The Covid-19 effect on men's health

Professor Geoffrey Hackett is one of the UK’s leading experts in erectile dysfunction, he is also a consultant at www.OxfordOnlinePharmacy.co.uk. This month, he shares his insights into the ways in which lockdowns have impacted men’s sexual health and the importance of understanding the long-term implications of failing to properly manage the condition as we continue in lockdown.

“Since the Covid outbreak began, routine consultations for non-urgent conditions have been subject to considerable delays. As a private specialist in men’s health, and specifically erectile dysfunction, I have been inundated by requests for help from men who are in desperate need of treatment.  The obsession with R numbers and Covid-19 deaths, to the exclusion of all other health-related outcomes, is already having considerable long- term implications, even beyond the cancer delays that are frequently being highlighted by the media.

“Against this backdrop, problems relating to sexual health are low on the list of priorities. Having said that ED sufferers need to understand that there are legitimate channels through which they can access support, including appropriate medications, outside of the NHS. Knowledge of these services are especially important as the NHS does not cover the costs of many of these treatments anyway.

“In my role as an ED specialist, over the past few months I have seen many queries which share a great deal of commonality and which can be remedied with the correct medication and treatment plan. I wish to share three examples of how the Covid-19 lockdown has been detrimental to sexual relationships, and how vitally important sexual health is to our overall wellbeing.

“The names used in the following examples are fictitious: Stanley, 75, became a widower in 2018, but in February 2020, he began a new relationship. Despite the new couple becoming intimate, Stanley was unable to achieve an erection. He suffered from an enlarged prostate which had been treated with surgery. He also had moderate chronic kidney failure. A recent scan of his aorta had demonstrated a small aneurysm, but no action was required. Stanley’s GP suggested that tablets might help his erection but that a specialist appointment was warranted to check if it was safe to go ahead. Due to Covid-19 restrictions, Stanley will have to wait nine months for a simple assessment to ascertain whether the proposed treatment is safe. He will spend this time alone in isolation. It is highly unlikely that the new relationship will survive. Stanley has a limited life expectancy and he is being deprived of the possibility of developing a relationship that would be potentially life-changing for two lonely people.

“Stephen, 28, is a very handsome young man with an excellent physique, who developed ED and a complete lack of sexual desire after he was treated for six months with Roaccutane, a drug used for severe acne. He was prescribed multiple antidepressants for two-three years, until he found his way to me, having read a paper I had written on side effects of these drugs. He had attempted suicide twice. After putting him on a complex - but successful - regime of hormone manipulation, he wrote me a Christmas card in 2019, telling me that “ I had changed his life” and that, for the first time in five years he felt motivated to meet girls and that a new relationship showed promise. In early June 2020, he informed me that the effect of lockdown and enforced separation had caused the relationship to fail. He had been unable to get his medication from the practice and admitted that he was experiencing some suicidal thoughts. A GP on telephone consultation had put him on an anti-depressant, meaning that we were repeating the cycle of previous failure.

“Patrick is a 76 -year old man with diabetes who had been a widower for five years. He was suffering from a loss of libido and erectile dysfunction. After significant investigation, I prescribed a three-monthly testosterone injection and daily Tadalafil. He had met Rose in late 2019 and they moved in together in early 2020. Due to Covid-19, his GP practice stopped all non-urgent treatment which included his testosterone injections. As a result, his symptoms returned accompanied by low mood and tiredness and his tadalafil ceased to work for his erections. Unable to see his GP and with the cancellation of his annual hospital follow-up, he stopped the Tadalafil altogether. His change in mood and frustration with sexual failure was too much for Rose, who moved back into her own flat. Both Patrick and Rose remain in isolation.

“As can be seen, the knock on effect of failing to treat erectile dysfunction can be significant. However, the negative impact of lockdown on men’s health is not limited to sufferers of ED. 

“The greatest impact of all will been seen among the single populations of all sexual orientations, especially those still living with parents. The transition from a way of life where sex and new relationships were a top priority, to a situation of enforced celibacy may be too much for many to handle.  A switch to the use of pornography and chat lines for release is highly likely, opening up many more vulnerable young people to risk from sexual predators. On the other hand, statistics have shown that enforced isolation with aggressive and manipulative partners is also leading to a rise in domestic abuse.

“Far more insidious, however, will be the likelihood that relationships will be radically changed. In some cases this will be a change for the better, the chance to spend more time communicating might enhance intimacy and relationships, but, in many cases relationship problems will be aggravated. As relationships deteriorate, there will be less opportunity for escape, avoidance, or other alternatives for sexual release. Many relationships only survive through these mechanisms. Services for relationship therapy, where they are even available, will be unable to cope with the backlog of cases and inevitably there will be consequences in terms of relationship and family breakdown.

“With the focus understandably on the reduction of Covid-19 cases, the likelihood is that sexual problems will remain very low down on the list of healthcare priorities over the coming months and yet, to the sufferer, a healthy sex life is often their only priority. Sex is hardly a matter of life and death, indeed, in the famous words of Bill Shankly, in reference to  football: “It is far more important than that!”

If you have been affected by any of the topics covered in this blog post and you would like to book an appointment with Professor Hackett contact or you would like to speak to a member of the pharmacy team about managing your ED please get in touch (info@oxfordonlinepharmacy.co.uk).

Professor Geoffrey Hackett’s new book: Just a Tiny Prick, is now available to purchase from Amazon.