Loss of taste and smell, shortness of breath, frostbitten fingers and toes or brain fog : since the beginning of the pandemic, we have all discovered the incongruous symptoms and other deleterious effects associated with Covid-19. But erectile dysfunction could also be added to the list. A problem studied in the context of a hundred scientific publications around the world, from Europe to the United States via Thailand and Turkey.
Several observational scientific studies have found higher rates of erectile dysfunction among men who recently contracted the disease. Other factors associated with the pandemic, such as stress, could, however, partly explain the phenomenon.
Penile vessels affected
When he received the first patients for this reason for consultation, Dr. Ranjith Ramasamy, director of the reproductive urology unit at the Desai Sethi Institute of Urology at the University of Miami, co-author of an article on the subject, first believed that “everything was psychological or stress-induced”, as he told the New York Times. But in the face of increasing cases of erectile dysfunction post-Covidhe looked into the phenomenon and found that “six months after the initial infection, the condition of the patients had generally improved, but they continued to complain of these problems” erectile.
An increase in cases difficult to quantify. If for Dr Ramasamy, the risk of erectile dysfunction increases by 20% after contracting Covid-19, according to Pr Emmanuele Jannini, professor of endocrinology and medical sexology at the University of Rome, men who have been infected by Covid-19 are nearly six times more likely to develop erectile dysfunction compared to those who have never contracted it, he says in the study he co-authored.
By what mechanism? Scientists know that Covid-19 can have a lasting effect on the cardiovascular system, as confirmed by a study published in March in the journal Nature by researchers at the American University of Saint Louis. And in practice, vascular problems can first show up in the sexual organs, which are supplied by smaller vessels, which are essential for ensuring good blood circulation and maintaining erections. Covid-19 can thus affect the blood vessels of the penis. However, “the penile artery 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, even before you see it in a larger artery,” Dr. T. Mike Hsieh, a male fertility urologist at the University of California, San Diego, told the American newspaper.
Other factors related to Covid-19
But other factors related to Covid-19 could also explain the increase in cases of erectile dysfunction. The authors of a study published in February in the journal Nature recall that the impact of the pandemic on individuals, their social relationships and their couple, as well as anxiety and depressive disorders and the social isolation it has induced, are all elements likely to affect erectile functions .
“Men’s erections are more complicated than people think,” explains the New York Times Dr Justin Dubin, co-author of an article on the deleterious effects of Covid-19 on men’s health. Granted, “you need good blood flow, you need nerves working, and you need good hormone levels, especially testosterone,” he said. “But you also have to be in a good frame of mind, and you have to be excited. If any of these criteria are not met, you may have difficulty getting an erection.
Another symptom of Covid-19 could also explain the alteration of male sexuality: loss of taste and smell observed in many Covid patients, depriving them of the senses essential to sexuality. “It is through odors that the excitation mechanism in the brain is triggered”, indicate Professors Bertolo, Cipriani and Bove, Italian urologists authors of a study on the effects of anosmia and ageusia on erectile dysfunction.
An early sign of cardiovascular risk
However, it happens that erectile disorders precede the appearance of cardiovascular diseases, as many pathologies having common risk factors: obesity, diabetes, high blood pressure, which are also risk factors for developing a severe form of Covid-19. In men, erectile dysfunction can thus precede a heart attack by about five years, according to Dr. Hsieh.
So when a patient consults him for erectile dysfunction, “he doesn’t just receive a prescription” for little blue pills, assures Dr. Hsieh, who first prescribes a battery of tests – cholesterol, diabetes, weight – as well as a better lifestyle in the event of poor eating habits and a sedentary lifestyle. And if post-Covid erectile dysfunction can in some cases resolve spontaneouslywhen the disorders persist, it is necessary to consult without delay, both to prevent them from settling, and to check that they are not the harbinger of other pathologies.