A wide array of symptoms and side effects have been associated with COVID-19. One that’s currently being studied? Erectile dysfunction, or ED. Preliminary studies show about a 20% increase in the incidence of erectile dysfunction in men who have had COVID-19 compared to men who haven’t had COVID-19, says Amarnath Rambhatla, M.D., a urologist at Henry Ford Health.
Here, Dr. Rambhatla answers questions about what we know—and don’t know—about COVID-19 and erectile dysfunction.
Q: Why does COVID-19 cause erectile dysfunction?
A: There are a few theories. One is that erectile dysfunction could be caused by psychosomatic reasons. When someone gets COVID-19, they could be fatigued and maybe a little depressed, and this could contribute to their inability to get erections.
Another theory is that COVID-19 might decrease testosterone levels and that could potentially cause erectile dysfunction. There could also be a nerve component, as COVID-19 can attack the nerves.
Researchers have also identified virus particles in the endothelium (which is located inside of the heart and blood vessels) and we know that COVID-19 is primed to cause endothelial dysfunction, potentially leading to erectile dysfunction.
Q: What makes someone more likely to develop erectile dysfunction after contracting COVID-19?
A: I have seen young, healthy men, as well as older men with other medical problems, develop erectile dysfunction after contracting COVID-19. But men who are older might be at an increased risk for developing erectile dysfunction due to underlying medical problems.
There are a few other reasons why older men could be at an increased risk of developing erectile dysfunction after COVID-19: Testosterone levels decrease as we age, and we know that testosterone is needed for normal erectile function. When you’re older, you are also more likely to experience an increased inflammatory response to COVID-19. Diabetes, high blood pressure, cardiovascular problems—all of these are underlying risk factors for developing more severe COVID-19, and older men are more likely to have these issues.
Q: If you have a mild or asymptomatic case of COVID-19, can you still get erectile dysfunction?
A: We’re speculating that erectile dysfunction is more common in men who have more severe cases of COVID-19, but until the studies are completed, we can’t say for sure.
Q: How long does erectile dysfunction after COVID-19 last?
A: We don’t know yet. It depends upon what’s causing it. Just like with other symptoms of COVID-19, some people are experiencing long-haul symptoms like brain fog, fatigue, and shortness of breath months after they’ve recovered from the virus. So for some, erectile dysfunction could be a long-haul symptom.
Q: Can erectile dysfunction occur with other viral infections?
A: While someone is sick, or in the early recovery phase, there’s always a potential that they may have some difficulty getting erections. It could be related to medications they’re taking or it could be related to the stress of being sick.
There are some viruses that can directly attack the testicles and can cause hormonal and fertility issues, as well as more long-term erectile dysfunction. Vaccines don’t lead to fertility issues or erectile dysfunction, but contracting the mumps, for example, can.
Q: If you have erectile dysfunction from COVID-19, what can you do about it?
A: It’s important to see your doctor--and perhaps see a urologist. There are effective treatments we can use to help men with erectile dysfunction--including post-COVID-19 erectile dysfunction--ranging from medications to surgical options, if necessary.
Q: Can getting vaccinated help prevent you from getting erectile dysfunction?
A: The studies haven’t been completed yet, but it makes logical sense that if you get vaccinated, it can protect you from getting COVID-19. And if you do get COVID-19, you’re more likely to have a mild case, and that could protect you from getting post-COVID-19 erectile dysfunction.
Dr. Amarnath Rambhatla is a urologist who specializing in men's sexual health. He sees patients at Henry Ford Hospital in Detroit, Henry Ford West Bloomfield Hospital and Henry Ford Medical Center – Royal Oak.