How? Coronavirus infection is already known to damage blood vessels, and vessels that supply blood to the penis appear to be no exception.
Researchers armed with an electron microscope found coronavirus particles in penile tissue samples taken from two former COVID-19 patients who became impotent following their infection, which had occurred six and eight months earlier.
Further study revealed evidence of blood vessel damage in the penises of the COVID-19 patients, compared to two other men with erectile dysfunction who'd never been infected, the researchers reported May 7 in the World Journal of Men's Health.
"We found that the virus affects the blood vessels that supply the penis, causing erectile dysfunction," said senior researcher Dr. Ranjith Ramasamy, director of the reproductive urology program at the University of Miami's Miller School of Medicine. "The blood vessels themselves malfunction and are not able to provide enough blood to enter the penis for an erection."
Ramasamy compared this to organ damage in the lungs, kidneys and brain that's been found in COVID-19 patients.
"We think the penis also could be affected in a similar way," Ramasamy said. "We don't think this is a temporary effect. We think this could be permanent."
The new report focused on two recovered COVID-19 patients undergoing penile prosthesis surgery for their erectile dysfunction. Both men had normal erectile function prior to their infections.
One of the men had been severely sick with COVID-19 and spent two weeks in the hospital before he recovered, but otherwise was free from chronic health problems.
The other man had a relatively mild case of COVID-19, but suffered from clogged arteries and high blood pressure before becoming infected.
Both men still had COVID-19 particles in their penile tissue, as well as evidence of endothelial dysfunction — a condition in which the linings of small blood vessels don't function properly and fail to provide adequate blood supply to different parts of the body.
By comparison, two COVID-free men also undergoing surgery for erectile dysfunction had no evidence of the same sort of small blood vessel damage in their penises.
"I think this is probably not something men are discussing right now with all of the things that are going on," Ramasamy said. "I'm fairly certain in the next six months to one year we will probably get a better sense of the true prevalence of erectile dysfunction among COVID-positive men."
It makes sense that COVID-19 could affect men in this way, given the virus' ability to cause inflammation and damage blood vessels, said Dr. Ash Tewari, chair of urology at the Icahn School of Medicine at Mount Sinai, in New York City.
However, Tewari cautioned that men shouldn't panic until more research has been done.
"One or two patients don't make a fact, but this is worth investigating from our standpoint," Tewari said. "COVID is an endothelial dysfunction. The small arteries of the heart can get impacted in the same way that the penile blood vessels can get impacted."
Ramasamy urged former COVID-19 patients now suffering from erectile dysfunction to seek medical help.
"Don't think this is something that's going to go away on its own. We think this could be a long-lasting effect, and not a temporary one," Ramasamy said.
There's one other piece of advice he has for men worried about this.
"Don't get COVID. Get vaccinated, so you don't get COVID," Ramasamy said.
The Cleveland Clinic has more about COVID-19 and erectile dysfunction.
SOURCES: Ranjith Ramasamy, director, reproductive urology program, University of Miami Miller School of Medicine, Miami; Ash Tewari, M.D., chair, urology, Icahn School of Medicine at Mount Sinai, New York City; World Journal of Men's Health, May 7, 2021, online