Nearly two years into the COVID-19 pandemic, we are still just starting to learn about this virus. With millions around the world having a wide range of experiences between the extremes of asymptomatic cases to fatal ones, there is no standard slate of COVID symptoms and no standard protocol for treatment.
Researchers are still learning about the possible long-term effects of the virus. And some have discovered post-virus effects that indicate you had COVID, even if you were asymptomatic at the time of infection.
The Basic Symptoms
There are a few strange symptoms that can indicate you might have had COVID, but there are also many common ones.
The most well-known symptoms at the time of infection are fever, cough, shortness of breath, and fatigue. Which for some people means that testing positive for COVID will be an experience that is very similar to the flu. Another common COVID symptom is the loss of taste (ageusia) and/or smell (anosmia).
These are just the basics, though. As it turns out, some people have reported what’s been dubbed “long COVID.” And the research shows that both men and women can experience more intimate, less talked about symptoms following a COVID infection that have an effect on both sexual and reproductive health.
What Is Long COVID-19?
According to the Mayo Clinic, people who continue to experience COVID symptoms after their initial recovery have a condition described as “long COVID-19.” Some of these “long haulers” are developing health issues more than four weeks after a COVID diagnosis. The symptoms can sometimes persist for months.
Those who are most at risk for lingering COVID symptoms are older people and those who have serious medical conditions. However, there have been reports from young, otherwise healthy people of feeling unwell for months after infection. There have also been reports of strange symptoms that can pop up weeks or months later.
Two Strange Long-Term Symptoms
Numerous reports have stated some women with long COVID have experienced menstrual changes, while some men are said to experience erectile dysfunction (ED) long after their other COVID symptoms have subsided. This could be due to a person’s natural level of estrogen or testosterone, as well as how the virus affects reproductive systems. Let’s take a look at some of the research.
How COVID-19 Might Affect The Male Reproductive System
According to a study published in the Journal of Endocrinological Investigation, researchers found trends that suggest male COVID patients were more likely to experience a condition known as hypogonadism compared to men who have not had COVID. Hypogonadism is when a person’s sex organs release little or no sex hormone.
“Whether this state of hypogonadism is permanent or temporary is a question so far left unanswered,” the researchers explained.
The male COVID patients with hypogonadism also had lower counts of Leydig cells. These are found in the testicles, and they are extremely important. The Leydig cells maintain the male reproductive tract, assist in the production of testosterone, and are responsible for the generation of the sperm.
The researchers posit that testosterone suppression “might be one of the reasons for the large difference in terms of mortality and hospitalization rate between males and females and might also explain why SARS-CoV-2 most commonly infects old men.”
How COVID-19 Might Affect The Female Reproductive System
Some women have also experienced sexual and reproductive symptoms from COVID that doctors believe could be linked to hormones. According to Dr. Louise Newson—a general practitioner and menopause specialist—her research seems to confirm her thoughts that long COVID is likely related to low levels of estrogen and testosterone, though it doesn’t prove it.
Dr. Newson is conducting a pilot survey on the female sexual and reproductive symptoms of COVID, with 842 patients so far. She says the link between low hormone levels and long COVID has been neglected in other research.
She told Vox that many women have noticed worsening COVID symptoms just before their period starts, which is when estrogen levels are at their lowest. Dr. Newson suspects that it’s not a coincidence that long COVID symptoms like brain fog, fatigue, dizziness, and joint pain also happen to be symptoms of menopause.
More Research Is Needed
Newson says that anecdotally, the long COVID patients at her menopause clinic have improved with the right dose and type of hormone replacement therapy. However, more research is definitely needed to figure out the role of hormones in COVID cases.
That said, a study published in J Midlige Health found that “no definite association was found between menopause and COVID-19 outcome with hospital stay duration or disease progression.”
Meanwhile, one Turkish study published in The Aging Male found that low testosterone may increase the risk of respiratory infections.
Selahittin Cayan, MD, a professor of urology and the lead author of the study wrote, “Testosterone is associated with the immune system of respiratory organs, and low levels of testosterone might increase the risk of respiratory infections. In our study, the mean total testosterone decreased, as the severity of the COVID-19 increased.”
There’s also a study published in The Lancet that suggests COVID could impair men’s long-term sperm production.
In the end, more studies need to be conducted to say conclusively how COVID-19 can negatively impact our reproductive systems and hormones, but it is something to keep a close eye on.