Male Sexual Health and Sexual Behaviors during the First National COVID-19 Lockdown in a Western Country: A Real-Life, Web-Based Study

Abstract

Restriction measures enacted during the COVID-19 pandemic had severe effects on male sexual and reproductive health. We aimed to investigate the real-life impact and perception of sexual function in 2020 in Italy, as the first Western country experiencing a national lockdown by measuring relative search volume for keywords pertaining to sexual health and behaviors provided by Google Trends and sales data for pro-erectile treatments. No significant change was observed for erectile dysfunction and premature ejaculation. Interest towards most phosphodiesterase type 5 inhibitors decreased significantly during lockdown (e.g., sildenafil, p = 0.0002; tadalafil p = 0.0016), then reverted to pre-lockdown levels (e.g., sildenafil, p < 0.0001; tadalafil p < 0.0001), mirroring a concomitant sales decrement (p = 0.0292). A subsequent recovery to previous levels at the end of the social confinement was also found (e.g., after vs. before lockdown, sildenafil, p = 0.8459; tadalafil p = 0.1166). During lockdown, interest towards pornography significantly increased during restrictions (p = 0.0053) and remained high (after vs. before lockdown, p = 0.0004), whereas interest towards paid and casual sex declined (p = 0.0015 and p = 0.049, respectively), then reverted to previous levels (after vs. before lockdown, p = 0.3969 and 0.8373, respectively). During the first Italian lockdown, we observed a transient but measurable decrease of sexual health-seeking behaviors and changes in sexual behaviors, with unknown impact for sexual medicine and public health.

Change in Sexual Behaviour Among Men Who have Sex with Men During the COVID-19 Pandemic in the Czechia

“…in countries where higher social isolation, including substituting masturbation or online sex for sexual activity, could have led to a more drastic reduction in the number of sexual partners. However, we cannot reflect this fact too much in Czechia, where programs dedicated to the issue of sex did not exist during the COVID-19 pandemic, which may explain the fact that the majority of respondents did not change the number of sexual partners, which may also be associated with the fact that there was not such a drastic increase in watching pornography as in other studies that did not focus only on MSM [12,29,30], or operating online sex as in other studies [6,9,25]. A lower increase in viewing pornographic materials may be associated with absences in changes in the frequency of masturbation.…”

Relationship between hyperuricemia with deposition and sexual dysfunction in males and females

“…Several factors might exacerbate the psychological distress: recurrence of flares, feelings of inadequacy or stigmatization [ 132 ], or even difficulty of getting the needed treatments, as occurring during the COVID-19 pandemic [ 137 ]. In these regards, the psychological burden of COVID-19 and related containment measures, such as lockdowns and social isolation, have also been proven to exert negative effects on sexual health [ 138 – 140 ]. Several studies have indeed reported higher rates of depression, anxiety, and fatigue among gout patients [ 129 , 141 , 142 ], with worse symptoms occurring during acute gout flares but persistently decreased QoL even during remission.…”

Exploring the adult sexual wellbeing and behavior during the COVID-19 pandemic. A systematic review and meta-analysis

“…Researchers from various countries have tried to shed light on the impact of the pandemic on sexual health, and preliminary results have shown its influence on various aspects of sexual wellbeing ( 18 , 19 ). However, drawing a clear conclusion based on the studies of the field could be misleading due to the diversity of the recruited samples.…”