COVID-19 May Increase Women’s Risk of Sexual Problems

A previous COVID-19 infection makes it more likely a woman will experience sexual function issues — especially if she had long COVID, according to a study published December 5 in the Journal of Sexual Medicine.

Women who’d never had COVID-19 experienced significantly greater sexual desire, arousal, lubrication, and satisfaction than women who’d had COVID-19 or long COVID. Additionally, the study found that women who’d had COVID-19 had fewer sexual issues than women with long COVID when it came to arousal, lubrication, and frequency of orgasms.

Roughly 18 million Americans said they’d had long COVID previously, and 8.8 million said they currently had long COVID in the 2022 National Health Interview Survey released in June 2023.

Healthcare providers who are treating patients for long COVID need to be aware of these potential associations with sexual problems, says Amelia M. Stanton, PhD, a coauthor of the study and an assistant professor in the department of psychological and brain sciences at Boston University.

“Our findings suggest that it may be worthwhile for clinicians to proactively ask women with long COVID if they have been having any sexual difficulties, because it may be challenging for patients to bring these issues up on their own. That way they can come up with a plan to address any concerns together,” she says.

Most Studies on COVID’s Impact on Sexual Function Have Been in Men

The authors were motivated to explore COVID’s impact on cisgender women because the few studies that have focused on COVID-19’s impact on sexual function have looked at cisgender men, according to the authors. “Very little, if any, research has explored the impacts of long COVID on sexual function or sexual well-being across genders,” says Dr. Stanton.

Looking at COVID-19’s potential impact on sexual function is important, says Kyle Stephenson, PhD, an associate professor of psychology and the director of the Sexuality and Relationships Lab at Xavier University in Cincinnati, Ohio.

“Sexual function and well-being are considered important by people across cultures and are associated with overall quality of life,” says Dr. Stephenson, who was not involved in the research. “So understanding factors that impair the quality of one’s sex life is inherently important,” he says.

Researchers Studied Possible Connections Between COVID-19, Depression, Anxiety, and Sexual Function

The study included about 1,300 participants: 645 women who had never had COVID-19, 498 women who’d had COVID, and 170 with long COVID.

Sexual function was measured by the Female Sexual Function Index (FSFI), a self-administered questionnaire made up of 19 questions that fall into six domains: desire, arousal, lubrication, orgasm, satisfaction, and painful intercourse.

Each question was scored on a Likert scale, ranging from 0 to 6. The scores could range from 2 to 36, and based on previous research on women of reproductive age, scores below 26.55 indicated possible sexual dysfunction, according to the authors.

Currently, there are no established diagnostic criteria for long COVID. For this study, researchers asked participants whether they currently or ever had long COVID, based on a doctor’s diagnosis or the Centers for Disease Control and Prevention's working definition of long COVID.

Finally, investigators used a Depression, Anxiety, and Stress Scale to measure those symptoms.

Women With Long COVID Were More Likely to Have Sexual Problems

Although COVID-19 had an incrementally negative effect on sexual well-being (meaning that women who’d never had the novel coronavirus would have better sexual function than women who’d had COVID-19, and women who’d had it would have better sexual function than women with long COVID), researchers didn’t see a difference in overall sexual dysfunction between women who’d never had COVID and women who had.

“Both groups had scores on the FSFI that fell within the range that is generally associated with healthy sexual functioning or well-being. The difference emerged between women with COVID and women with long COVID, in that only women with long COVID fell outside that ‘functional’ range and were likely to have sexual problems more generally,” says Stanton.

Researchers Didn’t Find a Link Between Depression or Anxiety and Sexual Issues

Researchers expected to see a relationship between depression or anxiety and sexual dysfunction — but their analysis didn’t uncover any connection. “That would explain or partially explain the relationship between COVID or long COVID and sexual problems, but we didn’t see those relationships in our data,” says Stanton.

“The findings are a useful first step in confirming an association between COVID and impaired sexual function,” says Stephenson.

As the authors acknowledge, different data — especially data collected over a long period of time — would be necessary to study this link more comprehensively and to test whether effective COVID-19 treatment improves sexual function, he adds.

Although more research is needed to establish a causal link between COVID-19 and impaired sexual health, even the possibility should be publicized widely, says Stephenson.

“If people are aware that COVID can have lasting impacts on their sexual function, it could motivate them to take basic protective measures that, unfortunately, have been politicized and neglected by some segments of the population,” he says.

If You’re Having Issues With Sexual Function Post-COVID, Here’s What to Do

Women who are having problems with sexual function should talk to their healthcare providers, says Stanton. “There is still a lot of stigma and shame around sexual concerns, and the more we normalize these conversations, the better,” she says.

There are lots of evidence-based psychological treatments and programs that improve sexual function and well-being in women, including cognitive behavioral therapy and mindfulness-based approaches, says Stanton.

“If women are willing to disclose these challenges and are aware of their options, they are more likely to get connected to providers and care teams who know how to help,” she says.