Nikhil Prasad Fact checked by:Thailand Medical News Team Sep 25, 2026 35 minutes ago
COVID-19 may affect sexual and reproductive health through a surprisingly broad combination of vascular, hormonal, inflammatory, reproductive, and psychological pathways, according to a large systematic review.
A systematic review finds COVID-19 can affect sexual function, sperm quality, hormones, and menstrual health,
although many reproductive changes appear temporary
Researchers examined 218 reports, representing 214 conservative study or cohort units. The evidence covered sexual function, reproductive outcomes, psychological and behavioral factors, and biological mechanisms. However, the authors stressed that persistent infertility following COVID-19 has not been established.
Erectile Dysfunction Emerges as a Key Finding
Erectile dysfunction was the most consistently reported sexual problem. Of 31 study or cohort units examining erectile dysfunction, 28 reported an adverse signal, although some also documented recovery.
Results varied considerably. One study found erectile dysfunction in 64.7% of 153 sexually active men hospitalized with acute COVID-19. Another involving 42,406 men recorded new erectile dysfunction in 1.42%, corresponding to an adjusted 27% higher hazard.
Female sexual health was less extensively studied. One investigation found sexual dysfunction in 63.8% of women previously infected with COVID-19 compared with 36.2% of controls.
Sperm, Hormones and Menstrual Changes
As highlighted in this
Thailand Medical News report, reproductive changes were particularly noticeable soon after infection. Among 61 units evaluating semen outcomes, 30 reported adverse findings and 29 documented partial or complete recovery.
In 781 infertile men, sperm count, concentration, vitality, motility, and normal morphology declined during the first month following COVID-19 but recovered by approximately the third month. Another study found median total sperm counts of 67.49 million per ejaculate among COVID-positive men versus 102.48 million before the pandemic.
Hormonal effects were also reported. Among previously hospitalized men, biochemical hypogonadism declined from 95% initially to 30.1% after 12 months. Menstrual changes were reported in 17 of 30 relevant study units, although findings were inconsistent.
Fertility Effects Remain Uncertain
Importantly, changes in sperm or hormones do not automatically mean infertility. Assisted-reproduction findings were generally more reassuring: many studies found no significant deterioration in clinical pregnancy or live-birth outcomes, although treatment very soon after infection produced adverse signals in some research.
The researchers are from the Federal University of Alagoas, University Center of Maceió, and Federal University of Minas Gerais, Brazil.
Conclusion
Overall, COVID-19 appears capable of temporarily disrupting several components of sexual and reproductive health, particularly erectile function, semen quality
, and reproductive hormones, but current evidence does not demonstrate persistent infertility.
The study findings were published in the peer reviewed journal: COVID.
https://www.mdpi.com/2673-8112/6/10/169
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