Sexual behavior in men during COVID-19

KEYWORDS:
Coronavirus; pornography; testosterone

The rapid changes that have occurred during this pandemic have influenced people in various ways, affecting stress levels, finances, and health. As the world faces this situation, it is adjusting to a new reality involving the need for social distancing and a change in habits ¹ . We do not know what the lasting effects of the COVID-19 pandemic will be on patterns of sexual behavior. Social distancing affects all aspects of daily life and it is not clear whether it affects the sexual habits of married partners.

As the period of quarantine is prolonged, understanding changes in sexual behavior may provide information regarding potentially unhealthy sexual attitudes. This crisis is contributing to the experimentation of addictive sexual behaviors, such as those practiced via the internet ² . A pornography sharing website observed an increase in the use of free pornography during the quarantine, especially in Spain (61%) and Italy (57%). Similar patterns have been observed in the United States and regions of Asia, especially with regard to morning viewing ³ . Besides the consumption of this content by the adult population, the pandemic is exerting a negative impact on the physical, intellectual, emotional, and sexual activities of adolescents. When emotions are high and adolescents are more socially isolated, there can be an increase in the use of online pornography, the effects of which have implications in terms of emotional and relational problems in this generation ⁴ . Online content is active and portable, enabling fast and easy access through a variety of electronic devices, in which it is difficult for parents to monitor online media ⁵ .

Although the majority of adolescents in the cognitive and volitional age may not experience consequences, some cases could generate a reduction in desire, an increase in masturbatory practices, and a reduced interest in real sex due to the gap between what is possible and what is being fantasized, which could lead to potential health problems in terms of dependence, paraphilias, and sexual disorders ^5,6 .

Another vulnerable population in this pandemic is composed of men older than 60 years of age, 66.2% of whom could develop more severe forms of the disease ^7,8 . Androgen deficiency in this age group can exert a negative impact on multiple organs and quality of life ⁹ . Therefore, the maintenance of testosterone therapy is necessary. Low levels of this hormone may play a physiopathological role associated with SARS-CoV-2, as the worsening of hypogonadism with androgen depletion can contribute to the severe course of the disease and even death ¹⁰ .

Besides these complications amidst the pandemic, low levels of testosterone in men older than 60 years of age can further aggravate the lack of libido and low energy, generating profound suffering due to the negative impact on sexual behavior. Thus, specialized, multidisciplinary care is needed, with online medical appointments aimed at the continuation of hormone replacement therapy. Considering the relationship between mental and sexual health, these patients need close follow-up, as they may be at greater risk of manifesting preexisting sexual dsyfunctions ¹¹ .

• Funding
  None.

REFERENCES

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  Salonia A, Corona G, Giwercman A, Maggi M, Minhas S, Nappi RE, et al. SARS-CoV-2, testosterone and frailty in males (PROTEGGIMI): a multidimensional research project. Andrology. 2020. doi:10.1111/andr.12811.
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Publication Dates

• Publication in this collection
  16 Dec 2020
• Date of issue
  Dec 2020

History

• Received
  12 July 2020
• Accepted
  08 Aug 2020