How to treat erectile dysfunction in young patients during the pandemic?

COVID-19, a disease caused by the novel coronavirus (SARS-CoV-2), has become pandemic, affecting more than 100 million people throughout the world. During March 2021, Brazil occupied second place in the ranking of countries with the highest numbers of confirmed cases, totaling more than 11 million affected people and nearly 300 thousand deaths¹. With the new increase in the number of cases, cities have once more adopted restrictive measures regarding circulation and social activities, with the shutdown of non-essential services.

The set of measures adopted by the government associated with the dissemination of the disease, with large numbers of infected individuals and deaths, exert a negative impact on individuals and society as a whole². The population finds itself restricted in terms of habitual activities and is constantly exposed to news about the propagation of the disease as well as the accompanying morbidity and mortality rates, which has a negative impact on mental health due to fear, panic, unemployment, a reduction in income, the loss of relatives and friends, and social distancing from family circles³.

Sexuality is complex and encompasses several aspects, such as attitudes, behaviors, orientation, identity, and beliefs⁴. The negative impact of the pandemic on mental health can significantly affect one’s sex life. The few studies that have assessed the effects of the pandemic on sexual behavior demonstrate a reduction in the quality of the sex life of individuals and the number of sexual relations, especially among young, single individuals^5,6.

In urology offices, there has been an increase in the number of young men seeking care for complaints related to reductions in libido and erectile function in this peak period of the pandemic in Brazil. For the most part, these are patients with no other comorbidities or conditions that are harmful to sexual function and no history of sexual problems. Their complaints began precisely during the pandemic. Such patients seek a diagnosis and treatment and are unable to relate the sexual health complaint with a psychological condition of anxiety, fear, and depression caused by COVID-19.

It is of vital importance for urologists to be attentive when examining these patients. It is important to understand the turbulent period in which we find ourselves and its impact on the mental health of patients, bearing in mind the extent to which psychological wellbeing exerts an influence of one’s sex life.

Therefore, clinicians should address uncertainties related to the pandemic and its psychological effects by offering online appointments in an effort to clarify issues related to the prescription and doses of medications. Moreover, these young men should have their psychosexual history assessed, as most problems of this type in this population are psychosomatic. In this context, physician-patient dialogue is essential throughout the management of erectile dysfunction.

REFERENCES

• ¹
  World Health Organization. Coronavirus disease (COVID-19) pandemic. Geneva: World Health Organization; 2020. [cited on Mar. 31, 2021]. Available from: Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
  » https://www.who.int/emergencies/diseases/novel-coronavirus-2019
• ²
  Li W, Li G, Xin C, Wang Y, Yang S. Changes in sexual behaviors of young women and men during the Coronavirus disease 2019 outbreak: a convenience sample from the epidemic area. J Sex Med. 2020;17(7):1225-8. https://doi.org/10.1016/j.jsxm.2020.04.380
  » https://doi.org/https://doi.org/10.1016/j.jsxm.2020.04.380
• ³
  Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiatry. 2020;7(4):300-2. https://doi.org/10.1016/S2215-0366(20)30073-0
  » https://doi.org/https://doi.org/10.1016/S2215-0366(20)30073-0
• ⁴
  World Health Organization. Defining sexual health 2020. Geneva: World Health Organization ; 2020. [cited on Mar. 31, 2021]. Available from: Available from: https://www.who.int/reproductivehealth/topics/sexual_health/sh_definitions/en/
  » https://www.who.int/reproductivehealth/topics/sexual_health/sh_definitions/en/
• ⁵
  Yuksel B, Ozgor F. Effect of the COVID-19 pandemic on female sexual behavior. Int J Gynaecol Obstet. 2020;150(1):98-102. https://doi.org/10.1002/ijgo.13193
  » https://doi.org/https://doi.org/10.1002/ijgo.13193
• ⁶
  Jacob L, Smith L, Butler L, Barnett Y, Grabovac I, McDermott D, et al. Challenges in the practice of sexual medicine in the time of COVID-19 in the United Kingdom. J Sex Med. 2020;17(7):1229-36. https://doi.org/10.1016/j.jsxm.2020.05.001
  » https://doi.org/https://doi.org/10.1016/j.jsxm.2020.05.001

• Funding: none

Publication Dates

• Publication in this collection
  15 Oct 2021
• Date of issue
  June 2021

History

• Received
  22 Mar 2021
• Accepted
  26 Apr 2021