As the long-term impacts of COVID-19 continue to unfold, erectile dysfunction (ED) has emerged as a persistent and concerning issue for many men. While fatigue, muscle aches, and breathlessness are well-known long COVID symptoms, a recent study published in Scientific Reports highlights that ED is also a significant lingering problem, affecting 19% of men who were hospitalized for COVID-19. Notably, some of these men continued to experience ED up to two years after their initial infection.
Ongoing Effects of COVID-19 on Erectile Function
The study, which was part of the COVID-19 Recovery Study II, involved 609 men who were hospitalized in Japan between March and September 2021, during the peak of the alpha and delta variants. The median age of the participants was 48 years, with all individuals being at least 20 years old. Of the 116 men who reported ED following hospitalization, 86 experienced it one year after discharge, and 70 continued to face the issue two years later. Surprisingly, 40 men reported ED at both the one-year and two-year follow-up points.
While many men developed ED within 28 days of their COVID-19 infection (68.1%), a subset of 4.3% experienced the onset of ED several months after their infection. Interestingly, the study found no significant links between the severity of COVID-19, reinfection, vaccination status, or antiviral treatments and the likelihood of developing ED.
The Vascular Link: Blood Vessel Damage and ED
The potential cause of ED following COVID-19 is believed to stem from the virus’s impact on the vascular system. The virus may trigger an inflammatory response that damages the blood vessels, specifically the vascular endothelium—the inner lining of blood vessels. Erections occur when blood fills the corpora cavernosa, the spongy tissue in the penis, and any impairment to blood flow can make achieving an erection difficult.
This connection between COVID-19 and erectile issues isn’t new. Previous studies have suggested that the virus’s effects on blood flow and inflammation could contribute to sexual dysfunction. COVID-19 may also exacerbate other long COVID symptoms, which in turn could make ED more likely.
Other Long COVID Symptoms May Contribute to ED
The study also pointed to additional factors that could influence ED, including fatigue, shortness of breath, anxiety, and sleep disturbances. Men who reported ED were found to have higher levels of fatigue and shortness of breath, as well as elevated anxiety and depression scores compared to those without ED. These symptoms can hinder sexual excitement and performance, as being tired or anxious can significantly impact one’s libido and overall ability to engage in sexual activity.
Although the psychological impact of long COVID is well-documented, this research emphasizes how these overlapping symptoms could be contributing to the sexual dysfunction many men face post-infection. The study highlighted that men with ED were more likely to report sleep disturbances, which could further diminish sexual desire and performance.
Positive Outcomes and Available Treatments
The good news is that ED caused by COVID-19 may not be permanent. Some men in the study experienced improvements over time—29 men (25%) saw their condition improve, with 15 recovering within a month, others within several months, and a group improving within a year. However, a substantial portion of men—57 (49.1%)—still struggled with ED at the two-year mark.
Fortunately, there are various treatments for ED, ranging from lifestyle modifications to medications, counseling, and even surgical interventions. ED should not be considered an insurmountable barrier to a fulfilling sex life, and there are options to help manage the condition.
The Need for Post-COVID Care to Address Erectile Dysfunction
This research underscores the importance of addressing ED as part of post-COVID care, particularly for men dealing with other long COVID symptoms. Given the stigma often associated with ED, men may hesitate to bring it up with their doctors. Healthcare providers should proactively raise the issue with patients, especially those experiencing fatigue, anxiety, or other long COVID symptoms, to ensure they receive the care they need.
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