Articles

Are Cholesterol Medications Knocking Down Your Libido?

By Paul Hueseman, Pharm. D.

Statins, a drug class prescribed for high cholesterol, which includes medications such as Lipitor, Crestor, and Zocor is the second most highly prescribed medication class in the United States, particularly in men and women over the ages of 40.1 Since cholesterol is required for the production of male hormones, also known as androgens, many researchers have theorized that statins may reduce production of these hormones in men. This could lead to or exacerbate typical symptoms of male menopause or andropause such as decreased libido, depression and emotional irritability, joint pain, decreased energy, decreased muscle mass, increased fat mass in the belly area, and insulin resistance.

Researchers from the New England Research Institutes found that men using statins did have lower blood levels of androgens such as testosterone. Although, their conclusion was that this reduced level of androgens was more likely attributable to poor health rather than the use of statins.

To specifically look at this question-- whether statin use reduces androgen levels in the blood -- these researchers examined data from the Boston Area Community Health (BACH) survey, a population-based, NIH-sponsored, epidemiologic study. Data were collected between 2002 and 2005 on 1,812 men, including 237 statin users, and analyzed their blood for "free" or unbound testosterone, for total testosterone, dehydroepiandrosterone sulfate, or luteinizing hormone. The researchers found no relationship between statin use and free testosterone and most of the other associated compounds. There was a significant association between statin use and level of total testosterone in the blood, but that association vanished when researchers considered the patients' age, body weight, and history of cardiovascular disease and diabetes.

"We know that men with higher body mass index, diabetes and cardiovascular disease tend to have lower testosterone levels, and this largely accounted for the drop in testosterone in statin users," stated study author, Susan A. Hall, Ph.D., a research scientist at the New England Research Institutes. "In this study, statin use was just a marker for presence of other illnesses.

So, what does this all mean? It's the age old question – which comes first – the chicken or the egg? Does the statin medication cause some reduction in testosterone levels, that is still not completely understood from studies done to date. Or, are the men who start on statin medications not in their optimal health – have low testosterone – which is putting them at risk for a number of illnesses, including heart disease, insulin resistance, and other associated disorders.

1. Express Scripts 2006 Drug Trend Report
   
2. American Association for Cancer Research (2007, August 10). No Evidence That Widely Prescribed Statins Protect Against Prostate Cancer. ScienceDaily. Retrieved March 6, 2008, from http://www.sciencedaily.com¬ /releases/2007/08/070809114127.htm

3. Hall SA, Page ST, Travison TG, Montgomery RB, Link CL, McKinlay JB. Cancer Epidemiol Biomarkers Prev 2007;16(8):1587–94