As for the respiratory disease, COVID-19 produces some peculiar symptoms. This can impair the senses of smell and taste, leaving patients with “Covid toes” or even causing a swollen, bumpy “Covid tongue.”
Now scientists are investigating a possible link to a completely unexpected consequence of COVID-19: erectile dysfunction. A connection has been reported in hundreds of papers by scientists from Europe and North America as well as Egypt, Turkey, Iran and Thailand.
Estimates of the magnitude of the problem vary wildly. A paper by Dr Ranjit Ramasamy, director of reproductive urology at the Desai Sethi Urology Institute at the University of Miami, and colleagues found that the risk of erectile dysfunction increased by 20% after a battle with COVID-19. Other investigators have reported a significantly higher increase in that risk.
When patients first came to Ramasamy’s clinic complaining of erection problems, “we dismissed it, thinking it was all psychological or stress-induced,” he said.
But over time, he and other physicians began to see a pattern, he said. “Six months after the initial infection, patients were better overall, but they continued to complain of these problems,” said Ramasamy, who has written several papers on the topic, including erectile dysfunction and low sperm count. are written.
At the start of the pandemic, Dr. Professor of Endocrinology and Medical Sexology at the University of Rome Tor Vergata. Emmanuel Jannini reported a strong link between erectile dysfunction and COVID-19. When they compared men who were sick with COVID-19 to those who were not, they found that those who were infected were nearly six times as likely to report impotence as those who survived the coronavirus.
“Telling that the disease can affect your sex life is a tremendously powerful message,” Janini said, “especially for men who still oppose vaccination.” “The evidence is very strong.”
Research from imaging scans and biopsies indicates that the coronavirus can infect tissue within the male genital tract, where it can persist long after the initial infection. Scientists say it’s too early to be certain that erectile dysfunction is the cause, as many factors – psychological as well as physical – play a role in maintaining an erection and erection. The pandemic has led to increased social isolation and anxiety and depression, all of which may play a role.
Some researchers speculate that erectile dysfunction may be linked to the well-documented loss of ability to taste and smell experienced by COVID-19 patients, as these senses play a key role in sexual arousal. “It is through smell that the excitatory system in the brain is ignited,” wrote three Italian urologists in a paper responding to Jannini’s paper last year.
At least men need healthy blood vessels and good blood flow to develop and maintain an erection. The coronavirus can damage blood vessels and the lining of vessels, called the endothelium, because it binds to molecular receptors that are plentiful on endothelial cells.
The vessels cannot be constricted and stretched to allow blood flow to the penis. Injury to blood vessels can also contribute to more serious complications of COVID-19, such as heart attack, stroke and abnormal clotting.
“Our entire vascular system is connected; It’s not an isolated gender problem,” said Dr. T. Mike Hsieh, director of the Men’s Health Center at the University of California, San Diego.
But vascular problems may first appear in the sex organs, because the vessels there are much smaller. (Janini calls erectile dysfunction “the canary in the coal mine” for heart disease.) Erectile dysfunction and heart disease share risk factors—such as being severely overweight, having metabolic diseases such as diabetes, smoking, and old age— Which also increases the odds of having a severe COVID-19.
“The artery to the penis is one-tenth the size of a coronary artery, and when you have a narrower vessel, whether it’s a plumbing problem or a vascular problem, it will show up there first, before you see it as large. artery,” said Hsieh.
Erectile dysfunction can occur up to about five years before a heart attack, he said, and may be an early sign that there are other underlying risk factors.
“When I see a man for erectile dysfunction, they don’t just get Viagra or Cialis prescriptions,” Hsieh said. “They get a referral to a primary care aide or cardiologist to make sure their cholesterol is in check; their diabetes is under control; to discuss weight management, lifestyle or dietary changes.”
Erectile dysfunction could point to a better diagnosis of longer Covid-19, Janini said, or even worsening mental health.
“If you have a patient who has survived COVID, and you want to know whether he has had COVID for a long time, just ask him how it is going in bed,” Janini said. “If he is leading a normal sex life, the chances of him having severe long-term covid are very small.”
Left untreated, erectile dysfunction can lead to further complications. Cases of Peyronie’s disease, a condition that causes curved, painful erections as a result of fibrous scar tissue forming in the penis, and orchitis, an inflammation of one or both testicles, have developed in men who had COVID-19, According to published research.
Men who don’t have a normal erection for several months at a time can develop scar tissue and fibrosis, which makes erectile dysfunction harder to treat and can even cause the penis to shrink.
Erectile dysfunction may resolve on its own, but Hsieh encourages men with symptoms to see their physicians, and sooner rather than later.
“If you’re having these problems, don’t wait,” he said. “For the most part, we can get boys’ sex lives back.”