The COVID-19 pandemic altered daily life, impacting personal relationships and health behaviors. Many sought to understand how SARS-CoV-2 might affect intimate aspects of their lives, including sexual activity. This article explores COVID-19’s intersection with sexual health, covering transmission risks, safety measures, impacts on desire, and reproductive considerations.
Understanding Sexual Transmission of COVID-19
SARS-CoV-2 primarily transmits through respiratory droplets and airborne particles released when an infected person coughs, sneezes, or talks. Close physical contact, such as that occurring during sexual activity, facilitates this transmission. Concerns have arisen regarding the virus’s presence in bodily fluids associated with sexual activity.
SARS-CoV-2 RNA has been detected in various bodily fluids, including saliva, semen, vaginal secretions, urine, and feces. Saliva and feces/rectal swabs show the highest detection rates (approximately 83% and 32%), while detection in semen and vaginal secretions is considerably lower (about 1.6% and 2.7%).
Although the virus’s genetic material has been found in semen and vaginal fluids, this does not definitively prove direct sexual transmission of infectious virus. Viable SARS-CoV-2 (the live virus capable of causing infection) has not been successfully cultured from semen samples. Therefore, while close physical intimacy during sex could lead to transmission via respiratory droplets, the likelihood of direct sexual transmission through semen or vaginal fluids is considered low.
Practicing Safe Sex During the Pandemic
Practicing safe sex during the pandemic involves strategies to minimize exposure to close contact and respiratory droplets, the main transmission routes for SARS-CoV-2. Limiting sexual partners can reduce the risk of encountering an infected individual. Open and honest communication with partners about recent health status and potential exposures is also a practical step.
Maintaining good hygiene, including washing hands thoroughly with soap and water for at least 20 seconds before and after sexual activity, is a risk reduction measure. Limiting close physical contact to those within an immediate household or “sexual bubble” can further reduce exposure to the virus.
For those engaging in sexual activity outside their immediate household, using face masks during intimate encounters can help reduce respiratory droplet spread. While not a complete barrier, this adds an extra layer of protection. These measures collectively aim to lower the chance of viral transmission during intimate moments.
Impact on Sexual Desire and Intimacy
The COVID-19 pandemic and its associated stressors impacted sexual desire and intimacy for many. Increased stress, anxiety, social isolation, and disruptions to daily routines contributed to changes in libido and sexual function. The pervasive fear of contagion also played a role in altering sexual behaviors.
General stress, financial concerns, and loneliness linked to the pandemic were associated with changes in sexual desire. While initial reports indicated a potential increase in sexual desire due to confinement, mounting evidence later suggested a decline in sexual habits and desire, particularly for those experiencing long-term effects of the virus. For instance, a study of cisgender women found that those with COVID-19, especially long COVID, reported lower desire, arousal, lubrication, and satisfaction.
Illness itself, including symptoms of long COVID, can physiologically affect sexual well-being. Lingering physical and cognitive symptoms can reduce interest in sex and affect the body’s readiness for intimacy. These broader psychological and physiological effects underscore the complex ways in which the pandemic influenced personal relationships and sexual health.
Considerations for Reproductive Health
The impact of COVID-19 on reproductive health, including fertility and pregnancy, has been a significant concern. SARS-CoV-2 infection may temporarily affect male fertility. Decreased sperm concentration, motility, and changes in sperm morphology have been reported in men after COVID-19, with some improvements observed over time. This impact may be related to fever and inflammation caused by the infection, which can lead to testicular spermatogenic dysfunction.
For female fertility, COVID-19 might affect ovarian function and potentially interfere with assisted reproductive technology procedures. The virus’s ability to bind to ACE2 receptors, present in the ovaries, uterus, vagina, and placenta, raises concerns about its influence on follicular development and ovarian reserve. While some research indicates a temporary impact on menstrual cycles and ovarian function, most studies have not found a significant, permanent effect on ovarian reserve or overall female fertility.
COVID-19 infection in pregnant individuals has been associated with an increased risk of adverse outcomes, including preeclampsia, preterm birth, and stillbirth, especially with severe illness. A lower risk of miscarriage and Cesarean delivery has also been observed, possibly due to increased monitoring and prenatal care. Medical organizations consistently recommend COVID-19 vaccination for individuals who are pregnant, breastfeeding, or trying to conceive, as there is no evidence that vaccines cause fertility problems and they reduce the risk of severe illness in pregnant individuals and their babies.