Making Sense of Medical Science (MSMS)

"It's not hard, (it's not hard)"

–from the song, Piano, by Ariana Grande

COVID is very strange. Earlier I reported that the SARS-CoV-2 virus, which causes COVID-19, a mostly respiratory disease, also messes with one’s gut health. Elsewhere in these pages, I have also discussed the relationship between COVID and new-onset diabetes type 1, Parkinson’s disease, cancer, dementia, and cardiovascular problems. That is quite a panoply of symptoms unrelated to respiratory disease. We now can also add to that complex array of health problems caused by a respiratory virus, broad effects on the male reproductive system. Ouch!!

Several reports (here, here and here) together report that COVID-infected men often complain of the following several symptoms related to male genitalia:

• Testicular pain
• Erectile dysfunction (ED)
• Reduced sperm count
• Decreased fertility
• Smaller penis size
• Decreased sexual drive
• Swelling
• Prolonged erection

How in the world does a respiratory virus affect all this in the male reproductive system to cause what is sometimes referred to as “COVID penis?” 

Well, we now know that the organs of the male reproductive system, including the prostate, testicles, and penis actually can be infected by the COVID virus and, thus, have their functions compromised. This can lead to erectile dysfunction, decreased testosterone, and reduced sperm levels in 60-75% of infected patients (see here, here)

The fact that a respiratory virus can widely infect men’s junk recently was shown by research from Northwestern University. The study used body scanning technology to surprisingly show that the CoV-2 virus had infiltrated the entire male genital tract of infected monkeys (including the prostate, persimmons, and tallywhacker). From these results, the investigators concluded that the manifold reproductive problems linked to COVID-19 are not secondary effects of fever or inflammation but rather a direct result of the virus infecting cells throughout the male reproductive system. It is believed that CoV-2 infection of reproductive tissues can make the organ’s small blood vessel linings not function properly, which then causes reduced blood supply leading to ED, maybe shrinkage, and the other consequences.

Medical researchers at the University of Florida Health found that men with COVID-19 were more than three times more likely to be diagnosed with erectile dysfunction than those who didn’t have COVID.

A July 2024 review of 16 articles involving 1250 men with active or recent COVID infection  and 1232 healthy controls confirmed that sperm count and motility are significantly reduced in infected men. The results also showed reduced testosterone levels and abnormalities in other hormones affecting sexual function. The fact that COVID has such broad effects on the male reproductive system raises a concern that the disease could be sexually transmitted. Fortunately, no COVID mRNA was found in the semen of any of the infected men, which suggests a low possibility of sexual transmission of the virus.

Another question all of this raises is how long do these effects on men’s reproductive health last. The good news is that two studies published in 2023 and 2024 showed that the reduction in sperm count caused by COVID was transient. Sperm returned to normal levels and motility 3-6 months after infection. How long other problems persist is less  at this time.

All of this information provides yet another good reason to make every effort to stay current with the COVID vaccinations.

It is not hard.