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For a respiratory illness, Covid-19 causes some strange symptoms. It can diminish their sense of smell and taste, leaving patients with discolored “Covid toes” or even a swollen, bumpy “Covid tongue.”

Now scientists are examining a possible link to a completely unexpected consequence of Covid: erectile dysfunction. A link has been reported in hundreds of articles by scientists in Europe and North America, as well as in Egypt, Turkey, Iran, and Thailand.

Estimates of the magnitude of the problem vary wildly. D., director of reproductive urology at the University of Miami Desai Sethi Institute of Urology. An article by Ranjith Ramasamy and colleagues found that the risk of erectile dysfunction increased by 20 percent after a match with Covid. Other researchers have reported significantly higher increases in this risk.

Patients complained of erection problems and Dr. When they first started coming to Ramasamy’s clinic, “We refused, thinking it was purely psychological or stress related,” he said.

But over time, he and other doctors began to see a pattern, he said. Writing several articles on the subject, Dr. “Six months after the initial infection, patients improved overall, but continued to complain of these issues, including both erectile dysfunction and low sperm count,” Ramasamy said.

At the start of the pandemic, Professor of endocrinology and medical sexology at the University of Rome Tor Vergata, Dr. Emmanuele Jannini reported that there is a strong link between erectile dysfunction and Covid. When he compared the men who had Covid with those who did not, he found that those who were infected became sick. were about six times more likely to report impotence like those who avoid the coronavirus.

Dr. “To convey that the disease can affect your sex life is an extremely powerful message, especially for men who are resistant to vaccination,” Jannini said in an interview. “The evidence is very strong.”

Research from imaging scans and biopsies shows that coronavirus can infect tissue in the male genital tract and linger long after initial infection. Scientists say it’s too soon to be sure the link with erectile dysfunction is causal, as many factors – physiological as well as psychological – play a role in creating and maintaining an erection. The pandemic has led to social isolation and an increase in anxiety and depression, all of which may play a role.

Writing an article about the negative effects of Covid on men’s health, Dr. “Men’s erections are more complex than people think,” said Justin Dubin.

“You need good blood flow, you need nerves to fire, and you need good hormone levels, especially testosterone,” he said. “But you also need to be in a good mood and also need to be stimulated. If any of these go wrong, you may have trouble getting an erection.”

A professor at the Florida College of Dentistry, Dr. Joseph Katz said that in this sense, the pandemic is a perfect combination of convergent factors causing erectile dysfunction. Dr. Katz came across the topic of erectile dysfunction while researching the effects of Covid on oral health.

Some researchers think that erectile dysfunction may be linked to the well-documented loss of taste and smell ability experienced by Covid patients because these senses play an important role in sexual arousal. “Ignition of the arousal mechanism in the brain occurs through smells.” three Italian urologists wrote in a letter last year Dr. Responding to Jannini’s article.

At the very least, men need healthy blood vessels and good blood flow to develop and maintain erections. Because the coronavirus binds to molecular receptors abundant in endothelial cells, it can damage blood vessels and the lining of vessels called endothelium.

The veins may not narrow and stretch as needed to allow blood flow to the penis. Injury to blood vessels can also contribute to more serious complications of Covid, such as heart attacks, strokes and abnormal clotting.

Director of the men’s health center at the University of California, San Diego, Dr. “Our entire vascular system is connected – it’s not an isolated penile issue,” said T. Mike Hsieh.

However, vascular problems may occur first in the genitals because the veins there are very small. (For cardiovascular disease, Dr. Jannini calls erectile dysfunction “the canary in the coal mine.”) Erectile dysfunction and cardiovascular disease share risk factors such as being overweight, having metabolic diseases such as diabetes, smoking, and advanced age, which in turn leads to severe Covid-19. possibility of.

“The penile artery is one-tenth the size of a coronary artery, and when your artery is narrower, whether it’s a plumbing issue or a vascular issue, it will show up there first before you see it in a larger artery,” Dr. Hsieh said.

Erectile dysfunction can precede a heart attack by about five years, he said, and may be an early sign that there are other underlying risk factors.

Dr. “When I see a guy for erectile dysfunction, they just don’t get a prescription for Viagra or Cialis,” Hsieh said. They are referred to a primary care colleague or a cardiologist to make sure their cholesterol is under control, that their diabetes is under control, and to discuss weight management, lifestyle or dietary changes.

Dr. Jannini said that long-term erectile dysfunction can lead to a better diagnosis of Covid, even worsening mental health.

Dr. “If you have a patient who has recovered from Covid and you want to know if they have had Covid for a long time, ask him how he went in bed,” Jannini said. “If he has a normal sex life, the probability of having serious long-term Covid is very, very low.”

If left untreated, erectile dysfunction can lead to further complications. cases Peyronie’s diseasea condition that causes curved, painful erections as a result of fibrous scar tissue forming on the penis and orchitis, inflammation According to a published study, one or both testicles develop in men infected with Covid.

Men who do not have normal erections for several months at a time can develop scar tissue and fibrosis, making erectile dysfunction difficult to treat and may even result in shortening of the penis.

Erectile dysfunction may resolve on its own, but Dr. Hsieh encouraged men with symptoms to see their doctor, before it was too late.

“If you’re having these problems, don’t wait,” she said. “For the most part, we can get men’s sex lives back.”