Erectile DysfunctionHealth News

Erectile dysfunction after Covid-19

On March 11, 2020, the WHO declared the COVID-19 outbreak a pandemic, which became a serious test for the healthcare system, entailed unprecedented measures to reorient multidisciplinary and specialized clinics to increase the possibilities of providing medical care to patients with coronavirus infection, suspending planned operations, limiting inpatient and outpatient care for seriously ill patients, what should patients with erectile dysfunction do?

Currently, along with the continuing high incidence rate, the immediate and long-term consequences of COVID-19 for public health are becoming increasingly relevant. Globally, the outcomes and complications caused by the SARS-CoV-2 virus have yet to be fully determined. However, already today doctors of different specialties are faced with patients presenting complaints that may be related to the infection.

While conducting a consultative urological appointment, we drew attention to a significant number of patients who complain of sexual disorders, which they chronologically clearly associate with a COVID-19 infection.

Currently, there are no generally accepted ideas about the impact of COVID-19 on men’s health in general and erectile function in particular. In this regard, we regarded this problem as of scientific and practical interest.

Erectile dysfunction and Covid

During the period of seeking urological help, 14% of patients had sexual contacts with a frequency of 1 act per week, 27% had 1 act in 2-3 weeks, 59% had sexual contacts stopped. Thus, in 26 (59%) patients there was no sexual life, in 18 (41%) it was preserved, but with a significant decrease in the frequency and quality of sexual acts.

The main complaint of patients who retained sexual contacts was the inability to vivid emotional experiences and reactions.

If the sexual act was prolonged at least slightly, it was impossible to concentrate on the process due to various thoughts unrelated to sexual actions. Then came the strongest physical fatigue and mental irritation, combined with minor aggressiveness.

In the case of reaching orgasm, 100% of respondents noted the lack of brightness of sensations, which was before COVID pneumonia.

The diagnostic complex included physical examination, general blood and urine tests, biochemical blood examination, ultrasound examination of the prostate gland and scrotum organs, examination of the level of common prostate-specific antigen, hormonal status study – the total level of testosterone, luteinizing hormone, prolactin was determined.

The exclusion criteria were formulated in such a way as to eliminate as many known factors that can affect erectile function (erectile dysfunction) as possible, in order to most reliably assess the impact of a directly transmitted COVID infection. In accordance with this principle, the study did not include patients with severe concomitant diseases (diabetes mellitus, coronary heart disease, grade 3 obesity, tumor diseases, etc.), pronounced symptoms of lower urinary tract dysfunction, patients younger than 18 and older than 65 years, patients without a permanent sexual partner, as well as those who had hypogonadism diagnosed before COVID-19 disease.

What is the result?

The spectrum of the obtained data turned out to be quite homogeneous, due to a set of exclusion criteria. In general, the following are the most significant points.

No significant pathology was revealed in the physical examination of the men who applied. General clinical blood and urine tests, the results of biochemical blood tests in the examined cohort were within normal limits.

In order to systematize patients, analyze the causes of complaints and develop a therapeutic approach, the testosterone level as the main regulator of male sexual function was taken as a basis.

A decrease in libido and erection without the detection of laboratory markers of hypogonadism is probably the easiest form of such disorders and the most understandable in pathogenetic terms. In our opinion, these are patients with clinically significant asthenic syndrome after undergoing COVID-19.

The topic of viral lesions of the organs of the male reproductive system with negative consequences for fertility and the erectile component is not new for urological practice. The connection of reproductive disorders with the infection of mumps, herpes, papillomavirus, HIV and others, which to one degree or another cause disorders of spermatogenesis, is well known.

erectile dysfunction in 2022

Conclusions

COVID infection can have a negative impact on erectile function, but Viagra and other pills are able to cope with these disorders (not psychological).

The main causes of developing erectile dysfunction are a decrease in testosterone levels, endothelial dysfunction and prolonged asthenization.

However, a decrease in testosterone levels, as well as damage to the vascular endothelium, can be reversible, transient, as evidenced by the possibility of rehabilitation against the background of taking antiasthenic agents and PDE-5 inhibitors. According to our observations, it is with these funds that therapy should be started in the situations under consideration and only if there is no effect – add testosterone preparations.

The conducted research concerns only some aspects of the big problem of assessing the impact of COVID-19 on men’s health. In the context of the ongoing pandemic and the inevitable increase in the number of ill patients, further comprehensive studies are needed to clarify all the details and organize adequate andrological care for these patients.

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