MONTREAL -- Gentlemen, get your masks (and your vaccines, and your social distancing): COVID-19 could multiply your risk of suffering from erectile dysfunction -- and if you already suffer from it, you could also be at greater risk of being infected by COVID-19.

And we're not talking about older men who are already known to be particularly vulnerable to COVID-19: the average age of the subjects studied by Italian researchers was 33 years.

The author of the study, Dr. Emmanuele A. Jannini, issued a strong warning: "mask up to keep it up."

"It's a two-way association: if you have erectile dysfunction, you are more likely to have COVID-19, and conversely (...) people who have had COVID-19 seem to have a greater chance of developing erectile dysfunction," summarized Dr. Luc Valiquette, a urologist at the CHUM and a professor in the department of surgery at the Université de Montréal.

The risk was increased five- or six-fold in both cases.

The second association, the one that seems to show an increased risk of erectile dysfunction in men who have had COVID-19, is “particularly interesting," added Valiquette, who believes that the problem is possibly due to “pathologies at the level of endothelial dysfunction, from a vascular point of view."

This is a new aspect in addition to other unusual effects, such as loss of smell, that have already been associated with COVID-19, he said.

"Problems with taste or smell are immediate," Valiquette said. "People notice it right away. (...) People who are in the hospital in intensive care, or when they're on a ventilator, they don't talk about their erectile dysfunction problem because they're not in a situation where they're going to notice it."

So, it's possible that six months or a year from now we could be describing long-term erectile damage in men who have had COVID-19, he warned.

The first association, that men with existing erectile dysfunction are at increased risk for COVID-19, is quite "plausible," Valiquette said, since the two conditions share many of the same risk factors.

Erectile dysfunction is often linked to other factors -- such as high blood pressure, smoking, diabetes or obesity -- that put men at increased risk for COVID-19 and complications.

While it will take many more months, if not years, and many more studies to better understand the association between COVID-19 and erectile dysfunction, the Italian study gives at the very least one more reason to take the coronavirus very seriously.

The mortality rate of COVID-19 in young men is very low, and it is probably not the risk of dying from the virus that makes them most cautious. However, the risk of seeing problems with their erections may be a much greater incentive for them to wear a mask or to get vaccinated as soon as possible.

- This report by The Canadian Press was first published April 19, 2021.