Could Restless Legs Syndrome Be Linked to Erectile Dysfunction?

A new study finds that men with restless legs syndrome are more likely to have erectile dysfunction as well. Find out the relationship between the two conditions and what can be done.

On the surface, restless legs syndrome and erectile dysfunction (ED) seem to be two unrelated medical conditions — but new research indicates that they may in fact be linked.

A recent study published from Harvard University found that men who had symptoms of restless legs syndrome (RLS) face a higher risk of impotence, or erectile dysfunction. Researchers surveyed 11,000 men and discovered that those who met the standards for RLS were 50 percent more likely to become impotent than men without the syndrome. And the more frequent the RLS symptoms, the higher the risk.

This study builds on an earlier report published in the journal Sleep. And while it does not prove that the two conditions are always linked, it does provide a starting point for further research, says David Luterman, MD, medical director of the Sleep Center at Baylor University Medical Center in Dallas.

“Not everyone with restless legs has erectile dysfunction,” Dr. Luterman says. “But the occurrence is greater than in the general population.” The key may be dopamine, a neurotransmitter in the brain that plays a role in both RLS and ED. Dopamine helps to relax the muscles of the penis, leading to an erection, and many researchers believe that proper transmission of dopamine signals from the brain is essential to avoiding RLS symptoms. (Dopamine agonists, medications that increase the amount of dopamine in the brain, are often effective at treating RLS.)

“If both of these [conditions] are due to disorders with dopamine, there may be some link to dopamine — how it’s metabolized in the brain or what it does in the brain,” Luterman says. While these new findings won’t have an immediate effect on how RLS or ED are treated, he adds, they could influence future improvements in medications or other therapies. “But that’s many, many, many years down the road,” he says.

Diagnosing ED and Restless Legs Syndrome

In the meantime, there are ways to diagnose and treat both restless legs syndrome and erectile dysfunction. ED is characterized by an inability to get or keep an erection for sexual intercourse and is more likely to occur in older men. Many prescription medications, such as sildenafil (Viagra) and tadalafil (Cialis) are available to treat ED.

However, if these medications don’t work, a visit to a specialist is in order to check for underlying causes. “ED can sometimes be caused by atherosclerosis, which can affect blood flow to the penis,” Luterman says. “If you don’t respond to normal medications, you need to go to a urologist.”

The hallmark of restless legs syndrome is an uncontrollable urge to move one’s legs. Some people may feel strange sensations that are alleviated by moving the legs. “It can be a burning, an itching, a feeling like creepy-crawlies under your skin,” Luterman says. “Or you can have none at all, just a feeling like you’ve got to move your legs. The symptoms are always worse at night.” RLS commonly starts in midlife, but can occur at any age, he adds.

Medications are available to provide relief from RLS. Pramipexole (Mirapex) and ropinirole (Requip) are both effective in treating RLS, as long as you take them at the right time. “If you take them right at bedtime, you’re going to have problems for an hour or so,” Luterman says. “They should be taken one hour before bedtime so you’ve got a level built up.”

If these drugs don’t work, neurological medications, such as gabapentin (Neurontin), or narcotic pain relievers may be used to help relieve RLS symptoms. However, Luterman says, if leg movements don’t affect a person’s ability to sleep at night, medications may not be needed. “If you have leg movements and sleep like a baby, there isn’t a problem to treat,” Luterman says. “Or someone may just be a leg tapper. It doesn’t mean they have RLS.”

If you suspect that you may have RLS, visit your primary care physician or consult a doctor who specializes in sleep disorders.

By Jennifer Acosta Scott – Medically reviewed by Pat F. Bass III, MD,