{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:50:03Z","timestamp":1765212603836,"version":"3.46.0"},"reference-count":41,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Erectile dysfunction (ED) is a common sexual disorder in men, frequently linked to endothelial dysfunction affecting penile vasculature. Accumulating evidence suggests that vitamin D (VD) status may influence endothelial function and, consequently, erectile function. VD deficiency has also been associated with cardiovascular risk factors, which are well-known contributors to ED. Methods: A systematic review following PRISMA guidelines was conducted, analyzing studies from PubMed and Cochrane databases published between 2010 and 2025. Randomized controlled trials, observational studies, and pilot clinical trials examining the relationship between VD levels and ED in the general male population were included. Results: Out of 1335 identified articles, 10 studies met inclusion criteria, encompassing over 13,000 men. Observational studies consistently showed that men with moderate-to-severe or arteriogenic ED had significantly lower serum VD levels and poorer erectile function scores compared to those with mild ED. VD deficiency was independently associated with higher ED prevalence, irrespective of lifestyle, cardiovascular risk, or sex hormone levels. Although several observational studies suggested a potential optimal vitamin D threshold, definitive recommendations cannot be established due to the heterogeneity of available evidence and conflicting findings from randomized controlled trials. The latter demonstrated inconsistent effects of vitamin D supplementation on erectile dysfunction outcomes, with the largest trial reporting no significant reduction in disease prevalence. These findings underscore the critical need for rigorously designed trials targeting populations with severe VD deficiency and arteriogenic ED. Conclusions: This systematic review highlights an association between vitamin D status and erectile dysfunction, particularly in men with moderate-to-severe or arteriogenic ED. However, most of the evidence is derived from low-certainty observational studies. While observational data suggest potential benefits of adequate VD levels for sexual health, well-designed randomized controlled trials are essential to delineate causal relationships and potential for therapeutic efficacy.<\/jats:p>","DOI":"10.3390\/jcm14248630","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:20:29Z","timestamp":1765210829000},"page":"8630","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Association Between Vitamin D Levels and Erectile Dysfunction in Men: A Systematic Review"],"prefix":"10.3390","volume":"14","author":[{"given":"Radvil\u0117","family":"Matukaitien\u0117","sequence":"first","affiliation":[{"name":"Institute of Endocrinology, Lithuanian University of Health Sciences, Eiveni\u0173 Str. 2, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4492-264X","authenticated-orcid":false,"given":"August\u0117","family":"Pikelyt\u0117","sequence":"additional","affiliation":[{"name":"Medical Academy, Lithuanian University of Health Sciences, A. Mickevi\u010diaus Str. 9, LT-44307 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birut\u0117","family":"\u017dilaitien\u0117","sequence":"additional","affiliation":[{"name":"Institute of Endocrinology, Lithuanian University of Health Sciences, Eiveni\u0173 Str. 2, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robertas","family":"La\u017eauskas","sequence":"additional","affiliation":[{"name":"Institute of Physiology and Pharmacology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevi\u010diaus Str. 9, LT-44307 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rasa","family":"Verkauskien\u0117","sequence":"additional","affiliation":[{"name":"Institute of Endocrinology, Lithuanian University of Health Sciences, Eiveni\u0173 Str. 2, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4261-5014","authenticated-orcid":false,"given":"Jonas","family":"\u010ceponis","sequence":"additional","affiliation":[{"name":"Institute of Endocrinology, Lithuanian University of Health Sciences, Eiveni\u0173 Str. 2, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,5]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2025). International Classification of Diseases 11th Revision: ICD-11 for Mortality and Morbidity Statistics (MMS), World Health Organization."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0140-6736(12)60520-0","article-title":"Erectile dysfunction","volume":"381","author":"Shamloul","year":"2013","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1111\/jsm.12344","article-title":"Health-related characteristics and unmet needs of men with erectile dysfunction: A survey in five European countries","volume":"11","author":"Jannini","year":"2014","journal-title":"J. Sex. Med."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Przydacz, M., Chlosta, M., Rajwa, P., and Chlosta, P. (2023). Population-level prevalence, effect on quality of life, and treatment behavior for erectile dysfunction and premature ejaculation in Poland. Sci. Rep., 13.","DOI":"10.1038\/s41598-023-39968-9"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Banks, E., Joshy, G., Abhayaratna, W.P., Kritharides, L., Macdonald, P.S., Korda, R.J., and Chalmers, J.P. (2013). Erectile dysfunction severity as a risk marker for cardiovascular disease hospitalisation and all-cause mortality: A prospective cohort study. PLoS Med., 10.","DOI":"10.1371\/journal.pmed.1001372"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"128","DOI":"10.4161\/derm.20361","article-title":"Does vitamin D deficiency contribute to erectile dysfunction?","volume":"4","author":"Sorenson","year":"2012","journal-title":"Dermatoendocrinology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2946","DOI":"10.1016\/j.clnu.2020.12.025","article-title":"Vitamin D and cardiovascular health","volume":"40","author":"Vallecillo","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Peruzzu, D., Dupuis, M.L., Pierdominici, M., Fecchi, K., Gagliardi, M.C., Ortona, E., and Pagano, M.T. (2022). Anti-Inflammatory Effects of 1,25(OH)2D\/Calcitriol in T Cell Immunity: Does Sex Make a Difference?. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23169164"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"P\u00e1l, \u00c9., Ungv\u00e1ri, Z., Beny\u00f3, Z., and V\u00e1rb\u00edr\u00f3, S. (2023). Role of Vitamin D Deficiency in the Pathogenesis of Cardiovascular and Cerebrovascular Diseases. Nutrients, 15.","DOI":"10.3390\/nu15020334"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"324","DOI":"10.4103\/1008-682X.142137","article-title":"Serum 25-hydroxyvitamin D levels and testosterone deficiency in middle-aged Korean men: A cross-sectional study","volume":"17","author":"Tak","year":"2015","journal-title":"Asian J. Androl."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s12020-020-02482-3","article-title":"Relationship of Vitamin D status with testosterone levels: A systematic review and meta-analysis","volume":"72","author":"Martorella","year":"2021","journal-title":"Endocrine"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1007\/s12020-015-0641-7","article-title":"Longitudinal associations between lifestyle and vitamin D: A general population study with repeated vitamin D measurements","volume":"51","author":"Skaaby","year":"2016","journal-title":"Endocrine"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.3945\/ajcn.115.120873","article-title":"Vitamin D deficiency in Europe: Pandemic?","volume":"103","author":"Cashman","year":"2016","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.clnesp.2024.01.011","article-title":"The effect of three years of vitamin D supplementation on erectile dysfunction: Results from the randomized placebo-controlled D-Health Trial","volume":"60","author":"Waterhouse","year":"2024","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/S2213-8587(21)00345-4","article-title":"The D-Health Trial: A randomised controlled trial of the effect of vitamin D on mortality","volume":"10","author":"Neale","year":"2022","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_16","first-page":"7","article-title":"Treating erectile dysfunction with sildenafil alone versus combined with vitamin D3 in patients with low serum 25-hydroxy vitamin D3: A prospective randomized controlled open trial","volume":"19","author":"Yang","year":"2023","journal-title":"J. Men\u2019s Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e14473","DOI":"10.1111\/and.14473","article-title":"The effect of vitamin D replacement in patients with lower urinary tract complaint\/erectile dysfunction resistant to Tadalafil 5\u2009mg treatment: A pilot clinical study","volume":"54","author":"Ermec","year":"2022","journal-title":"Andrologia"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"144","DOI":"10.25122\/jml-2020-0009","article-title":"The Correlations of Clinical and Biochemical Indices of Vitamin D with Erectile Dysfunction","volume":"13","author":"Dumbraveanu","year":"2020","journal-title":"J. Med. Life"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e14568","DOI":"10.1111\/and.14568","article-title":"The relationship between serum 25-hydroxy vitamin D and arteriogenic erectile dysfunction","volume":"54","author":"Wu","year":"2022","journal-title":"Andrologia"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Zhang, J.H., Li, W., Wang, C.Y., Zhang, A.N., Jia, B.Z., Li, Y.W., Shi, Z.D., Tang, K.F., and Han, C.H. (2022). Correlation analysis of carotid artery intima-media thickness, serum 25(OH)D and men with erectile dysfunction. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.1027430"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2792","DOI":"10.1111\/jsm.12661","article-title":"Vitamin D and erectile dysfunction","volume":"11","author":"Barassi","year":"2014","journal-title":"J. Sex. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.atherosclerosis.2016.07.921","article-title":"Vitamin D deficiency is independently associated with greater prevalence of erectile dysfunction: The National Health and Nutrition Examination Survey (NHANES) 2001\u20132004","volume":"252","author":"Farag","year":"2016","journal-title":"Atherosclerosis"},{"key":"ref_23","first-page":"e13767","article-title":"Novel predictive risk factor of erectile dysfunction: Serum 25-hydroxy vitamin D","volume":"52","author":"Eren","year":"2020","journal-title":"Andrologia"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1080\/13685538.2018.1459544","article-title":"The relationship between erectile dysfunction severity, mean platelet volume and vitamin D levels","volume":"23","author":"Culha","year":"2020","journal-title":"Aging Male"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1080\/13685538.2017.1379488","article-title":"The relationship between vitamin D level and erectile dysfunction in patients with type 2 diabetes mellitus","volume":"21","author":"Basat","year":"2018","journal-title":"Aging Male"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1080\/13685538.2016.1271783","article-title":"Vitamin D treatment improves levels of sexual hormones, metabolic parameters and erectile function in middle-aged vitamin D deficient men","volume":"20","author":"Canguven","year":"2017","journal-title":"Aging Male"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1007\/s12020-015-0851-z","article-title":"Hypovitaminosis D is associated with erectile dysfunction in type 2 diabetes","volume":"53","author":"Caretta","year":"2016","journal-title":"Endocrine"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1159\/000523691","article-title":"Serum Vitamin D Level and Erectile Dysfunction in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis","volume":"106","author":"Liu","year":"2022","journal-title":"Urol. Int."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1111\/jdi.13089","article-title":"What is the best biological parameter to predict erectile dysfunction in men aged >55 years with type 2 diabetes?","volume":"11","author":"Raharinavalona","year":"2020","journal-title":"J. Diabetes Investig."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1111\/j.1439-0272.2009.00954.x","article-title":"Erectile dysfunction risk factors for patients entering dialysis programme","volume":"42","author":"Nassir","year":"2010","journal-title":"Andrologia"},{"key":"ref_31","first-page":"195","article-title":"Vitamin D Status in Renal Transplant recipients is not Associated with Erectile Dysfunction","volume":"56","author":"Zibar","year":"2017","journal-title":"Acta Clin. Croat."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"139","DOI":"10.5534\/wjmh.200176","article-title":"Low Serum 25-Hydroxyvitamin D Level as a Potential Risk Factor of Erectile Dysfunction in Elderly Men with Moderate to Severe Lower Urinary Tract Symptoms","volume":"40","author":"Kim","year":"2022","journal-title":"World J. Mens Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1055\/s-0030-1269854","article-title":"Effect of vitamin D supplementation on testosterone levels in men","volume":"43","author":"Pilz","year":"2011","journal-title":"Horm. Metab. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1111\/cen.13062","article-title":"Association between serum 25-hydroxyvitamin D and serum sex steroid hormones among men in NHANES","volume":"85","author":"Anic","year":"2016","journal-title":"Clin. Endocrinol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3720813","DOI":"10.1155\/2018\/3720813","article-title":"Vitamin D and Male Sexual Function: A Transversal and Longitudinal Study","volume":"2018","author":"Tirabassi","year":"2018","journal-title":"Int. J. Endocrinol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Crafa, A., Cannarella, R., Condorelli, R.A., La Vignera, S., and Calogero, A.E. (2020). Is There an Association Between Vitamin D Deficiency and Erectile Dysfunction? A Systematic Review and Meta-Analysis. Nutrients, 12.","DOI":"10.3390\/nu12051411"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e13211","DOI":"10.1111\/and.13211","article-title":"Serum vitamin D levels and erectile dysfunction: A systematic review and meta-analysis","volume":"51","author":"Wei","year":"2019","journal-title":"Andrologia"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1007\/s13679-021-00433-1","article-title":"Vitamin D and Obesity: Current Evidence and Controversies","volume":"10","author":"Karampela","year":"2021","journal-title":"Curr. Obes. Rep."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s12610-022-00182-8","article-title":"The role of male hypogonadism, aging, and chronic diseases in characterizing adult and elderly men with erectile dysfunction: A cross-sectional study","volume":"33","author":"Lisco","year":"2023","journal-title":"Basic Clin. Androl."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"270","DOI":"10.4082\/kjfm.2017.38.5.270","article-title":"Seasonal Variations and Correlations between Vitamin D and Total Testosterone Levels","volume":"38","author":"Sim","year":"2017","journal-title":"Korean J. Fam. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1111\/bcp.14521","article-title":"Quality and use of unlicensed vitamin D preparations in primary care in England: Retrospective review of national prescription data and laboratory analysis","volume":"87","author":"Wan","year":"2021","journal-title":"Br. J. Clin. Pharmacol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/24\/8630\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:46:47Z","timestamp":1765212407000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/24\/8630"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,5]]},"references-count":41,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["jcm14248630"],"URL":"https:\/\/doi.org\/10.3390\/jcm14248630","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,5]]}}}