We are living in a time of monsters, doing battle with wily viruses and putting up kaiju* tracking stations. But tracking does not help when defenses are not erected. The maps are bleeding red, especially in the South, and many people are hardly blinking as county after county goes down. COVID exhaustion is setting in for portions of the population, especially the vaccinated who figure they are safe. Many vaccinated Americans have decided the unvaccinated are not their problem, except for the risk of contagion they may pose.

An M.D. friend of mine recently shared a strategy for outreach that she thought might work to cut through vaccine hesitancy. Forget about oxygen levels, coughs and fever. She wanted to go straight for the test results that might cut through that Tucker-Carlson-glaze of irreality: sexual dysfunction. The evidence is mounting that COVID-19 can cause erectile dysfunction and even possible infertility (SARS-CoV-2 and Male Infertility: Possible Multifaceted Pathology – PubMed (nih.gov)).

For an unfortunate group of COVID-19 sufferers, one manifestation of COVID-19 is hyperinflammation, along with blood clots, little clots and sometimes bigger clots. Tony-nominated Broadway star Nick Cordero died more than 90 days after contracting the coronavirus, essentially from lung damage and clot consequences. His body had long since defeated the virus, but it could not undo the damage the virus had done.

What does this have to do with sexual dysfunction? “Researchers are piecing together that surviving COVID-19 may be associated with erectile dysfunction (ED), the inability to achieve and sustain an erection for purposes of sexual intercourse. The research points to three factors that can lead to the potential onset of ED in men who have had the virus:” (Yes, COVID-19 Can Cause Erectile Dysfunction – Cleveland Clinic)

1. Vascular effects. Erectile function is a both a predictor of and a consequence of heart disease. One hallmark of COVID-19 has been its ability to cause hyperinflammation throughout the body, “especially in the heart and surrounding muscles. Blood supply to the penis can become blocked or narrowed as a result of a new or worsened vascular condition caused by the virus.”
2. Psychological impact. 
3. Overall health deterioration. ED is typically a symptom of another underlying problem, frequently a vascular problem.

Maybe my M.D. friend is right. A lot of so-called tough guys are wandering through short TV segments explaining that they trust their natural immune system to fight off the virus. Unfortunately, that strategy has turned into a literally ultimate epic fail for many young and hearty middle-aged men who will never be old men. Others are getting lung transplants or slowly wandering around their houses lugging oxygen equipment. That guy with the oxygen tank? He’s not having sex, not any version that most of us would recognize anyway.

Let’s add a fact a lot of us know from having grown older: The things we thought we escaped from when young sometimes come back to bite us. A familiar argument of this nature relates to smoking: People who quit smoking decrease their risk of smoking-related illnesses, but the past does not simply vanish. Yes, people should quit but quitting does not erase the past. Not entirely.

Here are the results of a sobering study related to smoking: “Conclusion: There is a strong association between the intensity of cigarette smoking and degree of ED. Stopping cigarette smoking can improve ED in a considerable proportion of smokers. Age and the severity of ED before stopping are inversely related to the chance of improvement.” (Do cigarette smokers with erectile dysfunction benefit from stopping?: a prospective study – PubMed (nih.gov))

Eduhonesty: Readers may be asking, why all this smoking data? What do cigarettes and kaiju have to do with vaccine hesitancy?

The smoking data is great support for an argument that might help convince some men to get vaccinated. The biggest enemy of a solid erection is a damaged circulatory system. In doing research on this topic, I even came across one article where the author suggested that difficulty getting an erection could possibly be used diagnostically as an indicator of possible COVID-19 cardiovascular damage. I also found another study worth sharing that said upfront, “Erectile dysfunction (ED), as the hallmark of endothelial dysfunction, could be a short- or long-term complication of COVID-19. Additionally, “subjects with ED could potentially have a higher risk of contracting COVID-19.” (“Mask up to keep it up”: Preliminary evidence of the association between erectile dysfunction and COVID-19. – Abstract – Europe PMC)

I grant the study itself is a rather technical and wordy read. I’d focus on that ED “could be a long-term complication of COVID-19.” Also, the data suggests people who already have ED may have increased risk of getting COVID-19.

Let’s journey into a little speculative paranoia. The “Mask Up” article doesn’t say definitively that people with ED have a higher risk of getting COVID-19, only that logically the data supports the possibility. But here’s the Godzilla hiding below our sea of overflowing ICUs, the giant creature from the deeps that we should not ignore: That data’s not truly in yet. This monster could be sneaking up on us even now. The shadows are there. Studies show the virus in testicular tissue. Multiple reports of ED after COVID-19 are beginning to come in. The fact that this virus can blast blood vessels is well established.

Godzilla is in this post simply because some anti-vaxxers appear to be living in a monster movie, one where the evil 5G Nanobot kaiju is coming to eat their DNA. The vaccine hesitant often have some unreal or at least unsupported ideas as well. If we want to approach this time as a monster movie, I have a monster of my own to cast in my film: We’ll call him Erectile Dysfunction. I’ll bet that some of the anti-vax crowd will find my monster even scarier than the 5G Nanobot.

Our systems have been overwhelmed since early 2020. Research into erectile dysfunction is in its earliest stages. It’s happening now, but a great deal of more immediate research had to happen first. The ability to get an erection doesn’t rate much strategy-time when weighed against the need to supply oxygen to people on the edge of death. It doesn’t hit the radar when trying to pull people back from that edge before they enter the transplant zone.

Here’s a last article worth reading and sharing: “COVID-19 could cause male infertility and sexual dysfunction – but vaccines do not” at COVID-19 could cause male infertility and erectile dysfunction – but vaccines do not | PhillyVoice.

Godzilla returned to the sea but Tokyo did not just revert to an earlier version of itself. I think my friend is right, too. Many men who are not worried about their lungs or heart will take the possibility of long-term erectile dysfunction seriously because those big, technical words in research articles convey a simple idea — maybe the only kaiju that will rescue some of today’s vaccine hesitant once they catch COVID-19 is Viagra, and Viagra doesn’t work for everybody.

Common Viagra side effects include flushing; headache, dizziness, abnormal vision (blurred vision, changes in color vision), runny or stuffy nose, nosebleeds, sleep problems, muscle pain, back pain, or upset stomach. Users are told not to use this drug with nitrates, and to report severe dizziness, sudden loss of vision, and sudden hearing loss or ringing in the ears to their doctor immediately. Do the vaccine hesitant really want to become reliant on this drug? Viagra may be a port in the storm, but it’s no port I’d choose to visit unless I’d run out of alternatives.

Some things, once broken, can be hard or even impossible to fix. The unluckiest polio victims never walked again. Many of the denizens of this planet still have not wrapped their minds around the idea that this disease dose not operate like a toggle switch — it’s not sick or well, not for everybody anyway. (See When I Could No Longer Walk Up the Hill — And Amber Is Still Sick, Six Months Later | Notes from the Educational Trenches (eduhonesty.com)) Long haulers are real and nobody wants to haul this particular disability around through life. Among the many things masks and vaccinations may prevent: the need to cruise the Walgreen’s drive-up lane to pick up the latest Viagra refill.

Thanks for reading this slightly off-topic post. Masking and vaccinations will keep our students and teachers safer. Readers, please keep trying to reach across the philosophical divide that has developed around vaccinations. We can’t prevent massive misinformation from being shared across the internet, but we can keep supplying facts.

*Word for the day: kaiju [ˈkīˌjo͞o] — a giant monster especially featured in Japanese fantasy and science fiction movies and T.V. programs.

Study: Erectile Dysfunction Is 5 Times More Likely in Men Who’ve Had COVID-19 (verywellhealth.com), Effects of COVID-19 on male sex function and its potential sexual transmission – PubMed (nih.gov)

P.S.S. Studies can be found related to women’s sexual health and COVID-19 but these remain thin on the ground and frequently relate to the effects of quarantining and sheltering rather than direct illness. To be continued…

Hugs, readers. I hope the summer is giving you a chance to relax and regroup. Jocelyn Turner