Statins are an incredibly beneficial medication for people with conditions like high cholesterol — something that can increase your risk of heart disease. But could these blood pressure medications affect a normal bodily process associated with heart health: erectile function (ED)? Could there be a link between statins and ED?
Our health and the interconnected nature of our bodily functions are more complicated than most people know. And the medications that we use to treat certain conditions can have side effects ranging from mildly annoying to deadly and everything in between.
But when it comes to statins and ED, the connection isn’t necessarily something you need to fear. In fact, there might be benefits of statins for your sexual function.
To understand how statins and your sex life are intertwined, we first need to unpack some details about how statins function and what they do to your cardiovascular system.
After that, we can go with the flow all the way to your reproductive system.
For many men with high cholesterol, statins are a literal and metaphorical lifesaver. These medications help manage elevated cholesterol levels and reduce the risk of serious issues later in life.
Statins are basically liver-modifying drugs — they tell your liver how to process cholesterol differently, specifically by inhibiting the function of an enzyme known as hydroxymethylglutaryl-CoA reductase.
By inhibiting this enzyme, your liver is told to produce less cholesterol overall and to process existing cholesterol out of your body faster, lowering your cholesterol levels in a healthy manner.
So where does your penis come in (poor choice of words, we know) when we’re talking about the role of statins?
High cholesterol and other medical conditions statins are designed to treat are actually risk factors for erectile dysfunction in patients, especially as they age.
Aside from the psychological causes of erectile dysfunction, heart disease, blood pressure conditions, obesity and other health problems commonly associated with patients who might need statins are high on the list of problems that, when unaddressed, can cause ED later (or sooner) in life.
While statins may not be a direct treatment, they can help people with certain causes of ED reduce their symptoms.
As for the question of whether statins can cause erectile dysfunction, it’s unlikely.
The side effects of statins and statin therapy (and cholesterol-lowering drugs, in general) don’t really affect your quality of erection — at least based on what we know from clinical trials.
There’s very little evidence that statins can cause erectile dysfunction. In fact, statins are better correlated with reduced ED symptoms if you look at what experts have to say.
A 2019 systematic review and meta-analysis from the World Journal of Men’s Health stated that statins may actually improve erectile function because they achieve several end goals that can boost erectile health, namely:
Improve endothelial function, which supports erectile function
Increase the availability of nitric oxide, a crucial element in erections
Decrease oxidative stress on erectile tissues
That same meta-analysis, however, found that there’s a chance that statins may impair your erections. One of the functions of statins is blocking something called 3-hydroxy-3-methylglutaryl-coenzyme A reductase, which decreases testosterone (which itself promotes proper erectile function).
In a few circumstances where testosterone levels are at play in a hormonally triggered ED situation, statins may be worth examining for this potential risk.
But overall, the report was unconvinced that this testosterone-reducing behavior would yield a net reduction in erectile function. It concluded that statins generally can boost erectile function (and are not a cause of erectile dysfunction).
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We’ve said many nice things about statins thus far, especially when it comes to their impact on erectile health. Truth be told, studies have acknowledged a link between what statins do and what your penis does, but most have come short of calling statins an ED treatment.
There’s good reason for that: statins aren’t a treatment for erectile dysfunction. Just because something offers benefits doesn’t mean it’s a treatment. Orange juice may make you feel better if you have a sinus infection, but it’s not a treatment for a bacterial infection in your sinuses — get it?
So what does treat erectile dysfunction? According to the National Institutes of Health (NIH), ED treatments fall into three major categories: lifestyle changes, therapy and medication.
Research has long linked poor health (bad diet, no exercise, lots of smoking and drinking, etc.) to erectile problems. If we zoom out from a blood vessel in your penis to the larger portrait of sexual health and circulatory health, everything is connected.
Cardiovascular disease and sexual dysfunction are deeply linked, and when you prevent coronary heart disease, you can also see an improvement of erectile function.
If your bad diet and poor heart health are causing ED, statins may be one way of treating more serious issues related to your cardiovascular health, in general. Others include a good night’s sleep, eating better, exercising regularly and laying off the tobacco, alcohol, and illicit drugs.
There’s a piece of the puzzle we haven’t mentioned yet: emotional health.
We should point out that while some patients with ED struggle with physiological issues, others may have erectile dysfunction problems due to psychological issues like low self-esteem, fear of intimacy and performance anxiety.
Those psychological blocks are best treated with therapy, which can help you work through negative thoughts and patterns of thinking to correct your way of approaching intimacy—and get your erection back in the game.
One of the best, most practical approaches to erectile dysfunction therapy is cognitive behavioral therapy (CBT): a system in which you learn to reject negative, intrusive thoughts that may be causing you anxiety or harming your self-esteem.
With time and practice, you can learn to master those thoughts and take back control of what’s going on in your head. That will leave you better prepared to focus on the sex you’re trying to have.
Medication for erectile dysfunction most commonly takes the form of so-called PDE5 inhibitors — prescription drugs that make blood flow to your penis easier and help your penis engage the right muscles to solidify and maintain an erection. You’ve likely heard of a couple of these medications already.
There are no known interactions between PDE5s and statins, but talk to a healthcare professional about the risks of a negative response to sildenafil or other medications just to be safe.
Cardiovascular risk factors, coronary artery disease and other heart and flow of blood problems can adversely affect patients with erectile dysfunction. Whether to take them as a quality-of-life measure is ultimately up to you.
Statin treatment may yield benefits for some ED sufferers and create complications for others. While it’s relatively uncommon to see more problems as a result of statin use, it’s nevertheless a possibility.
When it comes to questions about your individual circumstances, speaking with a healthcare professional is always a wise choice. Someone with a knowledge of your unique issues is better qualified to help you navigate statin use and erectile concerns once they know more about you.
In the meantime — and this probably goes without saying — you should keep taking those statins as directed. Your health is about getting to live your longest, most meaningful life.
Finding the right medication combinations for your best quality of life is something you should do carefully and deliberately — and with professional support.
If you’re ready, we can offer that professional support today.
Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.