COVID-19 has affected the lives of every individual including the physical, social, emotional and psychological aspects of health. The physical restrictions which came along with this pandemic has changed the interpersonal and social relationships of many couples and people. The factors which influence the sexual and reproductive health of people include the risk perception and fear of contracting the virus through physical contact with the partners, lack of intimate time because of the presence of children and other family members at home all the time, social distancing, and emotional instability leading to decreased interest in sexual activity.

• Sexual Health; COVID-19; Quarantine

Rahim KA, Soomar SM (2025) “From Quarantine to Connection”: Exploring the Patterns of Sexual Health During COVID-19. JSM Sexual Med 9(5): 1171

COVID-19 being a new emerging disease has not only affected domains of life including physical, social, emotional and psychological, but also the sexual health. SARS CoV-2 is a novel virus which has impacted on sexual and reproductive health (SRH) greatly including virus contraction during pregnancy, immunosuppression related to HIV/AIDS, and other elements including a drastic rise in the gender-based violence, domestic abuse, and labelling stigma on people who acquired the novel coronavirus [1]. COVID-19 being declared as a pandemic by World Health Organization in March, 2020 imposed physical restrictions and social distancing around the globe, and changed the social relations amongst people because of the fear of the contagion of the disease [2]. These changes forced us to adapt and adjust in the new normal in to which we are living today, impacting the emotional stability of a person. There are growing evidences on the development of depression, anxiety, fear, post-traumatic stress disorder and other psychological responses in a response to COVID-19. A study was conducted in china which concluded that up to 45% developed depression, nearly 30% developed anxiety, and approximately 45% developed somatic symptoms as a result of epidemic of COVID-19 in China, with a negative correlation to psychological resilience [3]. These psychological outcomes have affected the sexual life of the people to a great extent. The fear of acquiring COVID-19 has led to physical distancing between couples with a wide restriction from kissing to having a complete sexual intercourse [4]. On the contrary, during the initial days of lockdown and quarantine, it was hypothesized that the expected number of births may rise till the time the lockdown is lifted as it gives couples more time to spend with each other leading to increased sexual intercourse and intimacy [5]. A study was conducted in Italy to identify the impact of COVID-19 on the sexual life of couples which concluded that the lockdown greatly affected the privacy of the couples because of the presence of children and parents at home all the time, and the fear of getting the virus hinders in the stimulation of getting a sexual desire ultimately leading to decreased sexual intercourse [5].

COVID-19 has affected the sexual health of young teenagers, adolescents and young adults also. With all the obligations that came with the lockdown and being quarantine, it opened the room for online connections amongst many people, especially teenagers. More than 60% of the teenagers reported that they engaged in online connection more often than the usual with their partners doing online dating, romantic and erotic interactions, sexting, doing virtual sex and a lot more activities [6]. We dig some of the common healthcare and medical sciences search directories including Scopus and PubMed and listed down some relevant sexual health them that may have strongly created a connection with COVID-19 and quarantine.

The objective of this narrative review was to explore the effect of COVID-19 on sexual and reproductive health, mainly concerned with physical, social, emotional, and psychological aspects. A detailed search was performed in various databases such as PubMed, Scopus, Google Scholar and Web of Science to collect appropriate literature published from January 2020 up until December 2024. We used a combination of key phrases (i.e., “COVID-19,” “sexual health,” “reproductive health,” “pandemic”, “intimacy” and “relationships”) to extensively search the literature in different layers.

English peer-reviewed papers, reports, and policy papers were eligible if they discuss various facets of sexual health in connection with the COVID-19 pandemic. Furthermore, the articles were required to be first published in the year 2020. Subsequently, all meaningful pieces of evidence were identified, summarized, and narratively synthesized to form ubiquitous themes. The thematic approach method helped identify the overarching patterns illustrating the pandemic’s repercussions on the sexual behavior, intimacy, and reproductive health. Consequently, the method helped reveal the interacting clusters of topics relevant to the study’s aims.

Total four themes or topics have been noticed commonly available in literature. These are focused on sex and COVID transmission, sexual life and desires, self pleasure during quarantine and increased engagement in consuming pornographic content.

Sex and SARs CoV-2 transmission

The transmission of SARS CoV-2 in relation to sexual acts is debatable. There is empirical evidence that the transmission of COVID-19 follows the route of mouth when both the partner’s kisses each other as this is a respiratory virus and is found to be present in the saliva of the infected individuals. The virus also follows the route or oral-anal sex which was confirmed by a study in United states between men-to-men sex [7].

Researchers from China identified traces of SARS CoV 2 in the semen of few men who were either COVID-19 positive or they recovered from the infection; however, this does not necessarily mean that the virus can be sexually transmitted [8]. There are evidences which suggest the presence of coronavirus in the feces of the infected person, so there are chances of contracting the virus if you get exposed to the fecal material through oral sex, anal sex, or putting a sex toy in your mouth after it’s been used in someone’s anus [9]. However, there are no evidences on the presence of SARS CoV-2 in vagina or vaginal fluids. Thus, people may get the virus from sexual activities like fore play and kissing, but there no evidences on the spread of virus through vaginal intercourse [10].

Sexual life and desires during the pandemic

COVID-19 has not only affected the frequency of sexual intercourse but has also influenced the sexual desires of people. A study was conducted to identify sexual behaviors among females during pandemic which highlighted that frequency of sexual intercourse and having that sexual desires have significantly increased during the pandemic; however, the quality of sexual life has significantly decreased as females now report less desire to get pregnant, less desire to use the contraceptives and contracted more menstrual disorder than before [11]. On the contrary, a study conducted in China concluded that people now experiences low desires of having sex, low frequency of sexual intercourse, increased frequency of masturbation, and reported deteriorating relationships with their partners [12].

COVID-19 has greatly affected the sexual life of many individuals around the globe either positively or negatively. A study was conducted in Taiwan using an online survey recruiting more than 1900 participants which showed that up to 13% of the participants reported decrease in sexual intercourse and sexual satisfaction whereas nearly 3% participants reported an increase in the frequency and sexual satisfaction; however, the risk perception of getting novel coronavirus was negatively associated with the sex seeking behaviors and activities [13].

Pandemic and Pornography consumption

The growth of pornographic websites during the pandemic is tremendous. Because of the physical restriction which came along with this pandemic, the use of pornography raised significantly [14]. The risk perception of COVID-19 affected the sexual behaviors of men-to-men sex also (MSM), and they reported increase in the use sex phone, webcams and watching porn more often than before the pandemic [15]. Surprisingly, the gender diverse community in India reported increased use of pornographic content consumption than does the heterosexual individuals [16]. These changes in sexual habits are directly related to the social restrictions of staying at home, the presence of children and family members at home all day long, fear and risk perception of acquiring novel virus, variances in partner relationships and not being able to meet with people [4], which forces them to move towards pornography.With the increase in the use of watching adult websites in the early onset of the pandemic, many of the webpages made their premiums less costly or free access to increase their outreach. Till the end of April, 2020, the traffic growth raised up to 9% in Poland, 15% in Romania, 17% in Hungary, and 20% in Russia [17]. However, the traffic growth for a common adult website in the United Kingdom was approximately 27% at the beginning of the pandemic (by early March 2020), which then decreased to 10.5% by the mid of July, 2020 [18].

Self-Pleasure during quarantine

Not only has the pandemic led to the variances in the partnered sex, but it has also influenced the solo sex practices which are pleasure positive and referred to self pleasure experience. It is believed that alone individuals who are quarantined at their places have more time and desire to masturbate [19]. As discussed above, the amount of pornographic consumption have increased significantly during pandemic which is done not only to get visual satisfaction, but also as a medium to practice excess masturbation [20]. An online study was conducted in china which reported that 20% of the participants reported increased in the frequency of masturbating than before during the lockdown [12]. This has also increased the online sale of many sex toys around the globe.

People are now moving towards new digital modes of sexual satisfaction such as “sexting”. With the physical restrictions, the people are now paving their paths towards cyber-sex, in which they share nude pictures with each other and feel the sexual satisfaction and pleasure [21].

In conclusion, COVID-19 has affected all domains of life including the sexual health of many individuals around the globe. The sexual health and patterns of individuals are transformed depending on their self- experiences and self-perceptions. Thus, it cannot be judged that what is more positive and what is not? While some people had a chance to get more intimate during this lockdown, there were some people who were unable to experience this intimacy because of various reasons. In addition to this, the pandemic increased the frequency of pornographic content consumption, increased in the frequency of masturbation and sexting. However, further studies are required to identify the possibility of sexual transmission of the virus and individual experiences of sexual health and life during pandemic. Also, there is an increased need to expand the positive sexual health information related services around the globe.

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