What is true: SARS-CoV-2, the virus that causes COVID-19, poses a risk for both disorders.
Until now, little research has been done on how the virus or the vaccines affect the male reproductive system. But recent investigations by physicians and researchers here at the University of Miami have shed new light on these questions.
The team, which includes me, has discovered potentially far-reaching implications for men of all ages - including younger and middle-aged men who want to have children.
What the team found
I am the director of the Reproductive Urology Program at the University of Miami's Miller School of Medicine. My colleagues and I analyzed the autopsy tissues of the testicles of six men who died of COVID-19 infection.
The result: COVID-19 virus appeared in the tissues of one of the men; decreased numbers of sperm appeared in three.
Another patient - this one survived COVID-19 - had a testis biopsy about three months after his initial COVID-19 infection cleared up. The biopsy showed the coronavirus was still in his testicles.
Our team also discovered that COVID-19 affects the penis. An analysis of penile tissue from two men receiving penile implants showed the virus was present seven to nine months after their COVID-19 diagnosis. Both men had developed severe erectile dysfunction, probably because the infection caused reduced blood supply to the penis.
Notably, one of the men had only mild COVID-19 symptoms. The other had been hospitalized. This suggests that even those with a relatively light case of the virus can experience severe erectile dysfunction after recovery.
These findings are not entirely surprising. After all, scientists know other viruses invade the testicles and affect sperm production and fertility.
One example: Investigators studying testes tissues from six patients who died from the 2006 SARS-CoV virus found all of them had widespread cell destruction, with few to no sperm.
A new study on vaccine safety
Additional research by my team brought welcome news. A study of 45 men showed the Pfizer and Moderna mRNA vaccines appear safe for the male reproductive system.
This, then, is another reason to get the vaccinations - to preserve male fertility and sexual function.
Granted, the research is only a first step on how COVID-19 might affect male sexual health; the samples were small. Studies should continue.
Still, for men who have had COVID-19 and then experienced testicular pain, it is reasonable to consider that the virus has invaded testes tissue. Erectile dysfunction can be the result. Those men should see a urologist.
I also believe the research presents an urgent public health message to the US regarding the COVID-19 vaccines.
For the millions of American men who remain unvaccinated, you may want to again consider the consequences if and when this highly aggressive virus finds you.
One reason for vaccine hesitancy is the perception among many that COVID-19 shots might affect male fertility. Our research shows the opposite.
There is no evidence the vaccine harms a man's reproductive system. But ignoring the vaccine and contracting COVID-19 very well could.