As the world takes stock of the impact of Covid-19, even while contemplating and preparing for waves and variants, there has been early research into the relationships between Covid and erectile dysfunction and that between testosterone and severity of Covid.

The headlines have, of course, been grabbed by research published in the New England Journal of Medicine in August, which suggests that 10 to 30 percent of those infected with the virus could experience ongoing debilitating symptoms that may cause “significant disability.”

Separately evidence seems to be mounting that within the longer term impact men's sexual wellness is a big contributor. Recently, in an interview with National Geographic, Dr Ranjith Ramasamy, a urologist at University of Miami Hospital’s urology clinic, mentioned evidence that men who did not have any erectile dysfunction before contracting Covid-19, have experiences severe versions of the condition since.

Interwoven with the increasing evidence around ED, has been the emerging narrative around the linkage of testosterone with severity of Covid-19. Early on during the pandemic, in March and April of 2020, it was hypothesised that higher testosterone is linked to increased severity of symptoms, as men were over-represented in the worst outcomes. That hypothesis has not held since, as it has been found that men with lower testosterone had worse experiences after contracting the virus than those with higher testosterone.

Now the direction of cause and effect seems to have reversed with findings of lower testosterone in men who have recovered from Covid-19. According to research by Salonia et al, published in the journal Andrology, "Overall, a significantly lower levels of LH and tT were found in patients with COVID-19 compared to healthy controls (all p < 0.0001); conversely, healthy controls depicted lower values of circulating E2 (p < 0.001)."

This body of research will continue to grow, but what seems quite clear is that sexologists will have a significant role to play as the world emerges from this pandemic.

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