LOW 25-HYDROXY-VITAMIN D3 CONCENTRATIONS ARE ASSOCIATED WITH SEXUAL SYMPTOMS IN MIDDLE-AGED AND OLDER MEN

Several observational studies have linked vitamin D to cardiovascular health. Through its role in nitric oxide production in the vascular epithelium, vitamin D metabolites mediate endothelial function and can as such play an important role in erectile function. We investigated associations between 25-OH-vitamin D3 (25(OH)D3) concentrations and sexual function in a large cohort of European men.

This cross-sectional study included data from men (40-79 years) who participated in the European Male Ageing Study (EMAS). 25(OH)D3 was measured by radioimmunoassay. Sexual symptoms were assessed using a validated questionnaire (EMAS-SFQ). Regression analysis was used to study the association between serum 25(OH)D3 concentrations and sexual symptoms (frequency of sexual thoughts, frequency of morning erection and ability to maintain a sufficient erection), with adjustments for age, center and smoking status.

25(OH)D3 was measured in 3233 community-dwelling EMAS participants, with a mean age of 60.0 years (SD 11.0). Mean 25(OH)D3 concentration was 24.98 μg/L (SD 12.70). 27% of men had low frequency of sexual thoughts, 38% experienced a decrease in morning erection frequency and 29% reported erectile dysfunction.

Linear regression analysis showed significantly lower 25(OH)D3 levels in men who reported sexual symptoms: beta coefficient and 95% confidence interval: -1.15 (-2.22; -0.08), p-value 0.036 for low frequency of sexual thoughts; -2.53 (-3.51; -1.55), p < 0.001 for lower morning erection frequency and -1.69 (-2.80; -0.59), p = 0.003 for erectile dysfunction.

Logistic regression analysis comparing men with 25(OH)D3 concentrations <=20 μg/L to men with 25(OH)D3 concentrations >20 μg/L confirmed that men with normal 25(OH)D3 had a lower risk of having sexual symptoms: odds ratio and 95% confidence interval: 0.83 (0.69; 0.98), p: 0.033 for low frequency of sexual thoughts, 0.76 (0.65; 0.90), p = 0.001 for lower morning erection frequency and 0.74 (0.61; 0.88), p = 0.001 for erectile dysfunction.

We observed an association between lower 25-hydroxy-vitamin D3 concentrations and sexual dysfunction in middle-aged and older community-dwelling men. Whether the association between low vitamin D and sexual dysfunction is mediated by vascular or other mechanism rather than a reflection of poor health should be further investigated.

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