Doctors are trying to determine whether or not there is a relationship between erectile dysfunction (ED) and COVID-19 illness. Increasing numbers of men are complaining of ED following an infection, but too little research has focused on the issue thus far to draw any conclusions. 

Why A Link between COVID and ED Would Not Be Surprising

Dr. Emmanuele Jannini, professor of endocrinology and medical sexology at the University of Rome Tor Vergata, said he would not be surprised to learn that the SARS-CoV-2 virus and subsequent illness harms male sexual health. There are several reasons why:

• Blood flow. A human’s erection is generated solely by blood flow. When an injury or disease damages the cardiovascular system, as COVID-19 has been known to do, blood vessels all over the body can be impacted. 
• Inflammation. Jannini suspects that patients who have had pneumonia are at even higher risk. Pneumonia causes inflammation in endothelial cells, which line your blood vessels. Inflammation can easily lead to ED, he said, and persist even after acute illness has passed.
• Blood oxygen levels. Pneumonia can result in lung damage, reducing your ability to get enough oxygen in your blood. Insufficient blood oxygen is a well-known cause of ED.
• Testosterone. The coronavirus may affect cells in the testicles, including Leydig cells that produce testosterone, which controls libido and desire. Autopsies of people who have died from COVID-19 showed “significantly reduced Leydig cells.”
• Sensory loss. Loss of the sense of smell has become a common COVID-19 symptom. An inability to pick up scents can hinder our ability to become sexually aroused.
• Emotional and psychological disturbance. Even for those who are physically capable of getting and sustaining an erection, depression, and anxiety (whether pandemic-induced or otherwise) can contribute to ED.

Erectile Dysfunction Isn’t Just about Sexual Health 

According to Dr. Ryan Berglund, a urologist at the Cleveland Clinic, “Anything that could affect the ability of the artery to effectively deliver sufficient blood supply to create an erection could lead to erectile dysfunction.” He warned, however, that long-term ED associated with COVID-19 may indicate other underlying health issues such as heart disease, which can lead to a heart attack or stroke. He recommends that people suffering from prolonged ED contact their healthcare provider and go for a checkup.

As for whether or not erectile dysfunction may be directly related to COVID-19, Berglund said there’s not enough information to make a determination. He concedes that:

• ED is not an uncommon problem with viral infections
• The scale and severity of COVID-19 have led to higher-than-usual vascular issues
• COVID-19 has caused a tremendous amount of psychological stress

While one or each of these may play a part, however, Berglund said that all the evidence we have so far is anecdotal, and serious observational studies would need to be done to discern what kind of relationship, if any, exists between ED and COVID.

One helpful study design he recommends would involve men in the same age group with similar health status, to determine whether or not rates of ED differ depending on coronavirus infection.

When people get an illness, he added, they tend to blame the illness for things that happen afterward, whether or not there’s a connection. This may be one of those instances.

*Lin II, R. (2021, July 6). Can Long COVID Lead to Long-Term Erectile Dysfunction? Los Angeles Times. https://www.latimes.com/california/story/2021-07-06/can-covid-19-cause-lasting-erectile-dysfunction

Much about the novel coronavirus, i.e., COVID-19, is still not fully understood. As research progresses and our knowledge of the virus increases, information can change rapidly. We strive to update all of our articles as quickly as possible, but there may occasionally be some lag between scientific developments and our revisions.