The new link between the failure to rise and Covid-19

I first saw Jackson in the Sexology Clinic last year in August. He had come with a complaint of progressive failure of erection. He was accompanied by his wife who was frustrated and on the brink of walking out of the marriage.

"If it were not for my age I would have left," Nancy, Jackson's wife, explained, "all these years we have been working hard and more or less postponed leisure life, now we are supposed to enjoy the honeymoon we missed and, he fails to rise."

Jackson was 76 years while Nancy was 72 years old then. They both had hypertension and, Jackson was also diabetic. They had been out on holiday in Seychelles for two weeks but the holiday ended up being a battlefield.

"I used a lot of money on the holiday and what did I get from it?" Jackson asked, "bad-mouthing and belittling, she has to learn to treat me as a husband."

I stepped in to curtail the rising emotions. I explained the many causes of erectile dysfunction and asked that we focus on getting a solution.

As men grow older their testosterone tends to go down from the age of 30 years and this can result in erection problems as they hit their 50s, 60s, or 70s.

After a full evaluation, I found Jackson to have low testosterone. His cholesterol was also high and this together with diabetes and high blood pressure had damaged his blood vessels making erection impossible. He got treatment for the diseases and by January this year, his erections had improved.

Fast forward, March 2020, and Jackson calls me that he wanted to come for review in the Sexology Clinic. Covid-19 pandemic had just been declared in Kenya. I requested that we do online consultation because I realised that Jackson had risks for severe Covid-19 disease.

From studies that have been done to date, anybody can get Covid-19 and, everyone, babies, children, middle-aged and the old are all getting the infection. Amazingly, however, up to 80 percent of those infected show no or very mild symptoms. Another 15 percent of the Covid-19 infected people get moderate to severe symptoms that require treatment in a hospital. The remaining five percent get a very severe and critical disease.

It is important to note that while anyone can end up with critical Covid-19 disease, the majority of cases that end up in ICU are those above the age of 60 years, the hypertensives, diabetics, those with high cholesterol and the obese. These are the same factors that aggravate most sexual dysfunctions in men and women.

"So in your thinking does it mean that if you are treating me for erection failure then you are also reducing my chances of getting severe Covid-19 disease?" Jackson asked. That was a clever question that made me reflect. Indeed, weight management through good nutrition and exercise; prudent management of diabetes, high cholesterol, and hypertension are all critical in managing the ravage caused by both diseases.

Jackson agreed to have online consultation and we continued to do that till sometime in early May. A month ago he called asking how to handle intimacy if one of the partners has symptoms of Covid-19. He had throat pains, a cough, and a fever. I asked him to immediately seek medical help. He was diagnosed to have Covid-19 and admitted due to the multiple risk factors he had. His wife was also put on quarantine.

Jackson went through the full cycle of Covid-19 disease. He developed breathing problems and was put on ventilation support in ICU for seven days. He was lucky to pull through and was discharged a week ago. His wife has remained negative for the disease.

"Possibly the prudent measures we took to treat the erectile dysfunction helped in my recovery from this Covid-19 disease," Jackson said when I met him in the hospital during discharge. I nodded, realising how measures to invigorate sexual function could benefit Covid-19 control.