Use of statins might improve erectile function, according to a meta-analysis of studies on the subject.
Erectile dysfunction (ED) is often attributed to endothelial dysfunction brought on by atherosclerosis. Statins, usually prescribed to decrease levels of low density lipoprotein (LDL – “bad” cholesterol), have been found to benefit endothelial dysfunction.
While it may be easy to assume that statins would, in turn, help men with ED, past research has had mixed results. Some studies have shown the benefits of statins for ED patients, but others have found that ED rates increase when men take statins.
Researchers from Rutgers Robert Wood Johnson Medical School in New Jersey, USA conducted the current analysis. Their goal was to learn more about statins and ED by reviewing studies that used the five-item International Index of Erectile Function (IIEF), a widely-used assessment tool. Higher scores on the IIEF indicate better erectile function.
The researchers searched four databases (MEDLINE, Web of Knowledge, the Cochrane Database, and ClinicalTrials.gov) using the keywords “erectile dysfunction” and “statin” along with the names of various types of statins.
They eventually analyzed eleven studies that involved a total of 713 patients. The mean number of patients per study was 64.8 and the mean age was 57.2 years.
Overall, they found that men who took statins had an average IIEF score increase of 3.4 points when compared to men in control groups. Statins appeared to be more effective than phosphodiesterase-5 (PDE5) inhibitors (a standard first-line therapy for ED) and lifestyle modifications. For example, the increases in IIEF scores were about one-third to one-half more than those seen in studies of men taking PDE5 inhibitors.
The researchers suggested that decreases in LDL cholesterol levels and better endothelial function could have improved the participants’ erectile function. However, factors unrelated to LDL cholesterol, such as better availability of nitric oxide, could also be involved.
The meta-analysis did have some limitations. The number of participants was small and the studies used different methods and different doses of statins.
The authors also acknowledged that some studies have found increased rates of ED among men who take statins. This may occur because statins can lower levels of testosterone, a hormone necessary for firm erections. “We may speculate that the effect of statins on ED is determined by the balance of two opposing effects of statins, specifically, improved vascular health and lowering of testosterone,” they wrote. They added that future research is needed to better understand this balance.
The analysis was first published online in March in the Journal of Sexual Medicine.
The Journal of Sexual Medicine
Kostis, John B., MD and Jeanne M. Dobrzynski, BA
“The Effect of Statins on Erectile Dysfunction: A Meta-Analysis of Randomized Trials”
(Full-text. First published online: March 29, 2014)