It’s been nearly a year since the first COVID-19 vaccines received emergency use authorization from the Food and Drug Administration (FDA), but some people still have questions about the shots—especially about the possibility of sexual side effects—that are keeping them from getting vaccinated.
Nicki Minaj, for instance, wrote on Twitter this week that she’ll get vaccinated only “once I feel I’ve done enough research. I’m working on that now.” Minaj then followed that up with a bizarre and questionable story about her cousin in Trinidad who “won’t get the vaccine cuz his friend got it & became impotent,” she wrote. “His testicles became swollen. His friend was weeks away from getting married, now the girl called off the wedding.” But the truth is that there’s no research to suggest that the COVID-19 vaccines can alter sexual performance—including sperm production, erectile dysfunction, or swollen testicles.
“There is no evidence that vaccines, including COVID-19 vaccines, cause male fertility problems,” according to the Centers for Disease Control and Prevention (CDC). The most common side effects of the COVID-19 vaccines are slightly different depending on which vaccine you get, but they generally include pain at the injection site, fatigue, headache, fever, and chills. Those side effects are temporary (lasting just a day or two, typically) and tend to be more severe after the second dose than the first.
Some people develop side effects that are much more noticeable, even to a degree that can actually make it difficult for them to do their usual tasks during the day—including, possibly, having sex. But, again, those side effects are temporary and do not specifically include sexual performance issues or swollen testicles (technical term: orchitis).
On the other hand, there is some preliminary evidence that the coronavirus can cause issues with sexual performance—especially for those with penises. For instance, a small study published in the journal Andrology looked at survey data for 100 sexually active men (25 had COVID-19 at some point, 75 did not). Their results showed that men who had COVID-19 were much more likely to report having erectile dysfunction than those who hadn’t had the virus.
Another recent study, this one published in the World Journal of Men’s Health, actually looked at tissue samples from four people (two of whom had COVID-19 previously) undergoing surgery to treat severe erectile dysfunction. The researchers detected viral particles in tissue from both of the participants even though they had long gotten over their infections. They also found evidence of issues with endothelial cells (which line blood vessels) in those who’d had COVID-19, which suggests that the virus can actually affect sexual function by damaging those cells.
That’s why the American Society for Reproductive Medicine (ASRM) recommends COVID-19 vaccines to men who are eligible to receive them. “COVID-19 vaccines should be offered to men desiring fertility, similar to men not desiring fertility, when they meet criteria for vaccination,” the ASRM said in a statement. (The ASRM does note that some people develop a fever after vaccination, and a fever can temporarily reduce sperm production, “but that would be similar to or less than if the individual experienced fever from developing COVID-19 or for other reasons.” A recent study in JAMA confirmed that it’s unlikely you’ll experience a significant drop in sperm production after the vaccine.)
Of course, there are plenty of other possible conditions that might cause someone to develop sexual performance issues—whether or not they’ve had COVID-19 or the vaccines. In fact, some of the most common causes of orchitis are actually other infections, including mumps and sexually transmitted infections like gonorrhea or chlamydia, the Mayo Clinic explains. Orchitis can also be a result of epididymitis, a bacterial infection in the epididymis. Getting your regular vaccines (including the childhood MMR vaccine, which protects against mumps) and sticking with safer sex practices, such as getting tested for STIs, can reduce the risk for conditions that cause orchitis.
It’s perfectly normal to have questions about the COVID-19 vaccines and to be nervous if you hear that someone you know may have had a less than stellar experience with them. But it’s important to talk through those questions and concerns—and weigh any potential risks and benefits of the vaccine against those of getting a COVID-19 infection while unvaccinated—with a qualified and trusted expert, like your primary care doctor, rather than to speculate wildly on social media.