Nicki Minaj turned a lot of heads Monday when she told her 22 million followers on Twitter that she refused to take the COVID vaccine to attend the Met Gala, and that she planned to do more “research” before she got the shot.

But rumors like the one Minaj heard, particularly around men’s sexual health, have made up a common thread of COVID vaccine conspiracies that really do affect vaccine decision-making.

And they obscure an actually alarming fact: COVID-19 itself, not the vaccine, can “linger” in the penis and have serious effects on men’s sexual health.

Aymann Ismail: What do we know right now about how COVID can affect men’s sexual health.

Aaron Spitz: To the extent that we know there’s a separate and distinct problem that COVID is causing in men’s sexual health—aside from a man’s lungs, his heart, and all of that—there have been studies looking at fertility.

It’s a chicken-egg question: Did they have bad COVID because they had low testosterone, or did the COVID give them low testosterone.

But it’s entirely possible that the COVID made them have low testosterone, because in autopsy studies of men who died from COVID, a small percentage of them had inflammation and injury in the testicles themselves?

There are men who are seeking care for erectile dysfunction and low testosterone because they had COVID, and it’s verifiable that that’s why they have it.

That’s because a more common relationship between erectile dysfunction and COVID is likely to be anxiety and stress.

The stress component of COVID is a lot more likely to be the cause of erectile dysfunction than coronavirus itself?

There is no evidence of the vaccine causing any impairment to testosterone production or causing any inflammation or pain in the testicles or causing erectile dysfunction.

A guy may think he has erectile dysfunction because of the shot when it’s really performance anxiety?

The COVID vaccine is not causing an infection in your body.

Whereas the COVID infection, in fact, can attack the cells of the testicle because that virus binds to those cells and then it can drop its viral load into the cells and then it reproduces and then it explodes itself.

But it is not due to the COVID vaccine.

Do your patients often ask about COVID and sexual performance in men.

Have you been seeing any misinformation that you want to take this moment to dispel when it comes to how the COVID vaccine affects a man’s health.

The best thing I can say is when male health has been studied in the context of the COVID vaccine, what’s been demonstrated is that sperm counts temporarily improve.

Just to be very clear, what is the greater risk for a man’s sexual health: getting the COVID vaccine or not getting it.

The greater risk is not getting the vaccine because it’s very hard to have good sex when you’re dead.