Vitamin D deficiency is independently associated with greater prevalence of erectile dysfunction: The National Health and Nutrition Examination Survey (NHANES) 2001–2004


      • Both Vit D deficiency and ED have been linked to increased cardiovascular risk.
      • We found that both Vit D deficiency and ED were common in US men, with prevalence of 30% and 15%, respectively.
      • We found Vit D deficiency was independently associated with ED after accounting for lifestyle and vascular risk factors.
      • Additional research is needed to evaluate whether treating Vit D deficiency improves erectile function.


      Background and aims

      Erectile dysfunction (ED) and atherosclerotic cardiovascular disease (ASCVD) share many common risk factors, and vascular ED is a marker for increased ASCVD risk. Low 25-hydroxyvitamin D [25(OH)D] concentrations have been associated with increased ASCVD risk, but less is known regarding the relationship of low 25(OH)D with ED. We determined whether 25(OH)D deficiency is associated with ED independent of ASCVD risk factors.


      We performed cross-sectional analyses of 3390 men aged ≥20 years free of ASCVD who participated in NHANES 2001–2004. Serum 25(OH)D was measured by the DiaSorin radioimmunoassay; deficiency was defined as levels <20 ng/ml (<50 nmol/L). Self-reported ED, assessed by a single validated question, was defined as men who reported being “never” or “sometimes able” to maintain an erection. We assessed the relationship between 25(OH)D deficiency and ED prevalence using adjusted Poisson regression methods.


      After accounting for NHANES sampling, the weighted prevalence of 25(OH)D deficiency and of ED were 30% and 15.2%, respectively. 25(OH)D levels were lower in men with vs. those without ED (mean 22.8 vs 24.3 ng/mL, respectively; p = 0.0005). After adjusting for lifestyle variables, comorbidities, and medication use, men with 25(OH)D deficiency had a higher prevalence of ED compared to those with levels ≥30 ng/ml (Prevalence Ratio 1.30, 95% CI 1.08–1.57).


      In this cross-sectional analysis of a representative sample of U.S. men, vitamin D deficiency was associated with an increased prevalence of ED independent of ASCVD risk factors. Additional research is needed to evaluate whether treating vitamin D deficiency improves erectile function.

      Graphical abstract



      25(OH)D (25-hydroxyvitamin D), ED (Erectile Dysfunction), ASCVD (Atherosclerotic Cardiovascular Disease), US (United States), NHANES (National Health and Nutrition Examination Survey), RIA (Radioimmunoassay), PRs (Prevalence Ratios), CI (Confidence Intervals), PDE5 (Phosphodiesterase type 5), BMI (Body Mass Index), CRP (C-Reactive Protein), GFR (Glomerular Filtration Rate), MMAS (Massachusetts Male Aging Study)
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