Can Covid Lead to Impotence?
Some studies find higher rates of erectile dysfunction among men recovering from the illness. But other factors related to the pandemic, like heightened anxiety, may also be to blame.
A patient with long Covid is examined in a hospital in Israel. Some research indicates that the coronavirus may linger in cells in the male genital tract.Credit...Amir Cohen/Reuters
By Roni Caryn Rabin
For a respiratory disease, Covid-19 causes some peculiar symptoms. It can diminish the senses of smell and taste, leave patients with discolored “Covid toes,” or even cause a swollen, bumpy “Covid tongue.”
Now scientists are examining a possible link to an altogether unexpected consequence of Covid: erectile dysfunction. A connection has been reported in hundreds of papers by scientists in Europe and North America, as well as in Egypt, Turkey, Iran and Thailand.
Estimates of the magnitude of the problem vary wildly. A paper by Dr. Ranjith Ramasamy, director of reproductive urology at the University of Miami’s Desai Sethi Urology Institute, and his colleagues found that the risk of erectile dysfunction increased by 20 percent after a bout with Covid. Other investigators have reported substantially higher increases in that risk.
When patients first started coming to Dr. Ramasamy’s clinic complaining of erection problems, “We dismissed it, thinking it was all psychological or stress induced,” he said.
But over time, he and other physicians began to see a pattern, he said. “Six months after the initial infection, patients had gotten better overall, but they continued to complain of these problems,’’ including both erectile dysfunction and low sperm counts, Dr. Ramasamy, who has written several papers on the topic, said.
At the outset of the pandemic, Dr. Emmanuele Jannini, a professor of endocrinology and medical sexology at the University of Rome Tor Vergata, reported a strong link between erectile dysfunction and Covid. When he compared men who had been ill with Covid with those who had not, he found that those who had been infected were nearly six times as likely to report impotence as those who had avoided the coronavirus.
“Communicating that the disease can affect your sexual life is a tremendously powerful message,” especially for men who still resist vaccination, Dr. Jannini said in an interview. “The evidence is very strong.”
Research from imaging scans and biopsies indicates that the coronavirus can infect tissue within the male genital tract, where it may linger long after the initial infection. Scientists say it is too early to be certain that the link to erectile dysfunction is causal, since so many factors — psychological as well as physiological — play a role in producing and maintaining an erection. The pandemic has led to social isolation and a surge in anxiety and depression, all of which may play a role.
“Men’s erections are more complicated than people think,” Dr. Justin Dubin, who co-wrote a paper about the adverse impact of Covid on men’s health, said.
“You need good blood flow, you need the nerves to be firing, and you need good hormone levels, specifically testosterone,” he said. “But you also need to be in a good state of mind, and you also need to be aroused. If any of these things go wrong, you may have an issue getting an erection.”
In that sense, the pandemic is the perfect confluence of converging factors for causing erectile dysfunction, Dr. Joseph Katz, a professor at Florida College of Dentistry, said. Dr. Katz stumbled on the issue of erectile dysfunction while investigating Covid’s effects on oral health.
Some studies find higher rates of erectile dysfunction among men recovering from the illness. But other factors related to the pandemic, like heightened anxiety, may also be to blame.
A patient with long Covid is examined in a hospital in Israel. Some research indicates that the coronavirus may linger in cells in the male genital tract.Credit...Amir Cohen/Reuters
By Roni Caryn Rabin
- May 5, 2022
For a respiratory disease, Covid-19 causes some peculiar symptoms. It can diminish the senses of smell and taste, leave patients with discolored “Covid toes,” or even cause a swollen, bumpy “Covid tongue.”
Now scientists are examining a possible link to an altogether unexpected consequence of Covid: erectile dysfunction. A connection has been reported in hundreds of papers by scientists in Europe and North America, as well as in Egypt, Turkey, Iran and Thailand.
Estimates of the magnitude of the problem vary wildly. A paper by Dr. Ranjith Ramasamy, director of reproductive urology at the University of Miami’s Desai Sethi Urology Institute, and his colleagues found that the risk of erectile dysfunction increased by 20 percent after a bout with Covid. Other investigators have reported substantially higher increases in that risk.
When patients first started coming to Dr. Ramasamy’s clinic complaining of erection problems, “We dismissed it, thinking it was all psychological or stress induced,” he said.
But over time, he and other physicians began to see a pattern, he said. “Six months after the initial infection, patients had gotten better overall, but they continued to complain of these problems,’’ including both erectile dysfunction and low sperm counts, Dr. Ramasamy, who has written several papers on the topic, said.
At the outset of the pandemic, Dr. Emmanuele Jannini, a professor of endocrinology and medical sexology at the University of Rome Tor Vergata, reported a strong link between erectile dysfunction and Covid. When he compared men who had been ill with Covid with those who had not, he found that those who had been infected were nearly six times as likely to report impotence as those who had avoided the coronavirus.
“Communicating that the disease can affect your sexual life is a tremendously powerful message,” especially for men who still resist vaccination, Dr. Jannini said in an interview. “The evidence is very strong.”
Research from imaging scans and biopsies indicates that the coronavirus can infect tissue within the male genital tract, where it may linger long after the initial infection. Scientists say it is too early to be certain that the link to erectile dysfunction is causal, since so many factors — psychological as well as physiological — play a role in producing and maintaining an erection. The pandemic has led to social isolation and a surge in anxiety and depression, all of which may play a role.
“Men’s erections are more complicated than people think,” Dr. Justin Dubin, who co-wrote a paper about the adverse impact of Covid on men’s health, said.
“You need good blood flow, you need the nerves to be firing, and you need good hormone levels, specifically testosterone,” he said. “But you also need to be in a good state of mind, and you also need to be aroused. If any of these things go wrong, you may have an issue getting an erection.”
In that sense, the pandemic is the perfect confluence of converging factors for causing erectile dysfunction, Dr. Joseph Katz, a professor at Florida College of Dentistry, said. Dr. Katz stumbled on the issue of erectile dysfunction while investigating Covid’s effects on oral health.
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