Can COVID-19 cause erectile dysfunction (ED) or affect sperm? (Updated 5/24/21)

Biology/Immunity Clinical Symptoms

A: It’s possible. #VaxUpToGetItUp

TL;DR: Due to its impact on inflammation and the vascular system, it is biologically plausible that COVID-19 contributes to erectile dysfunction. But as with much COVID-19 research more, ahem, hard data is needed.

COVID-19 infection HAS been associated with a reduction in sperm counts in early research. A recent study found that 6% of recovered COVID patients had no sperm, 18% had less than normal (compared to 1% and 3% in the general population). A previous study found “significant impairments in semen quality parameters” in those previously infected with COVID-19 compared to healthy controls. These impacts could be due to the direct impacts of the infection itself or medications taken during treatment for the infection. Whether these effects are long-lasting is not yet known.

A recent study of the Pfizer/BioNTech COVID-19 vaccine, on the other hand, showed it does NOT impact sperm parameters.

Potential biological mechanisms linking COVID-19 and reproductive function:

🥜 Testosterone and testicular/penile damage: The ACE2 enzyme that is the entry point for SARS-CoV-2 in host cells is highly expressed in the testis, including cells that produce testosterone. Testicular damage in COVID-19 might decrease testosterone production. Post-mortem examinations of testicular tissue from 12 COVID-19 patients showed evidence of this type of damage. A recent small study found COVID-19 viral particles and small blood vessel damage in the penile tissue of two men undergoing ED treatment 6 to 8 months after infection.

🌭 Vascular system: Erectile dysfunction is associated with vascular (blood vessel) health. Vascular damage associated with COVID-19 “is likely to affect the fragile vascular bed of the penis.” The pro-inflammatory cytokines associated with COVID-19 have also been linked to clinical progression of ED.

💔 Effects on the heart: With the impact of COVID-19 on myocarditis, arrythmias and other cardiovascular events, COVID-19 survivors are more likely to develop severe cardiovascular disease. This can impact ED directly as well as through cardiovascular treatments such as β-blockers and antihypertensive drugs.

🍆 Lung damage: Pulmonary fibrosis (scarring in the lungs) impairs lung function and oxygen saturation which may impact ED. Chronic lung diseases, including interstitial lung diseases and chronic obstructive pulmonary diseases (COPD) are associated with ED.

Overall, most of the plausible biological impacts of COVID-19 on erectile dysfunction overlap significantly with the other serious potential long-term effects on the lungs and cardiovascular system. We hope our followers take these risks seriously and minimize their risk of infection *regardless* of a potential link with sexual dysfunction.

BUT, if the specter of ED is an additional motivator to be safe, by all means keep it up!

Those Nerdy Girls

Further reading:

Potential biological mechanisms linking COVID-19 and ED (summarized above)

COVID-19 and sperm counts

COVID-19 and male reproductive function: a prospective, longitudinal cohort study

Can Covid-19 Coronavirus Cause Long-Term Erectile Dysfunction? Here Are 2 More Studies

Link to Original FB Post