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Article: Study links restless leg syndrome with erectile dysfunction in older men Back to article | View all comments

Author: Tamer M. Fouad, M.D. | January 03, 2010

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September 26, 2010 04:17 PM
Tamer M. Fouad, M.D.'s avatar

A valid point Dr. Aroon, and one that could have easily been disclosed. Frankly I think it would have been more compelling than the link with erectile dysfunction. As I mentioned earlier in this discussion, the authors were out to confirm an earlier study which they published linking Parkinson’s disease to erectile dysfunction and suggesting a role for central dopaminergic hypofunction.


September 26, 2010 03:07 PM
M. Aroon Kamath, M.D.'s avatar

Dear Dr. Tamer,
Thank you for sharing this interesting study with us. There is at least one study which had observed a significant ethnic difference in the prevalence of restless legs syndrome especially in women. Non-African-American women (Caucasian) reportedly experienced restless legs syndrome (RLS) four times more often than their African-American counterparts [1]. In the article you have cited, of course, only a cohort of men were studied! However, it might be interesting to see the ethnic breakdown of the group studied.

1. Wahid Rashidzada, MD, Syed I. Nabi, MD, Ammar Alkhazna, MD et al. Racial Differences in the Prevalence of Restless Legs Syndrome. Paper presented at American College of Chest Physicians CHEST conference 2009.


April 22, 2010 10:19 PM
M. Jagesh Kamath, M.D.'s avatar

Sixty percent of men remain potent at 5th decade while 33% at 70 years.ED increases with age and may be related to atheroslerosis,medications,smoking,alcohol,diabetes,cholesterol and injuries.


April 22, 2010 11:13 AM
jane's avatar

i just have a question, at what age is it likely to affect the performance of the man?


March 03, 2010 03:04 AM
Tamer M. Fouad, M.D.'s avatar

Thank you Dr. Kamath for your kind comments.

I believe the point you make is very interesting. It would indeed be interesting to know whether these patients received drugs such as Sildenafil citrate (Viagra - approved in 1998, before the study was conducted).

The authors here were confirming an earlier observation which they published linking Parkinson’s disease to erectile dysfunction and suggesting a role for central dopaminergic hypofunction.

There are several limitations of cross sectional studies in general, but I think a complete evaluation of erectile dysfunction is warranted. This is a very common disease with well known risk factors all of which should be evaluated - depression / intake of SSRI antidepressants, medication history (use of thiazides for hypertension), neurological disease and testosterone levels. Diabetes mellitus, an important risk factor for erectile dysfunction and whose neurological complications can be confused with RLS was excluded from the study. However, cardiovascular disease is an equally important risk factor. It is widely known that erectile dysfunction could be an early sign of future cardiovascular disease and conversely, that cardiovascular disease can also lead to erectile dysfunction. It is hypothesized that endothelial dysfunction is a common incriminating factor for both disease. The Health Professionals Follow-Up Study (HPFS), from which this cross sectional analysis was taken, was conducted to evaluate the risks of chronic diseases such as cardiovascular diseases and cancer in men.

Thank you again for sharing your ideas. Your note is completely justified!


March 02, 2010 02:13 AM
M. Jagesh Kamath, M.D.'s avatar

Very interesting.The common factor relating to both would be nitric oxide which is a main vasoactive agent in Erectile Dysfunction and also in restless leg syndrome where variant association NOS1 gene is found.Mov Disord. 2008 Feb 15;23(3):350-8.

Variants in the neuronal nitric oxide synthase (nNOS, NOS1) gene are associated with restless legs syndrome.
Winkelmann J, Lichtner P, Schormair B, Uhr M, Hauk S, Stiasny-Kolster K, Trenkwalder C, Paulus W, Peglau I, Eisensehr I, Illig T, Wichmann HE, Pfister H, Golic J, Bettecken T, Pütz B, Holsboer F, Meitinger T, Müller-Myhsok B.

Institute of Human Genetics, GSF-National Research Center for Environment and Health, Munich, Germany. .(JavaScript must be enabled to view this email address)
May be some thing to work on.Thank you Dr.Fouad for a very thought provoking blog.


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