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Try out PMC Labs and tell us what you think. Learn More. Coronavirus is an infectious disease that has affected many countries, changing daily life. For many individuals, sexual activity has decreased, physical contact within couples has been reduced.

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Obviously, to maintain a safe sex life, it is essential to know how to avoid the virus transmission. Distance creates irritability, fear, anxiety, endangering sexual life: it is reasonable to have sex between cohabiting partners unless one or both are at risk of infection. Despite this, the pandemic allows us to think of new sexual intimacies mediated by sextoys and technology.

Not all distant couples are willing to have sex online, and it is difficult for singles to engage in casual sexual relations, so after the pandemic there will be many couples who will have to remodel and many singles who will seek a partner. Using the Internet to maintain active sexual activity appeared to be an excellent alternative to diminish the distance between partners or to increase online knowledge.

The most common advice for separated couples was to maintain constant digital contact to alleviate nostalgia and lack. This was the springboard to use sexting, meeting via webcam or making a hot call that make the couple more uninhibited. Using the webcam, also sometimes with the possibility to use sex toys, could create also the opportunity to enrich the future sexual repertoire.

Practicing online sex with the stable partner far from home has helped some to keep their desire active and to satisfy it in order to be able to realize it once the pandemic has ended. The purpose of this narrative review of available evidence on sexuality during COVID pandemics is to provide recommendations to help people facing their sexual life in this critical period.

Between the31 December and of the 27 November there were 60, confirmed cases of Covid in accordance with the applied case definitions and testing strategies in the affected countries and a reported 1, deaths World Health Organization, The most common transmission routes of the novel Coronavirus include direct transmission through coughing, sneezing and droplet inhalation and contact transmission contact with oral, nasal, and ocular mucous membranes Qiu et al.

Respiratory droplets and physical intimacy, which implies being within someone's personal space e. Humanity has witnessed a high and rapid increase of mortality, especially among the elderly who have been obliged to face the disease and die alone, in intensive care wards, without the proximity of their loved ones. In many countries, people have felt in danger while being isolated and quarantined for almost three months. They had to reduce or entirely eliminate all close social contact and live their lives within their own homes.

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It has been a difficult period for everyone: children and adolescents have been unable to attend school and see their companions or friends, unemployed women and men have been trying to survive on their savings and some elderly people have been left alone at home or in retirement homes. Everyone has had trouble dealing with the situation of stress and discomfort that has threatened our lives and those of our families.

Covid has also affected sexuality among adolescents, young people and adults, transforming their attitudes towards long-distance couples. We included in this narrative review all the literature found on the specific aspect of sexuality in the Covid era.

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We selected all the articles written in English, originating from Western Countries, to facilitate cultural interpretation and access to the full text, based on the availability of data presented. After reading the abstracts, we selected 28 articles based on their contents and aims.

After reading the full text, we selected 20 articles for this review. In the following paper we will discuss sexuality during the Covid era, considering different aspects such as sexual health and function, masturbation, relationships and sexual transmission, also in specific subgroups such as youths and LGBTQ.

The pandemic has obviously complicated sexual intercourse, changing social relations around the world due to restrictions and the fear of contracting the disease Van Doremalen et al. The fear of contagion brought sudden change, giving people no time to adapt to the new situation — a dramatic period during which images of disease and death were broadcasted daily on social media. The literature has examined the psychosocial responses of the population to the grave situation and the most frequent topics are fear, depression, anger, a sense of guilty, pain and loss, post-traumatic stress and stigma Pan et al.

Everything has been turned upside down, daily routines and freedom have been restricted, there has been a loss of independence and a loss of work, which has instilled a sense of uselessness among men and a sense of helplessness in the face of the emergency Qiu et al.

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Couples have been weakened by being confined at home together for 24 hours a day, space limitations, quarrels between cohabitants and differences of opinion. But all negative emotions also have a negative impact on sexual intercourse, in fact sexual health is part of emotional and social well-being Li et al. During this period, sexual relationships between partners have suffered; in couples with children, the negative impact has been reinforced by the continuous presence of children at home, due to the closure of schools, and consequently the difficulty in seeking and finding moments of intimacy.

Sexuality is greatly influenced by sexual desire and the latter is inhibited by negative moods. Indeed, emotions such as anxiety and depression have been associated with low levels of desire. To the contrary, those who were in a stable relationship but did not live together have felt strong mutual desire that they have been unable to satisfy due to the restrictions imposed. In these cases, however, the use of Internet has potentially been the source of a different sexual experience, even though not all couples were willing to engage in online sex.

The situation has been different for single people for whom casual sexual intercourse has been made difficult. For those accustomed to extramarital intercourse at work or elsewherethere has been no opportunity to fulfill their sexual desires, firstly because almost employment has been reduced and secondly due to forced coexistence and limited outings Chen et al.

Considering the WHO guidelines on social distancing and sexual abstinence, facing the pandemic has been tough for those without a stable sex partner. Hence, a safe recommendation for people who wanted to satisfy their sexual needs without the risk of infection has been masturbation Turban et al.

According to Kaplanmasturbation is a construction and should fulfil sexual fantasies. Furthermore, the quarantine could be viewed as an opportunity to create new fantasies and discover new preferences through documentaries, films and educational materials.

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Not only have psychological implications decreased sexual desire, but logistical problems have also reduced sexual relations. A British study presented data from a cross-sectional epidemiological online survey Jacob et al. In an American study conducted on couples Lehmiller et al. An Italian study Schiavi et al. Despite the extended cohabitation time, women who live with their partners have ificantly reduced sexual activity. A Polish study Fuchs et al. They also found a decreased frequency of sexual intercourse compared to the period. The majority of women declared that the reason might be associated with isolation from the partner Finally, only 3.

Similar were found in a Turkish study Yuksel and Ozgor, Participants had ificantly better total FSFI scores before the pandemic than during the pandemic The other three domain scores for arousal, orgasm, and satisfaction were ificantly higher before the pandemic than during it 3. In an Australian study Coombe et al. However, Most participants Across all variables, men who have sex with men MSM were the most likely to report having less sex than in A smaller of participants 1.

Regarding sexual activity, when participants were asked if they had changed their sexual practices because of Covid, When stratified by frequency of sexual activity during lockdown, those who reported less or no sex during lockdown were more likely to report using sex toys alone A total of 98 participants Studies have shown that the virus is present in saliva, so kissing, which is the most common practice during sexual intercourse, is very risky during the pandemic. Unfortunately, fecal-oral transmission is also possible, as the virus has been found in the feces samples of infected patients Ott and Santelli, and in the seminal fluid and urine of infected people.

However, there is no evidence that Covid is transmitted through vaginal or anal intercourse, but there is some evidence of oral-fecal transmission and this implies that anilingus may represent a risk of infection. Infected pregnant women who had a vaginal delivery have not given birth to infected babies, but SARS-CoV-2 may be present in the semen of recovering patients Eaton et al. The disease may be present in the male reproductive tract and although the virus cannot replicate, it can persist.

In this case, if it is present in the sperm, then it would be essential to prevent transmission through abstinence or the use of condoms Centers for Disease Control and Prevention, Sexual expression is a central aspect of health; sometimes this aspect is neglected by health professionals and many individuals can develop insidious thoughts at a particular moment, when mental health is most susceptible. For example, some groups representing sexual and gender minorities may be victims of sexual stigma, as revealed by the trauma caused by other pandemics such as AIDS.

Therefore, recommending abstinence may evoke memories of stigmatization and prolonged abstinence is unlikely to be effective, given the well-documented failures of public health interventions on this subject Ott and Santelli, Abstinence is the most basic approach to sexual health during the pandemic, in fact, during a pandemic, masturbation is a further safe recommendation for people to satisfy their sexual needs without the risk of coronavirus infection. Sexual health is everyone's right and sexual activity is a fundamental part of life and physical health in general.

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Poor health can affect sexuality, as is the case for diabetes, chronic pain, depression, heart disease, and cancer, which can impair sexual function. Quarantine during the pandemic has compressed sexual activity and little information has been given on how to maintain good sexual health. Sexual health is essential part of the general health of couples and families. Studies have correlated sex with greater mental health satisfaction, increased levels of intimacy and love in relationships, improved ability to perceive, identify and express emotions, and the reduced use of defense mechanisms Zhang et al.

In a Spanish study Ballester-Arnal et al. Approximately one third, However, there were ificant differences according to gender. Women represented a ificantly higher percentage In general terms, desire decreased among men while it increased among women. An Italian study Panzeri et al. Men

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