What may happen after you go through COVID-19 remains a standing concern. There’s certainly the risk of getting any of the common but often hard-to-deal-with long COVID symptoms like fatigue, muscle aches, breathlessness, headaches, difficulty thinking and alterations in taste listed on the World Health Organization website. But there’s also erectile dysfunction. ED may not always come up during long COVID discussions but a study recently published in Scientific Reports found that 19% of 609 men surveyed continued to have ED in many cases for up to two years after being hospitalized with COVID-19.
Over Half Of The Men With Erectile Dysfunction Had It Two Years After COVID-19
This was part of the COVID-19 Recovery Study II looking at those who spent time as inpatients with COVID-19 in one of 20 hospitals in Japan between March and September 2021. If you recall, that was during the alpha and delta variant phases of the pandemic. All of those surveyed were at least 20 years of age with the median age being 48 years. Of the 116 men that reported having ED at some point after the hospitalization, 86 did so one year afterwards, 70 after two years and 40 at both time periods.
ED didn’t necessarily come quickly in all cases. While 79 (68.1%) reported developing ED within 28 days of their COVID-19 infection, for six (4.3%), the ED emerged in the period two to five months after they had been infected. The researchers didn’t find any associations between COVID-19 severity, reinfection, vaccination frequency or antiviral treatment with the likelihood of ED.
Damage To Blood Vessels May Be Leading To Erectile Dysfunction
This study certainly wasn’t the first evidence that COVID-19 could pose a stiff problem for the penis. I wrote about evidence of this ED problem with COVID-19 before for Forbes in 2020 as well as in 2021. A thought is that the severe acute respiratory syndrome coronavirus 2 can trigger the release of inflammatory cytokines along with lead to decreased oxygen levels in the blood that in turn can damage the inner lining of blood vessels, known as the vascular endothelium. And erections result when blood rushes through arteries into the corpora cavernosa, spongy tubes of tissue that are in the shaft of your penis. Impeding the blood flow into these tubes could erect a problem getting an erection.
Other Long COVID Symptoms Could Be Contributing To Erectile Dysfunction
The study raised another set of possible set of contributors to ED: other long COVID symptoms such as fatigue, shortness of breath, anxiety and sleep disturbances. In the study, those with ED had higher rates of shortness of breath and fatigue than those without ED. Their scores on the Hospital Anxiety and Depression Scale-D and the EuroQol 5-dimensions for pain/discomfort and anxiety/depression went up after COVID-19 compared with before. Additionally, those with ED were more likely to have sleep disturbances as well.
All of these things could make it harder to get sexually excited. When you are tired, for example, “OK, let’s do this” may not be the first thing that comes to your mind. Or the second, third or twenty-eighth. As I’ve written before, erections aren’t exactly like Netflix shows, on demand. Instead, they do often require the man to feel good about the situation and himself, which is harder to do when you are feeling anxious.
Of course, there’s the whole chicken-or-the-egg problem here. Are such symptoms leading to ED? Or is the ED causing anxiety and sleep disturbances? Is it a little bit of both? Or might it be different contributors for different people?
Support For Erectile Dysfunction Should Be Part of Post-COVID Care
The good news is that ED may not be permanent in all cases. In other words, there may be a happy ending to this story. The ED did improve in 29 (25.0%) of the men during that time period with 15 getting better within one month, one within two months, one within four months and twelve within a year. Fifty-seven (49.1%) did still have ED at the two-year mark.
Furthermore, there are treatments for ED. These range from counseling to lifestyle changes to medications to devices to surgery. The presence of ED should not mean the absence of a happy sex life.
All of this suggests that post-acute COVID-19 care should account for the possibility of erectile dysfunction. Men may not be willing to mention ED as problem since it still has unnecessary social stigma. Therefore, doctors may want to raise the possibility when talking to patients, especially for those suffering other long COVID symptoms.
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