Association between restless legs syndrome and erectile dysfunction: a systematic review and meta-analysis

To evaluate whether patients with RLS have increased odds of ED compared with non-RLS controls.

We conducted a systematic review and meta-analysis analyzing the odds of ED in patients with RLS. We included studies that: (i) evaluated adults with a diagnosis of RLS established by the pre-established criteria; (ii) included a control group without RLS; and (iii) evaluated outcomes related to the odds of ED in patients with RLS. We followed the PRISMA 2020 protocol.

This systematic review included a total sample of 33,740 participants. Patients with RLS had 70% higher odds of ED compared with non-RLS controls (OR = 1.70; 95% CI: 1.52-1.91; p < 0.001; I² = 0%). The group with severe RLS had lower odds of ED than the mild-moderate RLS group (OR = 0.67; 95% CI: 0.53-0.84; p = 0.0005). The RLS group presented increased odds of severe ED compared with non-RLS controls (OR = 4.51; 95% CI: 1.52-13.33; p = 0.006; I² = 0%), but no significant difference compared with controls for mild or moderate ED (p > 0.05).

Individuals with RLS have 70% higher odds of ED compared with non-RLS controls. Severe ED was more frequent among patients with RLS, while no significant differences were observed for mild or moderate ED. These findings support ED screening in patients with RLS.

The online version contains supplementary material available at https://doi.org/10.1007/s41105-026-00674-4.