health issues makes it all the more important to get vaccinated against the coronavirus.

“The potential impact of SARS-CoV-2 infection on sexual and reproductive health should be part of everyone’s decision to get vaccinated to minimize the chance of death, severe disease and hospitalization, and infection of the prostate, penis, testicles and vasculature (blood supply) of testicles,” Thomas Hope, lead investigator of the Northwestern study and a professor of cell and developmental biology at the Northwestern Feinberg School of Medicine, said in a news release.

Researchers at Northwestern also say they’re working on “interventions to mitigate the impact of the COVID-19 pandemic on male fertility.”

In the meantime, individuals who are experiencing issues with fertility or sexual dysfunction after COVID-19 “should evaluate their sexual health and fertility to determine if additional therapies could prevent or diminish future problems,” Hope said in the news release.

Vandana Ravikumar is a McClatchy Real-Time reporter. She grew up in northern Nevada and studied journalism and political science at Arizona State University. Previously, she reported for USA Today, The Dallas Morning News, and Arizona PBS.

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