Can COVID-19 or the Vaccine Cause Erectile Dysfunction?

If you’ve been following news about the pandemic, you may have heard that COVID-19 can cause erectile dysfunction (ED). While it may sound like an odd side effect, the data continues to grow. And now that vaccines are available in the U.S., you may be wondering if vaccination can also cause ED. Here’s what we know so far.

COVID-19 and ED

As early as June 2020, studies showed a link between COVID-19 and ED. This was an unexpected finding since people who were sick with COVID-19 were mainly having lung and respiratory symptoms. Ongoing research demonstrated that the COVID-19 virus attacks the endothelium. The endothelium is the lining of all blood vessels, like veins and arteries, in the body. The process is complex, but basically, when the endothelium is damaged, blood vessels don’t work properly and can’t deliver oxygen and other nutrients to the body’s organs. Without them, organs can’t function as well.  And since all organs have blood vessels, the COVID-19 virus could cause damage to any organ in the body this way — including the penis. 

Besides direct damage to the blood vessels in the penis, there are other potential ways that a COVID-19 infection can contribute to ED. These include: 

• Potential damage to the heart and lungs

• Low testosterone levels 

• Mental health problems related to the pandemic, whether people get COVID-19 or not

COVID-19 can cause direct damage to the penis

Science established damage to the endothelium as a cause of ED over a decade ago. When people first started reporting ED following COVID-19 infection, scientists began searching for evidence that COVID-19 was damaging endothelium in the penis. This can be difficult to prove since tests need to be run on penis tissue samples. However, one study was able to show that the COVID-19 virus can be found in penile tissue and blood vessels after the infection resolves. 

Although this study only included four people, it was able to show that men with COVID-19 had endothelial damage in their penis. At the same time, because this was such a small study, it is unclear how relevant it is to the whole population.    

COVID-19 causes heart and lung damage

COVID-19 can cause damage to the lungs and heart, including attacking the endothelium in these organs. While this isn’t directly related to the endothelium in the penis, scientists are working to show that this may contribute to ED. 

Damage to the heart and blood vessels throughout the body are known to cause ED, regardless of whether blood vessels in the penis are involved or not. This is because any blood vessel that is damaged can make it difficult for the blood to flow to the penis. Since COVID-19 causes inflammation and damage to blood vessels, this is one way the infection can lead to ED. 

In fact, ED sometimes might be the only physical symptom of more widespread blood vessel inflammation and damage. That’s why healthcare providers encourage people with ED after COVID-19 infection to speak up. Doing so could help them find and treat potentially more widespread blood vessel disease. 

COVID-19 infection also damages the lungs, which can make it difficult for the body to get the oxygen it needs. The relative lack of oxygen in tissues can also make it difficult for the body to achieve an erection. 

Scientists are still researching how COVID-19’s effects on the heart and lungs can lead to ED. Without direct evidence, we can’t be certain that heart and lung damage from COVID-19 gives rise to ED. 

Lower testosterone levels due to COVID may cause ED

The COVID-19 virus attacks a protein called ACE-2. This protein is found in high numbers on the surface of many cells, including cells in the testicles. Testicles are responsible for making testosterone and other important hormones involved in sperm creation. As a result, scientists think that COVID-19 can lead to issues with sex hormone production. 

One study showed that men with COVID-19 had some damage to cells in their testicles. Other studies also indicated that men with COVID-19 infection had lower levels of testosterone and other hormones important for sperm production. Overall, these studies were careful to point out that a direct relationship between COVID-19 infection and these outcomes has yet to be fully established. 

Mental health, ED, and COVID-19

Finally, it goes without saying that coping with the pandemic has caused many people to have trouble sleeping, depression, and anxiety. This heavy burden can have a major impact on sexual activity and desire; and in turn, it can raise the risk of ED in people who’ve had COVID-19. 

But studies are also showing that just being exposed to the pandemic can create enough stress to cause ED. A group from Turkey studied 159 male healthcare workers who worked in COVID units. These workers reported higher rates of post traumatic stress disorder (PTSD) and sexual dysfunction, including ED, than male healthcare workers who did not work in COVID units. 

Another study from Turkey, found that people were more likely to report sexual health issues, including ED, during the COVID-19 pandemic — this was true even among people who did not get infected with COVID-19. 

COVID-19 and long-term damage to the penis

The CDC has stated that certain long-term health concerns from COVID-19 should be expected and will need ongoing care. However, ED is not listed as one of those problems at this time. A publication in The Lancet that looked at survivors 6 months after a COVID-19 infection did not list sexual issues as ongoing problems that affect men. 

However, initial findings from another study suggest that ED can potentially be a short-term or long-term effect of COVID-19. This is because COVID-19 infection may result in continued cardiovascular and pulmonary issues, or issues that affect the heart and lungs, respectively. As mentioned earlier, since COVID-19 can contribute to ED by potentially damaging blood vessels or lowering oxygen circulation in the body, sexual dysfunction can potentially be a long-term consequence.

Remember, there isn’t enough research indicating that COVID-19 causes long-term damage to the penis. More studies are needed to determine if ED following COVID-19 can be a long-term issue or if it’s temporary.

Can the COVID vaccine cause erectile dysfunction?

None of the manufacturers of COVID-19 vaccines listed any issues related to sexual health or ED in their reports. The clinical trial data from the Moderna, Pfizer-BioNTech, and Johnson & Johnson vaccines show that the shots may cause pain or swelling where you received the vaccine. Other side effects can include:

• Nausea

• Vomiting

• Headache

• Chills

• Fever 

But there is no evidence suggesting that COVID-19 vaccines can cause ED or damage to the penis or testicles.  

Additionally, the Vaccine Adverse Event Reporting System (VAERS) has not released any information that links COVID-19 vaccinations to ED. The VAERS system is a national tool that monitors adverse reactions to all vaccines. Raw data is available to the general public and a summary is reported by the CDC. Currently, the CDC is monitoring several possible complications of COVID-19 vaccines. ED is not one of them. 

Can the COVID-19 vaccine affect sperm count or male fertility?

At this time, there is no evidence suggesting that COVID-19 vaccines impact sperm count. Two small studies looked at sperm counts following COVID-19 vaccination.

One study from the University of Miami examined sperm counts before and after COVID-19 vaccination. The study looked at both the Pfizer and Moderna vaccines and found no differences in sperm production. Another study, that has not yet been published, showed the same results. The CDC also states that COVID-19 vaccination is safe and does not affect fertility in males or females. 

Given that no correlation has been established between the COVID-19 vaccines and ED or sexual dysfunction, several health organizations encourage people who meet vaccination criteria to get their shots. 

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Written by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

Reviewed by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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