The Effect of Statins on Erectile Dysfunction: A Systematic Review and Meta‐Analysis

The researchers identified 11 randomised controlled trials (RCTs) and three observational studies. LDL cholesterol is the type that causes problems. Although statins are not recommended as primary treatment for erectile dysfunction in men with normal cholesterol levels, this effect could improve compliance in hypercholesterolemic patients treated with statins. The main findings in the literature concern atorvastatin, in particular, because statins and sildenafil, a selective inhibitor of phosphodiesterase type 5 (PDE5i), can activate the nitric oxide (NO) cyclic guanosine monophosphate pathway.

The figures were too low for Lescol or Pravachol for significance. You can learn more about salsalate as well as home remedies for joint pain and inflammation from “Graedons’ Guide to Alternatives for Arthritis. The other 50 received no treatment. In vitro contractility studies were conducted in the rabbit model, and in the rat model, the sildenafil effect on electrical stimulation—induced erection was investigated. In the meantime, providers can feel assured using statins in patients with ED.

I never had blood sugar levels that high before taking metoprolol. They acknowledged that their analysis included a small number of studies and that none of the studies lasted longer than six months. Why statins may not be the cause While researchers have looked into the possibility of statins as a cause for ED, other evidence has suggested otherwise.

Subgroup analyses revealed trends in the atorvastatin group to indicate that a change in the IIEF‐5 score is affected by age, severity of ED, and baseline serum levels of LDL. We can see, however, that at the beginning of the study, 26% of the patients in both groups were classified as having mild ED and approximately 74% as having moderate-to-severe ED. In another study, Fibbi and colleagues ( 2020 ) evaluated the effects of atorvastatin (5 and 30 mg/kg), given for 2 weeks to spontaneously hypertensive rats (SHR), on an experimental model characterized by impaired erectile function and overactivity of the procontractile RhoA/Rho‐associated, coiled coil‐containing protein kinase (RhoA/ROCK) pathway compared with their normotensive counterpart, Wistar‐Kyoto rats. In other words, statins may be pretty powerful in improving sexual function, especially since the chief purpose of these drugs is to treat high cholesterol. Kostis, MD, FACC, helps put this benefit in perspective: Statins can help people with ED if the cause relates to high cholesterol.

  • The results of this study showed that the voltage‐dependent erectile responses were suppressed by more than 30% in the obese diabetic Zucker rat, and the 3‐day treatment with rosuvastatin partially restored erectile response.
  • It is thought the pills may give men a boost in the bedroom by helping blood vessels dilate properly and improving blood flow to the penis.
  • MEDLINE, Embase, and the Cochrane Controlled Trials Register.
  • The patients who received atorvastatin presented a significant increase in IIEF-5 (13.)
  • Heart disease often occurs when there is a build-up of plaque in the arteries, which decreases blood flow to the heart, brain and rest of the body.
  • The accumulation of this substance is called atherosclerosis, and it can cause some severe complications, including an increased risk of ED.

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The researchers then performed a meta-analysis to combine the results of the included studies. These studies suggest that the length of the treatment with simvastatin in our patients (6 months) should have been sufficient to detect changes in ED. Rather than preventing the possibility of a heart attack in the future, the more immediate benefit of improving erectile function might improve adherence to statin therapy, he added.

Among men who had high cholesterol and erectile dysfunction – and who were taking statins – there was a statistically significant increase in erectile function, amounting to a 24. These are a class of drugs designed to temporarily boost the flow of blood to the penis during sexual stimulation. The investigators also remind us that PDE5 inhibitors are palliative, not curative. How many men suffer from erectile dysfunction?

  • I plan to STOP taking this drug and maintain the lower levels by eating better.
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New Study Provides Reassurance For Men Taking Blood Pressure And Cholesterol Modifying Medications:

(003), suggesting that the use of atorvastatin after radical prostatectomy with nerve preservation may contribute to a better recovery of erectile function. Members, time of onset of vardenafil orodispersible tablet in a real-life setting - looking beyond randomized clinical trials. This is not an indication of a security issue such as a virus or attack. Men who took statins (+/- sildenafil) generally saw their IIEF scores improve, indicating better erectile function. The diagnosis of erectile dysfunction and its extent were assessed using the international questionnaire erectile function (IIEF). “Participants experienced a 43% improvement in their erections, the effect is around half that of sildenafil [Viagra].

  • It’s now a symptom of potential, critical heart problems.
  • Though in most men testosterone metabolism in not affected by statin therapy, we have clear interference with testosterone biosynthesis in some of the affected men, and clear re-challenge evidence of the problem in others.
  • This was a systematic review and meta-analysis of studies assessing the effects of statin therapy on erectile dysfunction.
  • Patients with moderate ( r =.)
  • Almost all of these patients were taking statins (92%)—47% assumed β‐blockers and 28% diuretics (Kloner et al, 2020).

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This is very significant. Researchers believe that statins may work to improve erectile function by helping blood vessels dilate properly and improving vascular blood flow to the penis, which is often restricted in men with erectile dysfunction. Instead, see your doctor and voice your concerns. Previous research has suggested, however, that statin therapy may lower testosterone levels. The number of cases is small compared to the very widespread prescribing of lipid lowering drugs, especially statins. In this experimental study, 40, 8‐week‐old male Sprague‐Dawley rats were equally divided into4 groups, (n = 10): In my practice, ED is far and away the issue grappled with most, given the heavy representation of men over the age of 40 years with obesity, hypertension, and polypharmacy. Finally, another study evaluated whether postoperative statin use would contribute to earlier recovery of erectile function in men who underwent bilateral nervesparing radical retropubic prostatectomy for clinically localized prostate cancer ( Hong et al, 2020 ).

These patients were randomly assigned to 3 months of treatment with atorvastatin 40 mg (n = 12), quinapril 10 mg (n = 10), or placebo (n = 13), along with continued adjunctive use of sildenafil. Search, the oil can be very toxic in high dosages. In this study, 131 men were randomized to 40 mg of atorvastatin or matching placebo. Results remained independent of age and degree of LDL-C lowering.

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After 14 weeks of diabetes induction, basal and PDE5i‐elicited (intravenous mirodenafil, 1 mg/kg) erectile responses were assessed during cavernous nerve electrostimulation. It is possible that with the simvastatin dose administered, we did not achieve a sufficiently robust improvement in endothelial function to provoke modification in the ED. Questions for You to Consider What are statins? 00001), the IIEF domain (SMD = 4. Review articles linked fibrates with erectile dysfunction. Improvement in ED score with sildenafil was reassessed at 6 and 12 weeks of treatment with atorvastatin (80 mg daily) or placebo. All the participants were re-examined using the same processes (completion questionnaire IIEF-determination in blood levels of CHOL, LDL, HDL, TRG) after three months. They are effective, which is why cardiologists prescribe them for their patients at risk for heart attack, coronary heart disease, angina and stroke.

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A systematic review is an overview of primary studies. In other research, Dr. You can read more about performance anxiety and ED here. Doctors consider erection problems, especially in older men, as an early sign of heart disease. Because the science on statins and sexual function is so inconclusive, Dr. Results showed a total of 60 cases of erectile dysfunction.

Thus, although most studies suggested that statins are beneficial in male ED, the exact effect and the underlying, mechanisms of statins in ED are still controversial. It is unclear how statins may improve erectile dysfunction, but the researchers speculate that it may be due to decreased levels of LDL cholesterol and improved endothelial function – which includes the ability of blood vessels to dilate and constrict. In a small number of men, withdrawal of the lipid-lowering drug and re-challenge resulted in recurrent symptoms, though the re-challenge was usually not blind. Possible links to ED While ED isn’t a widely reported side effect of statins, researchers have explored the possibility. Each study used the International Inventory of Erectile Function survey, which includes a total of five questions and asks men to rank their sexual function on a scale of one to five. This is an appropriate way of pooling and studying the body of available evidence on a specific topic. Rarely, statins can cause liver damage. The study was small and presented as a poster at the congress (so, not yet published in a peer-reviewed journal and full details are not available).

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Therefore, statins are supposed to be effective in the treatment of erectile dysfunction, especially in patients with cardiovascular risk-factors with underlying endothelial dysfunction. There are several limitations to be considered in this study, including the small size sample, the limited dose ranges of the simvastatin-treated group and the lack of a physiological study of penile vascular function, such as Doppler ultrasound measures that could assess the endothelial function by flow-mediated dilation (such as endo-PAT 2020, Itamar Medical Inc. )In this study, 25 patients were recommended to take sildenafil (a minimum of 2, 100‐mg tablets/wk) for 4 weeks. 16, 18, 19, 21, 22, 23, 26 The explanations of how statins could improve ED are based mainly on the pleiotropic effects of this class of medication, that is, effects that go beyond simply lowering cholesterol levels. Eleven randomized controlled trials in which ED was assessed were identified from the 186 results of a search conducted by the authors of Medline, Web of Knowledge, Cochrane Database, and ClinicalTrials. Statins, with or without sildenafil, could help men with erectile dysfunction (ED), according to Chinese researchers who conducted a literature review. Although 37% of subjects improved, none of the patients regained completely normal erectile function as defined by an IIEF-5 score greater than 21.

Finally, pretreatment with atorvastatin increased plasma NOx concentrations, sildenafil‐induced hypotension, and tachycardia significantly ( Castro et al, 2020 ).

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The drug is often prescribed to help prevent stroke and heart attack but while statins are widely used as a cholesterol-reducing drug, it appears it also has versatile effects as to treat some other health conditions. Statins prevent your body from making new cholesterol and may help reduce the amount of plaque already built up on artery walls. Another study evaluated the frequency of ED after liver transplantation and discussed the potential risk factors. “How statins could boost your love life: Total cholesterol (CHOL), low (LDL) and high (HDL) density lipoproteins and triglycerides (TRG) were assessed in all participants. New study on covid-19 estimates 5.1 days for incubation period. The results of the study were well reported in the Daily Mail. Although systematic reviews and meta-analyses are the appropriate way of pooling and studying the body of available evidence on a specific topic, it only included 11 RCTs featuring 713 people.

Chou and colleagues reported that statin use was associated with the reduced risk of incident erectile dysfunction (ED) in middle-aged men in Taiwan. Statins and male sexual health: I want to know if there is anything I can take for arthritis pain that will not give me stomach ulcers, raise my blood pressure or lead to a heart attack. WASHINGTON (March 29, 2020) — Statins are associated with a significant improvement in erectile function, a fact researchers hope will encourage men who need statins to reduce their risk of heart attack to take them, according to research to be presented at the American College of Cardiology’s 63rd Annual Scientific Session. The pills are unlikely to be prescribed for the condition in those without cardiovascular risk factors, at least in the near future, the researchers said. The researchers studied databases of published literature to identify studies that had assessed the effects of statin therapy on erectile dysfunction. In another study, Dadkhah and colleagues ( 2020 ) evaluated 131 patients with ED not responding to sildenafil. 5 (Figure 1) and the percentage without erectile dysfunction fell to 21% (Figure 2).

The number of people buying a statin (such as Lipitor or Zocor) rose 88% from 2020 to 2020, from 15. Statins don’t touch any of these. The condition is very common in older men, especially those with heart problems, for which statins are frequently prescribed. Statins are used to control LDL Cholesterol in our bodies. Methods A literature review was performed to identify all published randomized double‐blind, placebo‐controlled trials of statins for the treatment of ED.

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8, 13, 14, 15 In our study, with patients without clinical manifestation of vascular disease and no associated comorbidities, simvastatin proved safe and effective to reduce the cholesterol levels. The other three compared statins plus sildenafil with placebo plus sildenafil. Additionally, there was no difference in the IIEF score between the groups at follow‐up, although at the beginning, 26% of the patients of both groups presented with mild erectile dysfunction and 74% with moderate to severe erectile dysfunction.

Lead study investigator John B. Although it is not usual to have this issue occasionally, people with ED experience it regularly. Full results from this study are being presented during the ACC 2020 but were released early via a special preconference press briefing, focused on consumer-interest news. The three observational before and after studies did not show a significant difference in IIEF score before and after statin administration. The results of a recent randomized, double‐blind, placebocontrolled clinical trial (Simvastatin treatment for erectile dysfunction trial) did not support the use of simvastatin as an erectogenic medication (Mastalir et al, 2020). Patients of group 1 were instructed to ingest only 50 mg of sildenafil per day if needed after hospital discharge, whereas the patients of the group 2 were also prescribed atorvastatin at a dose of 10 mg daily from postoperative day 1 to 90.

Scientists were surprised how successful the cholesterol-busting drugs were in helping to combat erectile dysfunction. So, my erectile difficulties are causing problems in our marriage. Blocked blood vessels (atherosclerosis) may also lead to ED. After each treatment, mean IIEF‐5 scores were significantly higher than baseline. “But the important thing is that by improving cholesterol levels, patients were also benefiting from better erections.

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Potential subjects were excluded if they were currently using antilipidemics. Lower scores represent poorer sexual function. (4) but not for pravastatin and fluvastatin (Do et al, 2020). For the comparison of statins with placebo, the mean IIEF‐5 (SMD = 2. )It flies in the face of fears statins contribute to impotence.

More than 50 per cent of men over 40 experience some level of erectile dysfunction.

In hfPSMCs, high glucose significantly increased not only membrane RhoA expression but also ROCK activity (increased phosphorylation of the ROCK substrate myosin phosphatase target subunit 1) and several RhoA‐dependent functions such as proliferation, migration, and smooth muscle—related gene expression ( Morelli et al, 2020 ).

Statins, Testosterone, and ED: The Study

This research includes a meta-analysis adding up results from 11 randomised controlled trials that found a 24. Get tested and see a doctor. In high dose statins and in rare occasions, people are at risk for increased blood sugar (or Type 2 Diabetes), muscle cell damage, liver damage and cognitive problems. They identified 11 such trials in which men completed the International Inventory of Erectile Function survey, which consists of five questions, each scored on a five-point scale, where low values represent poor sexual function.

Popular Cholesterol-lowering Drugs May Offer Added Benefit For Men With Erectile Dysfunction.

I believe that this beta blocker is raising my blood sugar. Recent research suggests that statins may be able to treat ED more generally. Before statin therapy, no correlation was observed between IIEF score and any individual cardiovascular risk factor. 8 years; statin therapy was given for approximately 4 months with a mean decrease in LDL-C in treated men that ranged from 138 mg/dL to 91 mg/dL (47 mg/dL). There is tentative evidence that cholesterol reduction with statins can also help erectile function.

Concurrently, group S received simvastatin (20 mg/kg daily). Brachial artery flow—mediated dilation, endothelium‐independent dilation via nitroglycerin, and penile doppler blood flow did not vary significantly in patients given quinapril or atorvastatin compared with placebo ( Bank et al, 2020 ). In this evaluation, 12 men (mean age, 58 years) with moderate to severe ED despite an adequate sildenafil trial were enrolled in a randomized, double‐blind, placebocontrolled pilot study. It is unclear how statins may improve erectile dysfunction but the researchers speculate that it may be due to decreased levels of LDL cholesterol and improved endothelial function – which includes the ability of blood vessels to dilate and constrict.

Conclusions and “Open Issues”

April 16, 2020 -- Statin therapy prescribed to lower cholesterol also appears to lower testosterone, according to a new study that evaluated nearly 3,500 men who had erectile dysfunction or ED. Purchase access, 19 was used for the measurement of depressive mood. Venezuela, however, they should not be used in patients receiving nitrate therapy, and nitrates should not be administered within 24 hours of sildenafil (Viagra) or vardenafil (Levitra), or within 48 hours of tadalafil (Cialis). Should you suffer from ED now, don’t panic. 2 point improvement in IIEF score.

Abstract

The good news is that the problem is reversible on stopping statins, and that drug switching helped in a number of cases. In the study presented at the American College of Cardiology conference, experts performed a meta-analysis on 11 previous randomised, controlled studies on erectile dysfunction and statins. Compared with placebo, quinapril improved symptoms of ED significantly, as measured by the International Index of Erectile Function 5 (IIEF‐5) questionnaire. These include those in the penis. Erectile function was measured using a questionnaire (the International Index of Erectile Function [IIEF] questionnaire) completed by more than 2,000 men at the beginning of the study and again at a mean follow-up of 5. Additional studies with more patients will be necessary to detect smaller differences in the responses obtained with simvastatin in relation to the placebo.

Research in 2020 suggested that statins might actually cause erection problems by lowering testosterone levels. 00001), and the global efficacy question (odds ratio = 6. Unfortunately, our website is currently unavailable in most European countries. In this study, the authors evaluated 2 groups of patients:

For this reason, it is unlikely that doctors will start to prescribe statins for treating ED any time soon. In 2020, a study was done by the West China Hospital in Sichuan University that concluded that use of statins reduced testosterone levels. After a 1‐month washout period, the patients received a single dose of atorvastatin, 10 mg/d, for 1 month; similarly, after a 1‐month washout period, atorvastatin, 10 mg/day, and sildenafil (a minimum of 2, 100‐mg tablets/wk) were administered for 1 month as a combination therapy. They searched the MEDLINE, Embase, and Cochrane Controlled Trials Register databases for randomized controlled trials (RCTs) that involved statin treatment for ED. Results of this study showed that in the placebo group, impotence resolved in 2 men only after the study drug was stopped, whereas in the simvastatin group, impotence resolved in 14 men despite continued simvastatin treatment. Medical problems that lead to a statin prescription might also be to blame for changes in sexual function, said Dr.