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Study links restless leg syndrome with
erectile dysfunction in older men
Westchester, Ill. — A study in the Jan. 1
issue of the journal Sleep shows that
erectile dysfunction was more common in
older men with restless leg syndrome (RLS)
than in those without RLS, and the magnitude
of this association increased with a higher
frequency of RLS symptoms.
Results show that erectile dysfunction was
16 percent more likely in men with RLS
symptoms that occur five to 14 times per
month (odds ratio of 1.16) and 78 percent
more likely in men whose RLS symptoms occur
15 or more times a month (OR=1.78).
The associations were independent of age,
body mass index, use of antidepressants,
anxiety and other possible risk factors for
RLS.
Fifty-three percent of RLS patients and 40
percent of participants without RLS reported
having erectile dysfunction, which was
defined as a poor or very poor ability to
have and maintain an erection sufficient for
intercourse.
The results suggest it is likely that the
two disorders share common mechanisms, said
lead author Xiang Gao, MD, PhD, instructor
at Harvard Medical School, associate
epidemiologist at Brigham and Women's
Hospital and research scientist at the
Harvard School of public health in Boston,
Mass.
"The mechanisms underlying the association
between RLS and erectile dysfunction could
be caused by hypofunctioning of dopamine in
the central nervous system, which is
associated with both conditions," said Gao.
Data were collected from 23,119 men who
participated in the Health Professionals
Follow-up study, a large ongoing U.S. cohort
of male dentists, optometrists, osteopaths,
podiatrists, pharmacists and veterinarians.
Participants were between the ages of 56 and
91 years, with a mean age of 69 years. To
reduce possible misclassification of RLS,
participants with diabetes and arthritis
were excluded.
Participants were questioned in 2002 about
RLS diagnosis and severity based on the
International RLS study group criteria. RLS
was defined as having unpleasant leg
sensations combined with restlessness and an
urge to move; with symptoms appearing only
at rest, improving with movement, worsening
in the evening or at night compared with the
morning, and occurring five or more times
per month.
About four percent of participants had RLS
(944 of 23,119 men), and about 41 percent
(9,433 men) had erectile dysfunction. Men
with RLS were older and were more likely to
be Caucasian. The prevalence of erectile
dysfunction also increased with age.
The authors noted that the association
between RLS and erectile dysfunction also
could be related in part to other sleep
disorders that co-occur with RLS. For
example, obstructive sleep apnea and sleep
deprivation may decrease circulating
testosterone levels.
They also pointed out that the
cross-sectional design of the study did not
allow for a determination of causality.
Further epidemiological studies are needed
to clarify the relationship between the RLS
and erectile dysfunction and to explore the
biological mechanisms underlying the
association
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