Impact of the COVID-19 Pandemic & Vaccines on Men's Sexual Health

In this episode of BackTable Urology, Dr. Aditya Bagrodia and Dr. Ranjith Ramasamy discuss the effects of the COVID-19 pandemic and COVID vaccines on various men’s health topics, including testosterone levels, erectile dysfunction, and male fertility.

First, Dr. Ramasamy discusses the effects of COVID-19 on hypogonadism. He notes that in the initial stages of the pandemic, many providers attributed low testosterone levels as result of a sedentary and less active lifestyle because of the lockdown. However, it was later discovered that the SARS-CoV-2 virus binds to the ACE2 receptor, an important receptor present on the surface of testosterone-producing Leydig cells. Thus, temporary testosterone deficiency is a direct impact of COVID-19 infection. Dr. Ramasamy advises his recovered patients to naturally increase their testosterone levels by eating, exercising, and sleeping well.

COVID-19 is also linked to higher rates of erectile dysfunction. Dr. Ramasamy explains that the cause of ED may not be psychogenic, as the SARS-CoV-2 virus affects endothelial cells lining blood vessels. Studies have also shown that the virus can be present in penile tissue seven to 9 months post-infection. As a result, Dr. Ramasamy urges urologists to differentiate between psychogenic and vasculogenic erectile dysfunction.

Next, the doctors discuss the impact of COVID-19 on fertility. Research has shown that a COVID-19 infection may decrease sperm count in semen three to six months post-infection. Most patients have normal sperm counts after 6 months. Although birth rates have declined due to the uncertainty during the pandemic, Dr. Ramasamy notes that more male patients have requested fertility consultations with him as a proactive family planning measure.

Finally, Dr. Ramasamy uses evidence-based medicine to debunk myths about the mRNA COVID-19 vaccination on male sexual and gonadal function. He cites his most recently published article, “Sperm Parameters Before and After COVID-19 mRNA Vaccination” (JAMA) and emphasizes that there is no link between the vaccine and declining sperm count.