The Tribune

By Dr Greggory Pinto

Statement: COVID-19 can lead to your death.

Response of many men: Only one percent might die

Statement: COVID-19 can kill your family

Response of many men: My family is strong

Statement: COVID-19 can cause a stroke

Response of many men: I don't live in fear

Statement: COVID-19 can cause erectile dysfunction

Response of many men: Hold on ... let me go get my mask and hand sanitiser. Please keep six feet away from me!

COVID-19 can unfortunately lead to erectile dysfunction, both during the time of having the virus and possibly even after recovery from it.

Erectile dysfunction involves the inability to achieve or sustain a satisfactory erection, with possible low sexual libido or premature ejaculation.

Erectile dysfunction is a complex issue with several physiological and psychological mechanisms at play.

In its simplest terms, there are four necessary contributors to have a normal erection. These four contributing factors are blood supply, nerve supply, testosterone and the emotional/psychological component.

COVID-19 can negatively impact each of these four factors and thus lead to erectile dysfunction.

The respiratory symptoms of COVID-19 are well-known, along with common complications such as fever, fatigue and the possible loss of taste and smell. Long-term effects of the novel coronavirus may include many negative health issues, including respiratory, neurological complications and erectile dysfunction.

A scientific article in the Journal of Endocrinological Investigation found a correlation between COVID-19 survivors and erectile dysfunction. The published research found that erectile dysfunction is a perfect biomarker of general physical and psychological health.

The risks factors for developing COVID-19 complications are the same predisposing health conditions that can lead to erectile dysfunction, such as obesity, diabetes, hypertension, cancer, cardiovascular disease and advanced age.

COVID-19 sadly leads to people with underlying health issues to have more severe, acute and long lasting complications. Long-term complications include possible scarring and fibrosis of penile erectile tissue, in addition to other erectile dysfunction complications.

Inflammatory response to COVID-19

Chronic inflammatory effects of COVID-19 play a role in erectile dysfunction. Erectile dysfunction is related largely to poor blood supply to the penis, so it is expected that conditions that impair blood supply, such as COVID-19, will lead to erectile dysfunction.

The response of the body to the COVID-19 virus can lead to a hyperinflammatory state whereby small blood clots are formed and inflammation of the lining of blood vessels occurs. Impaired blood supply secondary to small blood clots impeding blood supply and inflammatory degradation of blood vessels will lead to poor quality erections and difficulty maintaining erections.

COVID-19 causing lower testosterone

The novel coronavirus can negatively impact the testicles and reduce the production of testosterone by the testicles and further negatively impact erectile function. There are two ways that lowered testosterone levels related to COVID-19 can interfere with erectile function; testosterone is necessary for normal erectile function so low testosterone will lead to poor erections.

Secondly, testosterone aids in suppressing body inflammatory responses so lower testosterone levels will mean inflammation is suppressed to a lesser degree so inflammatory molecules will cause more severe damage to blood vessels. Damage to blood vessels to the penis will further worsen erections.

COVID-19 related stress, anxiety and depression

A October 2020 published research article linking COVID-19 and erectile dysfunction in the Journal of Sexual Medicine involved examining the anxiety and depression levels of 7,000 Italian men who never contracted the coronavirus. The research examined the mental health issues related to COVID-19 lockdowns and their relationship to erectile dysfunction. The global pandemic has led to high levels of anxiety, stress and depression that has led to an upsurge in erectile dysfunction.

It must be stated that having erectile dysfunction does not mean you have COVID-19. Erectile dysfunction to some degree is quite common and caused in the vast majority of cases due to health conditions unrelated to the coronavirus.

There is no evidence and zero concerns that the COVID-19 vaccine could cause erectile dysfunction.

Wear a mask, practice physical distancing and maintain proper hand hygiene.

COVID-19 can potentially be devastating and even life-threatening. Unfortunately, erectile dysfunction is one of a long list of medical complications COVID-19 can cause.

No matter what the cause or causes of your erection problems, you can always rise again.

The greatest tragedy is continuing to suffer in silence and not seek a solution.

• Dr Greggory Pinto is a board certified Bahamian urologist and laparoscopic surgeon. He has trained in Germany, South Africa and France, and is a member of the European Association of Urology. He can be contacted at OakTree Medical Center, #2 Fifth Terrace & Mount Royal Avenue. Telephone: (242) 322-1145 (6) (7); e-mail: welcome@urologycarebahamas.com, or visit the website:www.urologycarebahamas.com.