Can COVID-19 lead to Erectile Dysfunction?

As the world moves into an Endemic phase, we continue to live with a virus that has changed our lives since  2020. At this point, many of us have been infected and recovered from this infection. Some of us with mild symptoms recovered within a few days to weeks. Unfortunately, many individuals across the globe continue to suffer from long COVID syndrome.

Many patients have heard of the most common long-term effects of COVID-19: such as breathing difficulties, brain fog, and constant fatigue. But there is mounting evidence that suggests, COVID-19 may also have a negative impact on sexual health in both men and women. Healthy men who previously had no such problems of this nature have started developing erectile dysfunction (ED) after their COVID-19 infection.

In fact, studies show that men are six times more likely to develop problems achieving an erection after contracting the COVID-19 virus compared to men who didn’t get COVID. 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.

There are four COVID-related factors that may lead to erectile dysfunction:

1) Endothelial dysfunction

2) Dysfunction in the autonomic nervous system (ANS), including cardiovascular and pulmonary issues

3) Psychological issues aggravated by the pandemic

4) Other causes (such as endocrine dysfunction)

Endothelial Dysfunction

Endothelial cells are a single layer of cells that are found in the blood vessels. These cells play an important role in regulating the process of  dilation (relaxation) and contraction of blood vessels to ensure enough blood flows in the body. It also helps to regulate the blood clotting mechanism, and controls inflammatory responses in the surrounding tissues.

There is research now available to prove that the SARS -CoV-2 virus targets the ACE2 receptors found in endothelial cells that leads to endothelial dysfunction, leading to vascular leakage, thrombosis, blood clots, and an exaggerated inflammatory response.

Erections rely solely on blood flow, so anything that interferes with the blood vessels’ ability to deliver blood to the penile tissue to create an erection could lead to erectile dysfunction. As the penis is one of the most vascular organs in the body, it’s not surprising that endothelial dysfunction caused by long COVID can lead to this problem.

Disruption of the Autonomic Nervous System 

The parasympathetic nervous system and the sympathetic nervous system perform different functions of the body. 

All the vascular events described above to ensure that an erection can occur are carefully orchestrated by the autonomic nervous system (ANS).

Studies show that the initiation, maintenance, and rigidity of penile erection are controlled by two sections of the ANS known as the parasympathetic nervous system (PNS) and sympathetic nervous system (SNS). To start, the PNS increases blood supply to the spongy tissues in the penis to allow an erection to occur. As sexual arousal increases, the SNS takes over until ejaculation.  

Hence, any disruption in this balance between both systems lead to erectile problems.

Psychological issues aggravated by the pandemic leading to Erectile Dysfunction

The COVID-19 pandemic has had a significant impact on the mental and sexual health of many people. The results of many studies show a link between mild depressive disorder and ED caused by the lockdown. Therefore, it is extremely important to undertake interventions aimed at improving health and overall well-being as well.

If you are an individual suffering from Erectile Dysfunction post Covid, know that help is available. Your healthcare provider would first need to get a detailed history and proceed with a physical examination and lab investigations before deciding a suitable treatment plan for you. 

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