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Sex & COVID

Dr. Lisa Lawless

Dr. Lisa Lawless, CEO of Holistic Wisdom
Clinical Psychotherapist: Relationship & Sexual Health Expert

Finger people wearing masks eating

An Evolving Virus

This article was last updated 2-22-24

There is a great deal of misleading information about COVID, so we get our data from leading epidemiologists to ensure that what we report is as up-to-date and as accurate as possible. 

COVID is constantly mutating; thus, COVID information is changing all the time. As we learn more about it and vaccines are evolving, we will update this page. Should you have any concerns about it, you should speak with your healthcare provider about the latest information and how it may impact your personal health.

As for information, we still don't know a lot about the impacts that COVID has had on sexual health. There are small and short-term studies that have been done, and there are some more extensive long-term studies still in progress. The psychological, immunological, and systemic effects of COVID are still not well understood.

What we do know is that it has been impacting those who are elderly, immunocompromised, and disabled much more dramatically. See related guides:

Sexual Functioning & COVID

You are not alone if you or someone you know is experiencing sexual issues due to COVID. Because COVID affects the circulatory system, which is directly linked to sexual functioning, it makes sense that sexual functioning would be affected in some people. The primary health factors surrounding COVID-related sexual dysfunction are vascular issues, psychological impacts, and overall health deterioration.

There is still a great deal of research needed, but sexual health issues that have become of concern are vaginal dryness, testicular pain, erectile dysfunction (ED), penis shrinkage, higher rates of sexual dysfunction, and loss of libido.

For those with a penis, the main concern has been ED due to cardiovascular and circulatory problems with damage to endothelial cells (they line blood vessels), which may also be damaged by the virus. For those with a vulva, COVID may potentially disrupt your mucus production, which can impact your vaginal lubrication.

Multiple studies have shown that women's frequency of sexual intercourse and satisfaction decreased after COVID-19 disease. It has not been determined what has explicitly caused these effects, but it should be considered as important as the issues surrounding ED.

How Is COVID-19 Similar To HIV?

Some people thought staying at home during lockdowns or wearing masks might weaken the immune system, but research shows that's not true. It's actually getting COVID-19, which can weaken the immune system. In fact, research has shown that it has similarities to the way that HIV weakens the immune system.

COVID Damages Our Immune Systems

While COVID-19 and HIV are very different diseases in terms of transmission, progression, and treatment, an NIH study has found a similarity in how these viruses can impact certain functions of the immune system. Specifically, COVID-19 infection damages the CD8+ T cell response, showing long-term damage to the immune system after infection, which is similar to hepatitis C or HIV infections.

What Does This Mean?

The similarity in the damage caused by these viruses suggests that COVID-19, much like HIV or hepatitis C, could have long-lasting effects on the immune system. This can mean prolonged recovery periods, increased vulnerability to other infections, and possibly other long-term health issues. So, the mystery illness or a cough that lasts well over a month that many are reporting could be just one of the countless repercussions of this.

The Heart Failure Pandemic & Sex

In December of 2023, Japanese researchers indicated that COVID-19 might lead to a higher risk of heart failure due to persistent viral infection in the heart, even in the absence of notable heart disease.

Because the heart plays a crucial role in sexual function, impairment in cardiac tissue could lead to difficulties in sexual performance, such as erectile dysfunction or decreased vaginal lubrication.

In addition, if one is taking medicine to address heart issues related to COVID-19, they may experience side effects like erectile dysfunction or reduced arousal from such medications.

COVID Pink Eye & STDs

One variant (Arcturus / XBB.1.16 subvariant) can cause "COVID eye," which is conjunctivitis (pink eye) and is very contagious by transmitting through the hand-to-eye spread.

Pink eye can be bacterial or viral, and "COVID eye" is viral. Thus, it is not related to the bacterial infections of conjunctivitis associated with chlamydia and gonorrhea. Viral conjunctivitis, on the other hand, can also be caused by herpes simplex virus, varicella-zoster virus, and other viruses like COVID.

Conjunctivitis and vision loss have been associated with COVID as far back as the original virus. The British Medical Journal discusses the loss of ocular nerve fibers as a symptom of long COVID. We know that the SARS-CoV-2 virus can be a virus capable of infecting nerve tissue (neurotropic) as it can infect neurons.

Most people experience this as a loss of taste and smell, but the SARS-CoV-2 virus can also infect the optic nerve and the surrounding tissue, which can cause vision disturbances and vision loss, along with severe headaches. Take these symptoms seriously and seek medical attention if experiencing visual disturbances.

It is not currently reported if COVID's viral pink eye can sexually spread to another partner based on genital contact. Thus, it is best to err on the side of caution, practice good hygiene, and avoid contact with others when experiencing symptoms of pink eye or COVID to prevent the spread of the virus.

Back To Normal?

COVID No Longer Considered A Public Health Emergency

After three years with over 6 million hospitalizations and 1.1 million U.S. deaths, the COVID public health emergency ended on May 11, 2023. But what does this mean?

COVID still exists, and it continues to kill people and cause long-term disabilities. Because COVID will no longer be considered a public health emergency, the data and tracking will be scaled back, vaccines and tests will no longer be free, and those eligible for Medicaid because of the COVID emergency will lose coverage (approximately 24 million people).

So what is really changing is the U.S. government's approach to COVID, which means less prevention and accessible care.

People Want To Move On

It is essential to acknowledge that we all wish we could get back to 'normal' in the world; however, persistent health issues may impact people even when they have mild cases of COVID, which affects sexual health, and life expectancy.

The world has changed due to SARS-CoV-2. Whether people are psychologically prepared to accept that is irrelevant because it is a reality. The world has been fundamentally altered and will continue to be different.

Repeat COVID infections can cause cumulative physical damage to major organ systems such as the liver, kidney, lungs, and heart. Elevated protein signatures typically predispose people and act as early indicators of Alzheimer's disease and dementia in individuals who have had COVID.

Post mild-COVID infections, immune system dysfunction, and dysregulation can persist for over a year. This could lead to numerous detrimental effects, but most likely, it's the reason we're witnessing an increase in viral, fungal, and bacterial infections which can also impact sexual health.

When people are immunocompromised or borderline immunocompromised, viruses mutate faster. System dysfunction and dysregulation underpin several other diseases like autoimmune disease and cancer. Those who are immunocompromised have significantly higher cancer rates, increased risks of STDs, decreased sexual desire and functioning.

The FDA has moved toward annual vaccination, but as we know, COVID isn't seasonal like influenza. While this may offset some of the harsher aspects of a winter surge, COVID infections occur year-round, with new mutations typically driving spring and summer waves. Therefore, we can anticipate harmful repeat infections in populations that aren't avoiding SARS-CoV-2.

The idea of returning to normal is comforting, something people really want to cling to, but it's simply not reality. Consequently, we can expect an increased disease burden in the future due to recurrent COVID infections which includes sexually related conditions.

Long COVID & Sexual Health

Data shows that repeated exposure to the COVID is one of the most significant risk factors for developing long COVID. Because the circulating strains are more resistant to antibodies than earlier strains, it can make it easier to get them again and again. Thus, if you keep catching COVID, you're increasing your chance of experiencing long COVID every time you get a new infection.

As of January 24, 2022, an estimated 57 percent of the world population has been infected with COVID at least once, although testing has dropped, so it is most likely higher than that number.

Experts indicate the risk of getting long COVID is around 5% to 20%. Given the current world population of approximately 8.05 billion people, the estimated number of individuals who could potentially develop long COVID is a minimum of 402 million to 1.61 billion as of 2023. The profound implications of long COVID have fundamentally reshaped our world on multiple fronts, including politics, finance, and public health.

  • Because we know that COVID impacts circulation, there has been a massive increase in erection issues and arousal and sexual performance in all genders which is also a result of long COVID. The data is harder to determine because many people do not associate their sexual challenges with COVID or are too embarrassed to discuss it.
  • COVID can cause immune system dysfunction and dysregulation, leading to increased viral and bacterial infections, autoimmune diseases, and cancer. This can also cause an increase in vulnerability to STDs.
  • COVID has caused life expectancy to drop worldwide, which is expected to continue. It is too difficult to develop an entirely preventative vaccine unless there is a major technological shift as the virus mutates too rapidly and it is all over the world mutating. Thus, this will continue to cause continued personal and macro socioeconomic impacts, which include sexual health issues.

Long COVID Can Last For Years

A Long COVID study published in May 2023 included 460 people with COVID, and it focused on the two-year report of Long COVID symptoms and whether or not these people could return to work.

These 460 people, all of whom had PCR-positive COVID, were hospitalized. They found that 40% still had post-COVID condition issues at four months. They followed them for two years, and one out of three people they studied still had problems two years later.

Over half of the people who could not return to work at four months could not return to work two years later. The main problems were profound issues with thinking, sensory-motor problems like feeling movement, strength issues, and intense fatigue that left them disabled with a tremendous inability to process things cognitively, perform their job, or carry out daily activities or exercise.

This shows us that Long COVID persists even two years later for too many people. Some of these people contemplate self-harm or suicide due to the long-term health changes they face. Mental health issues, such as depression, anxiety, and cognitive impairment, can impact sexual health as well, as it is all interconnected.

David Putrino, director of rehabilitation innovation at New York’s Mount Sinai Health System reported that of those with Long COVID, less than 10% of patients have stubborn symptoms that don’t fully get better. It seems many people’s symptoms eventually come back, especially if they catch COVID again.

Between January 2020 and March 2022, the New York State Insurance Fund (NYSIF) received 3,139 workers' compensation claims for COVID-19, with 977 of those claims reporting long-lasting symptoms; within this group, 71% of individuals required medical treatment or were unable to work for six months or longer due to their symptoms.

Out of the people who experienced long-term effects from COVID-19, around 40% were able to go back to work within two months but were still getting medical treatment, while about 18% (which is about 5% of all COVID-19 cases) couldn't return to work for over a year; the insurance company discovered that almost everyone who had other health conditions or was hospitalized when they first got infected had long-lasting symptoms.

Long COVID & Estrogen

Sex hormones may play a role in Long COVID symptoms, with less impact on children due to lower hormone levels. Women are twice as likely to get Long COVID as men until age 60 when their estrogen levels are much lower. Once women hit 60, they tend to be equal to men in long COVID rates. Thus, there are theories that long COVID may be an estrogen-associated autoimmune disease.

COVID & Immune System Suppression

A major concern regarding SARS-CoV-2 is its effectiveness in overcoming natural immunity. A growing number of studies show that not only can SARS-CoV-2 suppress the natural immune system, but it can evolve to do so even more efficiently, which is partly why so many of the new variants are so easily able to transmit.

This may impact how we fight off other diseases in the future. Thus, there are concerns that getting COVID can make us more susceptible to other diseases than before, such as pseudomonas, MRSA infections, black fungus (mucormycosis), Candida auris, Mpox (monkeypox) and hepatitis. If this is correct, it could also impact STD vulnerability.

COVID & Cancer

COVID is increasing cancer rates, and while some worry COVID vaccines cause cancer, that is simply not true. Let's explore why COVID raises cancer rates and address the myth that vaccines may be part of the issue.

An overwhelming amount of literature shows that COVID causes immune system dysfunction and dysregulation and may significantly cause damage to T cells and antigen-presenting cells which can contradict the cells' ability to produce interferon-gamma (IFNG).

IFNG is a key cytokine when fighting cancer, and T cells are a primary cancer and tumor-fighting type of cell in your immune system. This is why we are seeing an uptick in cancer after COVID infections.

We know that COVID infections attack the immune system, which causes dysfunction and dysregulation. We also know that this is not caused by COVID vaccines, nor is cancer. In fact, there is no known mechanism by which the mRNA spike protein vaccines can cause cancer.

Sexual Performance After COVID Vaccines

At this time, there's no research to suggest that the COVID-19 vaccines alter sexual performance. While some of the side effects, such as fatigue and mild malaise, can make daily routines more difficult and impact the desire to have sex, these symptoms are typically brief and quickly resolved.

While there have been concerns that COVID vaccines cause issues with sexual health, they have all been debunked. So far, COVID vaccines have not been shown to negatively impact sexual health related to pregnancy, menstrual cycles, erectile performance, or sperm quality through any legitimate study.

Menstrual Cycle & COVID

COVID Effects

It is difficult to know just how much contracting COVID affects women's menstrual cycles because depression and anxiety can impact it. The stress of dealing with a pandemic and now an endemic might be what is contributing to that but right now it is unknown.

It has been reported that 25% of patients who have confirmed cases of COVID have had altered bleeding. Active studies are attempting to better understand any impacts on menstrual cycles surrounding COVID. So far, there have not been any significant changes to sex hormone levels noted, and all cycle length changes went back to normal within two months.

COVID Vaccine Effects

It has been reported by the National Institutes of Health (NIH) that women who received COVID vaccines had a temporary increase in the length of their menstrual cycles but they were still within the range of normal variation.

COVID Sexual Transmission

Colds and flu can be considered sexually transmitted diseases, which means that in this case, so can COVID. COVID is not blood-borne, like HIV or hepatitis, and is not thought to be transmissible through semen or vaginal fluids, but the virus has been detected in the semen of people who have or are recovering from the virus so precautions may be taken by using condoms.

It does seem to be present in fecal matter in some cases, which may be a concern regarding anal transmission so again, condoms may help with prevention. COVID can be transmitted through inhalation of respiratory droplets and saliva exchange during kissing.

Ways To Reduce Risk Of COVID Sexual Transmission

  • Wash your hands and shower before and after sexual activity.
  • Minimize how many sexual partners you have.
  • Avoid sex partners with COVID symptoms.
  • Avoid fecal, oral transmission, semen, and urine.
  • Use condoms and dental dams during oral and anal sex.
  • Wear a properly fitted NIOSH-approved N95 or N100 mask during sexual activity.
  • Wash sex toys before and after using them.
  • Disinfect area sexual activity took place.

COVID: As A Mass Disabling Event

COVID has become a mass disabling event through significant portions of the population being impacted with long-term health issues. This has occurred through long COVID related health issues that last more than three months.

The statistics are overwhelming, with 1 in 13 adults in the U.S. (7.5%) who develop and have long COVID. However, those numbers can be even higher depending on one's pre-existing health, age, gender, ethnicity, sexual orientation, and identity.

Because long COVID can lead to long-term temporary or permanent disabilities, many of the ableist aspects of our society concerning the treatment and resources for the disabled have become even more emphasized.

Perhaps with so many more people struggling with disabilities, there will be a greater urgency to understand the challenges in accessing healthcare, education, resources, employment, and other services. At least, that is our hope.

Examples of sexual disabilities related to COVID:

  • Erectile dysfunction
  • Loss of libido
  • Vaginal dryness
  • Painful intercourse
  • Difficulty having an orgasm
  • Premature ejaculation
  • Anxiety or depression related to sexual dysfunction
  • Fatigue or weakness which may impact sexual activity
  • Cognitive or memory impairment affecting relationships and sexual function

Additional Effects

Access To Health Care

Because the world became overwhelmed with healthcare demands due to COVID, people could not access routine sexual health services, including STD testing, contraception, and prenatal care. Many people are still catching up on addressing their sexual health care needs.

Sexuality, Relationships & Mental Health

The pandemic caused significant stress, anxiety, and depression for many people, which impacted sexual health. Because stress often contributes to a decrease in libido, difficulties with sexual performance, and strain in relationships have occurred. There have been severe ramifications on how people were impacted sexually and in their relationships and these issues continue for many people.

Social Distancing & Isolation

The pandemic impacted people by causing strain in relationships for both those dating and in committed relationships. It contributed to a decrease in sexual activity for some, especially for those not living with a partner. Many cohabitating couples experienced a strain on relationships, which may have also contributed to less sexual activity.

Do You Really Have A Mystery Illness?

That "Mystery Illness" going around is probably COVID, even if you have tested negative, and here's why. Something's been going around, and no, it's not your average cold or even the flu.

And guess what? It's not showing up on COVID-19 tests either! Loads of us are feeling under the weather, and yet, are those COVID tests? They're coming back negative.

Here's the tea on why we might be missing the mark. Waste water tests show that COVID levels are crazy high, meaning many people have it, yet most claim they don't. So, what's the deal?

Testing 101

Some of us might be skipping tests or not doing them right.

Timing is Everything

Thanks to our immune systems getting a workout from past infections, the virus might be playing a slow game, flying under the radar and causing those tests to show a negative result when it's actually a big YES!

Location, Location, Location

Some tests are better than others because they provide more accurate results. This can be seen in tests that provide the option to swab cheeks and throats, which might catch the virus better.

COVID Makes Other Illness Worse

If it really is not COVID, here is why COVID may still be a factor. If you have had COVID, it is important to understand that it might have thrown your immune system for a loop. This means we could be more open to other illnesses, making a simple bug feel like a monster truck hit us.

So, if you're feeling icky, the smart move is to play it safe and act like it's COVID. Because right now, with the virus still throwing curveballs, it's better to be cautious than sorry. Stay safe, stay healthy!

Sex Toy Sales & COVID

During COVID, sex toy sales went up. This was especially true during the initial lockdowns, but they continue with a steady rise. The increase in sex toy sales may be related to the following:

  • Sex toys that offer virtual connectivity, such as Bluetooth Apps, became more popular as they allowed partners to connect despite physical distance.
  • Due to sexual dysfunction caused by long COVID, there has been an increase in sex toys that address erectile dysfunction (ED), as well as painful sex, such as moisturizing lubricants, dilators, and Kegel exercisers.
  • There was a lot of panic buying during this time, and people wanted to ensure that they would have sexual supplies. Supply chain issues kept some sex toys and lubricants out of stock, and there have been price increases in materials, making sexual products more expensive. This led people to want to buy sex toys and sensual products before being affected by these issues.
  • People were not able to meet in person and were utilizing sex toys to pleasure themselves as well as be able to use them with one another remotely through app sex toys.
  • Many recreational facilities where people go to have sex were closed, and people had to stay in. Buying sex toys to spice things up at home was something people seemed to be doing more.
  • Sex toys can help reduce stress through sexual release, and during this stressful period, people were reaching out for self-soothing behaviors.
  • People who have never had a sex toy found themselves buying their first sex toy because of some of the reasons stated above. This has introduced sex toys to a larger population and made them more popular.
  • There may be a correlation between sexual dysfunction and sales of sex toys. For example, penis rings which help with erectile dysfunction, increased in sales by 4.9%. However, there is no data to correlate the increase in sex toy sales directly with health issues related to the virus.

In Conclusion

While COVID can be a controversial topic, mostly because it is often politicized, the most important thing is making sure you protect your health. Being informed, avoiding misinformation, using critical thinking skills, and understanding the science of your overall health and sexual well-being should be a priority. Allowing the stress of it all can take a toll on us, so make sure to nurture yourself and do what is right for you.

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