An Online Questionnaire Survey on the Sexual Life and Sexual Function of Chinese Adult Men During the Coronavirus Disease 2019 Epidemic

Abstract

Introduction There has been no report regarding the impact on male sexual life or sexual function by changes in lifestyle during the coronavirus disease 2019 (COVID-19) epidemic. Aim To investigate the changes in sexual life and sexual function of Chinese men during the COVID-19 epidemic. Methods An online questionnaire was created and the survey was administered through social media to Chinese adult men. Main Outcome Measure The main end point was the deteriorated erectile function or ejaculatory control ability, defined by self-evaluation or by decreased International Index of Erectile Function-5 items (IIEF-5) scores or increased premature ejaculation diagnostic tool (PEDT) scores. Results Altogether, 612 questionnaires were collected. About 322 (52.6%) subjects were unmarried. About 8.4% and 8.5% subjects reported deteriorated erectile function or ejaculation control ability by self-evaluation, whereas 31.9% and 17.9% subjects showed decreased IIEF-5 scores or increased PEDT scores. Subjects with deteriorated erectile function by self-evaluation and decreased IIEF-5 scores had higher General Anxiety Disorder-7 (P < .001 and P = .001) and higher Patient Health Questionnaire-9 score (P < .001 and P = .002) after the epidemic, decreased frequency of sexual life (P < .001 and P < .001) and physical exercise (P = .009 and .007) after the epidemic. Subjects with deteriorated ejaculation control ability by self-evaluation and increased PEDT scores had higher General Anxiety Disorder-7 (P < .001 and P < .001) and higher Patient Health Questionnaire-9 score (P < .001 and P = .002) after the epidemic. Subjects with decreased frequency of sexual life had reduced income (P < .001), increased anxiety (P < .001) and depression (P < .001). Married subjects had higher proportion of improved depression (P = .048) and increased frequency of sexual life (P = .010). Conclusion During the COVID-19 epidemic, decreased sexual function was present in a certain proportion of adult men, and the risk factors include increased anxiety and depression, and decreased frequency of sexual life.

The Epidemic of COVID-19-Related Erectile Dysfunction: A Scoping Review and Health Care Perspective

“… • Men engaged in new strategies to reduce their risks of infection from partners, and expressed high levels of concern about how HIV may affect COVID-19 risk, treatment, and recovery √ Maretti et al 2020 36 Italy Narrative Review • COVID-19 has dramatically affected the quality of life by changing inter-personal relationships, community life and obviously sexual health. √ Karsiyakali et al 2020 37 Turkey Patient Survey • Based on the International Index of Erectile Function and Female Sexual Function Index (FSFI) forms, a decline in sexual functioning was observed during the COVID-19 pandemic period • Living in a metropolitan area was associated with a decline in both sexual intercourse frequency and sexual desire during the COVID-19 pandemic √ Fang et al 2020 38 China Patient Survey • 8.4% and 8.5% subjects had deteriorated erectile function or ejaculation control ability by self-evaluation, whereas 31.9% and 17.9% subjects had decreased IIEF-5 scores or increased PEDT • Subjects with deteriorated erectile function and decreased IIEF-5 scores had higher General Anxiety Disorder-7 (P < .001 and P < .001) and higher Patient Health Questionnaire-9 score (P < .001 and P = .002) after the epidemic, decreased frequency of sexual life (P < .001 and P < .001) and physical exercise (P = .009 and .007) after the epidemic √ De Rose et al 2020 39 Italy Patient Survey • A higher proportion of health care workers had low sexual desire (65.3% vs 56.8%, p = 0.042) • Age, being female, being a health care worker, having children at home, living with the partner, and having low sexual satisfaction were predictors of low level of sexual desire √ Bulut et al 2021 40 Turkey Patient Survey • Both stress disorder and ED were seen at higher rates in healthcare professionals (p < .001). • The median IIEF-5 scores of nurses, married subjects, and those working in the Diagnosed Patient Area, were found to be higher (p < .001, p = .014, p = .011 respectively) √ Karagöz et al 2020 41 Turkey Patient Survey • Sexual function scores (IIEF erectile function domain and total FSFI) were lower during pandemic (24.55 ± 5.79 and 24.87 ± 7.88, respectively) vs. pre-pandemic period (26.59 ± 4.51 and 26.02 ± 6.22) (p = 0.001 and ...…”

“…An online questionnaire administered to Chinese men (n = 612) during the pandemic (April-May 2020) found that 8.4% and 8.5% subjects reported deteriorated erectile function or ejaculation control ability by self-evaluation, whereas 31.9% and 17.9% subjects showed decreased IIEF-5 scores or increased premature ejaculation diagnostic tool (PEDT) scores. 38 Subjects with deteriorated erectile function by self-evaluation and decreased IIEF-5 scores displayed higher General Anxiety Disorder-7 (p < 0.001 and p = 0.001) and higher Patient Health Questionnaire-9 score (p < 0.001 and p = 0.002) and decreased frequency of sexual life (p < 0.001 and p < 0.001) and physical exercise (p = 0.009 and 0.007). 38 Subjects with decreased frequency of sexual life had reduced income (p < 0.001), increased anxiety (p < 0.001) and depression (p < 0.001).…”

A Mid-to-Long Term Comprehensive Evaluation of Psychological Distress and Erectile Function in COVID-19 Recovered Patients

“…A great number of studies demonstrated the negative influence of COVID-19 pandemic on sexual health in different populations, including sexual arousal, frequency of sexual intercourse, orgasm, sexual satisfaction, and so on. 14 , 15 , 16 , 17 As for men subpopulations with COVID-19, little is known about their erectile function.…”

“…Published literature also demonstrated that erectile dysfunction (ED) is a likely consequence of COVID-19 for survivors and reviewed the possible mechanisms contributed to the potential onset of ED. 22 Together with the number of outpatients diagnosed with ED markedly increased during the pandemic 23 and some studies reported ED in other male subgroup, 14 , 24 , 25 , 26 it is most likely that COVID-19 patients may develop ED. However, currently, the erectile function in male recovered patients with COVID-19 remains unknown.…”

The Effect of COVID-19 and Its Control Measures on Sexual Satisfaction Among Married Couples in Kenya

“…A similar study done in China among men found increased rates of erectile dysfunction and quick ejaculation. 11 Authors related the findings to increased anxiety and depression.…”