Can COVID-19 cause erectile dysfunction (ED)?

Biology/Immunity Clinical Symptoms

A: It’s possible. #MaskUptoGetItUp

TL;DR: Due to its impact on inflammation and the vascular system, it is biologically plausible that COVID-19 contributes to erectile dysfunction. But as with much COVID-19 research more, ahem, hard data is needed.
This eyebrow raising headline made the rounds recently based on comments during a television interview by Dr. Dena Grayson, an infectious disease doctor. The ED remark was made in the context of emphasizing potential long-term effects of COVID-19 for those infected including heart and lung damage, fatigue and neurological impacts.

While little firm data exists to back up this link, scientists have written on the biological plausibility along with some preliminary data, summarized below.

Potential mechanisms linking COVID-19 and ED:

🥜 Testosterone and testicular damage: The ACE2 enzyme that is the entry point for SARS-CoV-2 in host cells is highly expressed in the testis, including cells that produce testosterone. Testicular damage in COVID-19 might decrease testosterone production. Post-mortem examinations of testicular tissue from 12 COVID-19 patients showed evidence of this type of damage.

🌭 Vascular system: Erectile dysfunction is associated with vascular (blood vessel) health. Vascular damage associated with COVID-19 “is likely to affect the fragile vascular bed of the penis.” The pro-inflammatory cytokines associated with COVID-19 have also been linked to clinical progression of ED.

💔 Effects on the heart: With the impact of COVID-19 on myocarditis, arrhythmias and other cardiovascular events, COVID-19 survivors are more likely to develop severe cardiovascular disease. This can impact ED directly as well as through cardiovascular treatments such as β-blockers and anti-hypertensive drugs.

🍆 Lung damage: Pulmonary fibrosis (scarring in the lungs) impairs lung function and oxygen saturation which may impact ED. Chronic lung diseases, including interstitial lung diseases and chronic obstructive pulmonary diseases (COPD) are associated with ED.

Overall, most of the plausible biological impacts of COVID-19 on erectile dysfunction overlap significantly with the other serious potential long-term effects on the lungs and cardiovascular system. We hope our followers take these risks seriously and minimize their risk of infection *regardless* of a potential link with sexual dysfunction.

BUT, if the specter of ED is an additional motivator to be safe… by all means keep it up!

The Nerdy Girls


Potential biological mechanisms linking COVID-19 and ED (summarized above)

Evidence for Long Covid

Interview with Dr. Dena Grayson

Link to original FB post