Is there any doubt that the COVID-19 pandemic has been a depressing hardship? First, there’s the illness itself, which can be severe enough to cause death. For those who develop the disease and survive, we’re just beginning to understand longer term side effects that can involve the lungs, heart, joints and muscles, and even the brain with increased risk of stroke, headaches, even mood and psychiatric disorders.

COVID and erectile dysfunction

We now know that there’s an association between the illness and erectile dysfunction (ED), thanks to an Italian study published March 2021 in the journal Andrology^[i]

Here’s the bad news: men – even younger men—who already experience difficulty getting or maintaining an erection are at greater risk for developing COVID. And no, it’s not because they are careless about having “unmasked” sex. It’s because ED is an early warning sign of cardiovascular disease.

The blood vessels in the spongy tissue of the penis don’t engorge (fill) with enough blood to sustain an erection due to poor heart and blood vessel function. This is called endothelial dysfunction. When you remember that COVID hits people harder who have pre-existing conditions, including heart and respiratory problems, it makes sense that younger men who may not even know they have early heart disease are more vulnerable to the action of the virus.

Sex and the brain

But wait, it gets worse! According to the study authors, ED may actually result from COVID for complex reasons—not necessarily physical. While men tend to focus on the penis as the source of their sexual pleasure, in fact erections begin in the brain. Yes, the brain IS the most important sex organ! Without the imagination, there is no desire, and without desire, there is no erection.

Therefore, what a man thinks and feels have as much if not more to do with erectile function. The social distancing and the lockdowns that have accompanied the pandemic have profoundly affected millions of people mentally, emotionally and psychologically. Isolation and “cabin fever” have taken the sexiness out of sex for those who now work from home full time, where they feel trapped, and especially for those who have lost work and income because of the pandemic.

The solution?

There is no easy remedy for the ED during the pandemic. Men who already experienced ED are less likely than ever to see a doctor, given the cautions that arose during the earliest lockdown before the spread of the virus was better understood. Men who are having performance problems due to pandemic-related anxiety, depression, irritability, etc. must continue to be patient as the world grapples to bring the virus under control.

From the authors’ viewpoint, the best hope lies in continued masking, and of course, universal access to vaccines. Until then, it’s important to have realistic expectations about “love in the time of COVID,” and to be optimistic about a brighter future. Most importantly, if you are a younger man already experiencing ED, talk to your doctor (by telehealth, if needed) about the possibility that you have early cardiovascular disease.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

[i] Sansone A, Mollaioli D, Ciocca G, Colonnello E et al. “Mask up to keep it up”: Preliminary evidence of the association between erectile dysfunction and COVID-19. Andrology. 2021 Mar 20.