Can statins impair sexual functioning in men?

I’ve noticed a general trend over recent years for increasing scepticism regarding statin drugs. There have been murmurings within the medical community, but where this shift is most readily observable is in the general public. It wasn’t so long ago that it was generally difficult for members of the public to access scientific and medical data. Now, with the advent of the internet, access to information is much easier. And while the information is of varying quality, one thing that’s for sure is that the drug industry and some factions of the scientific community are finding it increasingly difficult to sanitize data and prevent bad news getting out.

So, it’s no wonder now, I think, that increasingly people seem to be informing themselves and coming to their own conclusions about medical treatments including statins. I sense many doctors are uncomfortable with this, but I see it as a generally good thing. And sometimes, individuals will bring to me information that actually contributes to my own education.

A classic example concerns someone who I met this week who expressed concern about the pressure he was getting from his doctor to take statins. He had come across evidence that statins are not really very effective (which is actually what the evidence shows), but was perhaps more concerned about the potential for side-effects. One of his specific concerns related to the potential impact of statins on libido and sexual functioning.

I am obviously no stranger to the idea that statins may have side effects, but was actually not very familiar with this particular potential hazard, and decided to see if any evidence exists in the area. I turned up a 2010 study in which testosterone levels in men treated with statins and non-statin-treated men were compared [1]. This research is relevant because testosterone is a major driver of libido and sexual functioning. It turned out that those taking statins had lower levels of testosterone, and they also had higher scores of symptoms suggestive of ‘hypogonadism’ (low male hormone production).

This study is interesting, but it is ‘epidemiological’ in nature, which means that it can conclude that statins are associated with low testosterone and symptoms, but not that statins are causing these problems. To know whether statins actually cause these sorts of problems we need to look to ‘intervention’ studies, to see if individuals treated with statins can suffer from lowered testosterone.

The information in this area is scant, but I did find a couple of relevant studies. In one, just 12 weeks of treatment with 80 mg of simvastatin each day lowered bioavailable testosterone (testosterone that can have effect in the tissues) by about 10 per cent, a change that was statistically significant [2]. In another more recent study, 12 weeks of simvastatin at a dose of only 20 mg a day was found to have a testosterone-lowering effect too [3].

How is it that statins may suppress testosterone levels? Well, it turns out that cholesterol is the essential primary building block in the making of testosterone. It’s another example of the critical role that cholesterol plays in the body. And it’s another thing which might cause us to pause before assuming that driving levels of cholesterol down is a good thing.

References:

1. Corona G, et al. The effect of statin therapy on testosterone levels in subjects consulting for erectile dysfunction. J Sex Med 2010;7(4 Pt 1):1547-56

2. Dobs AS, et al. Effects of high-dose simvastatin on adrenal and gonadal steroidogenesis in men with hypercholesterolemia. Metabolism2000;49:1234–8

3. Hyyppa MT, et al. Does simvastatin affect mood and steroid hormone levels in hypercholesterolemic men? A randomized double-blind trial. Psychoneuroendocrinology
2003;28:181–94

10 Responses to Can statins impair sexual functioning in men?

  1. Suzy Kelham 16 November 2012 at 9:06 am #

    Both I and an MD who is now working as a nurse who had a stroke have taken statins in the past consider statins very dangerous drugs which should not be taken by anyone because of the serious side effects. Sincerely, Suzy

  2. julianne 16 November 2012 at 9:16 am #

    I have come across this – a couple of men I have talked too said their libido suffered badly with statins – I wrote about one mans numerous side effects http://paleozonenutrition.com/2010/09/05/men-statins-could-be-killing-your-mojo/
    This article talks about it too http://www.spacedoc.com/sexual_side_effects_statins.htm

  3. Janet B 16 November 2012 at 12:45 pm #

    I’ve recently had a wake up call about statins. About three months ago I accidentally forgot to take my nightly 40 mg Simvastatin (don’t ask) for an entire week. Towards the end of that week I realised that I wasn’t leaping out of bed 6 times a night with cramp from toes to buttocks. I didn’t make a connection with the statin but when I at last remembered to take a new pack up to the bathroom the cramp returned on the second night after resuming. I was suspicious but continued with the statin for another two weeks with painful results. I left it off for another two weeks and the cramp disappeared. I started again and the cramp reappeared. Now I am taking the statin every other night and tend only to have cramp every other night. In addition the lack of sensation I have in my feet I have always attributed to diabetic neuropathy (and it may well be) but I have noticed a considerable improvement in sensation in my feet since I have reduced my intake of the statin. Dr. Briffa, I am quite pleased with my mini study and though it wouldn’t stand up in a proper controlled trial, it has certainly been of use to me.

  4. Marie 16 November 2012 at 7:46 pm #

    I have never taken statins – nor will I.
    People close to me did and I saw their suffering.
    At the time, I had no idea that it could be due to side effects.

    Since then I have read one book after the other and many patient stories.
    There are many at spacedoc.net and askapatient.com (search for the different statins – they all have similar side effects) and if you are unlucky they can continue although you stop the medication.

    Consult your doctor if you intend to stop and do it slowly. I think there is a suggestion at spacedoc.net.

    I have just read the first half of an interesting, new book – Are your prescriptions killing you? by Armon B. Neel, Jr. (PharmD, CGP) and Bill Hogan.

    Armon B. Neel is a pharmacist living in Georgia.
    He is devoted to geriatric patients.
    His book is full of stories that can be useful no matter what age.

    Here are some of the issues that he writes about:
    Prologue – the Pharmacist Who Says No to Drugs, Introduction – a Pharmacist`s Journey, Good-Bye and Good Luck – helping yourself to a better health, Things change – our aging bodies, Piling On – the perils of polypharmacy, Off-Limits for older people – the Beers Criteria, a list that could save your life, Off the charts – do you really need those blood pressure drugs?, Phantom Killers – NSAID:s (Nonsteroidal Anti-Inflammatory Drugs), Proton Pump inhibitors – the miracle drugs that aren´t, Statin Roulette – drugs of last resort, Down and Out – druginduced falls, The Bone-Scare Drugs – what you should know about bisphosfonates and Does dad really have Alzheimer´s? – a look at drug-induced dementia

    Towards the end of the book he has a list of suggested reading and although I am not a doctor or a nurse, nor a pharmacist, I have read them all (I live in Scandinavia).

    I share most of his ideas but Americans seem more obsessed with bloodpressure monitoring at home etc. I don´t believe in that – it makes people worry and to be obsessed with their numbers.

  5. Kathy 17 November 2012 at 3:02 am #

    My husband had triple bypass surgery 12 years ago, and since then has been on the mandatory cocktail of cardiac drugs, including statins. One of the most life depleting side effects is the increased lethargy. Like the previous post, ‘forgetting’ to take the tablets gives an increased enthusiasm for all activities – definitely more frisky. Whether it’s the statins or the beta blocker, something definitely reduces libido. Conversations he’s had with other men on statins has revealed that it’s a common problem.

  6. Dr. Bill Wilson 17 November 2012 at 8:30 am #

    If you block the production of one of the most important substances in your body–cholesterol, be prepared for unintended consequences. I graduated from medical school at the University of Minnesota, the same school where Ancel Keyes set up his famous lab. Dr. Keyes was of course the person who first proposed that high cholesterol was the cause of heart disease in his Seven Countries Studies.

    This was of course the basis for our decades long “low fat” craze that seems to be driving our current epidemic of obesity, metabolic syndrome and type II diabetes. Dr. Keyes’ work also is the basis of using statins to reduce the production of cholesterol. It now appears that his theory was based on a house of cards.

    Based on recent research, the bad boys in our diet appear to be excessive fructose mainly from sugar and HFCS and high glycemic carbohydrates mainly from grains. If cholesterol plays a role in disease, it is clearly a minor role. Live and learn!

  7. PJ 18 November 2012 at 2:31 am #

    Janet B – As a woman, you probably shouldn’t be taking a statin at all. There are many studies out there that show that statins have absolutely no benefit for women and may be most harmful to women. I, for one, wouldn’t take anything I have proven to myself causes muscle cramping and loss of sensation in my feet! After all, the muscle cramping and neuropathy may be the only minor side effects you notice. What are the other, possibly severe side effects you don’t notice?

  8. Janet B 18 November 2012 at 11:42 pm #

    Thank you, PJ. For your interest. I took my lastever statin pill last Friday. Definitely no more – ever.

  9. PeggyC 19 November 2012 at 12:22 am #

    Janet B, I concur with PJ. As a woman, you definitely should not be taking a statin at all. So many of studies done show absolutely no benefit for women. Women need their cholesterol and all evidence points to longer life with higher cholesterol. I won’t let anyone in my family take a statin, but I especially refuse to even consider it for myself. All those possible side effects and no benefit? Hmmm. It’s a no brainer. Don’t take our word for it. Please search and peruse studies that give separate data for men and women and see for yourself. Then take those studies to your doctor. I have a very good friend, a woman, who has been taking statins for years (and her cholesterol wasn’t even particularly high–just barely over the artificial threshold protocol provides.) She developed a form of cardiomyopathy that lowered the volume her heart can pump and now has to take meds for that. The doctor, of course, refused to connect it to statins and blamed it on a virus, but I strongly suspect the statins and told her so. But no amount of exhortations or evidence from me counters the edict from her doctor to keep taking a drug that she has absolutely no need for. :(
    Dr. Briffa, just one more argument (as if I needed any) to refuse statins on my husband’s account. His doctor did suggest them. He also suggested a high carb low fat diet upon learning he was pre-diabetic. We ditched the advice and the doctor and went on a low carb high fat diet.

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  1. The Evidence Continues to Mount Against Statins | Healthy Advices - 31 July 2014

    […] Testosterone: Steroid hormone prolongation is also contingent on cholesterol, and statin therapy is compared with a tiny yet significant rebate in present testosterone levels in men. […]

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