Physicians have anecdotally reported that some male patients experience erectile dysfunction after a bout with COVID-19, The Los Angeles Times reported July 6.
To further assess whether COVID-19 is associated with erectile dysfunction, experts say observational studies that involve men in the same age group with similar health profiles are needed. This would allow researchers to see whether rates of erectile dysfunction differed depending on history of a COVID-19 infection.
"That, we haven't gotten to yet," Ryan Berglund, MD, a urologist with Cleveland Clinic, told the LA Times.
Six things to know about how COVID-19 may affect men's sexual health:
1. Pneumonia from COVID-19 can cause blood vessel inflammation. Inflammation of the endothelial cells, which line the body's blood vessels, can trigger erectile dysfunction.
"Anything that could affect the ability of the artery to effectively deliver sufficient blood supply to create an erection could lead to erectile dysfunction," Dr. Berglund said.
Another possibility is that the blood vessels themselves become inflamed in the same way COVID-19 may lead to myocarditis or heart muscle inflammation, according to Dr. Berglund.
2. Pneumonia from COVID-19 may also cause lung damage. This could affect the body's ability to get sufficient oxygen in the blood, which is tied to erectile dysfunction.
3. The coronavirus may be able to infect testosterone-producing cells. It's possible that Leydig cells can become infected. These cells also have ACE2, which is the protein the SARS-CoV-2 virus uses to initiate cell infection. Early research has shown some people who died from COVID-19 had reduced Leydig cells, according to the LA Times.
4. Arousal could be affected if a person's sense of smell was altered from COVID-19, experts said.
5. The pandemic's mental health effects can't be ignored. Even if a person didn't have COVID-19, the effects of the pandemic on daily life could heavily affect a person's mood and lead to erectile dysfunction.
6. Persisting erectile dysfunction linked to COVID-19 may indicate more serious conditions. "The most concerning thing here would be that erectile dysfunction related to the disease may be an indicator of other underlying vascular disease related to COVID-19," Dr. Berglund said.