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Sadly, 'Covid Dick' Is Real

A man's claim that his penis shrank after a bout of covid-19 isn't far-fetched, though the risk may be low in general.

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Photo: Roberto Machado Noa/LightRocket (Getty Images)

It seems we can add sexual dysfunction to the long list of unexpected and unpleasant effects of the coronavirus. Thankfully, this doesn’t appear to be a common occurrence, and there are some potential remedies that those afflicted can try.

This week, the Slate-run sex advice podcast How to Do It discussed the harrowing tale of an anonymous letter writer who was suffering from what’s come to be known as “covid dick.” The writer, who identified as a heterosexual man in his 30s, said that he had gotten very sick and was hospitalized from covid-19 last July. After he was discharged, he began experiencing erectile dysfunction (ED). Though his symptoms did improve after seeing a doctor, the man reportedly was left with a glaring reminder of his ordeal. Describing himself as above average in penis size before covid-19, he said that his penis had now shrunk about 1.5 inches and that he had “become decidedly less than average.”

The podcast hosts, to their credit, also interviewed a pair of urologists who rightly noted that there’s a clear trail of evidence linking covid-19 to erectile or sexual dysfunction. A study this past November, for instance, found that men with covid-19 were about three times as likely to develop a new case of ED than those who didn’t catch covid-19. Some research has suggested that the risk may be nearly six times higher, yet other estimates are smaller, suggesting around a 20% increased risk. A small percentage of people with long covid, including women, have also reported sexual dysfunction as one of their symptoms. And sometimes, ED can indeed lead to shrinkage, especially if it’s caused by physical damage and scarring that causes the penis to stop becoming regularly erect.

There are a few theories as to how covid-19 can cause ED. The infection can possibly reach penile tissue and directly damage the surrounding blood vessels. It may also be due to the indirect effects of infection on the immune system, which may trigger damaging inflammation. (An overreacting immune system and blood vessel damage are also the prime suspects behind “covid toes.”) And the experience of hospitalization in severe cases can take a toll on the body, penis included. The risk of ED from blood vessel damage is probably greater in people who already have other relevant health conditions that can affect circulation, such as type 2 diabetes. Many cases of ED can also be chalked up to stress and anxiety, and covid survivors are unfortunately at higher risk of experiencing that as well.

That said, age is by far the largest risk factor for ED, with as much as 70% of men experiencing some level of it by their 70s. And while we don’t seem to have solid data on the actual prevalence of covid-related ED, it doesn’t appear to affect a huge proportion of men. The November study, for instance, found that slightly less than 5% of men in the sample were diagnosed with ED after covid-19.

As the Slate hosts note, there are readily available treatments for ED, such as the drug sildenafil (Viagra). And even a shrunken penis can be treated or prevented through what one urologist refers to as “penile rehab,” which can involve stretching exercises and/or penis-pumping devices. So not all hope is lost if you’re worried about the dreaded covid dick. And for the record, there’s no evidence at this time of a link between ED and getting vaccinated for covid-19.