Cholesterol and Erectile Dysfunction

By Kathleen Doheny. Medically reviewed by Tom Iarocci, MD. May 7th 2016

While some men may find it a bother to take the drugs known as statins every day to lower their “bad” LDL cholesterol, a new report may persuade them to pop those pills with fewer complaints.

According to the report, statin medicines not only protect against heart attack and stroke risk, but may also improve your sex life. More specifically, there’s a link between lower cholesterol and healthier erections.

It’s long been known that a major source of erectile dysfunction is cardiovascular, and that erectile dysfunction could be an early warning sign of heart disease. The same process that clogs arteries in the heart can clog arteries elsewhere and reduce blood flow that normally supports erections.

Statin medications lower bad cholesterol, which benefits the inner lining of the blood vessels (i.e., the endothelium). Healthier blood vessels can mean healthier erections.

"If you need statins for your heart health, then you may get some additional benefits — your erections may get better," says John Kostis, MD, professor of medicine and director of the Cardiovascular Institute at Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey. He predicts that the finding will likely boost the chances a man will take the cholesterol-lowering drugs as prescribed, helping his heart, brain and sex life in the process.

While the preventive benefits in terms of heart attack and stroke risk reduction may take years to become evident, the effect of the statins on sexual health, as measured in this study.

Cholesterol, Statins & ED

Previous studies about statins and erectile function have resulted in conflicting findings. Some have found statins may lower levels of testosterone and actually worsen erectile dysfunction (ED).

To address the debate, Kostis reviewed 11 studies that had previously been published, looking at all the results in a ''big-picture'' way to evaluate the bottom line. The studies included more than 700 men, with researchers assigning them to a statin or placebo group to evaluate how or if their erections changed.

On average, the men had moderate ED when entering the studies, Kostis says. The average follow up time was four months.

The study researchers used a measure of erectile functioning known as International Inventory of Erectile Function (IIEF). Men reported various personal experiences, including confidence in getting and keeping an erection; how often the erections were hard enough for intercourse; how long they lasted; how difficult it was to finish intercourse; and how satisfied they were with it.

The scores of the men taking statins compared placebo rose on average by about 3.5 points on the 25-point scale. The improvement in ED for the men on statins held, even accounting for age. Additional studies are necessary, however, to better understand these improvements and to learn the extent to which they may be clinically meaningful. “ED may be a preliminary warning sign of cardiovascular disease. It's like the canary in the coal mine," he says.

Caveats About Statins

As with any medication, there are risks and benefits to consider. The study findings are not a reason for those without high cholesterol to take a statin just to improve their erections, Kostis says. Rather, they should be viewed as an additional potential benefit for men who already need to lower their cholesterol to reduce heart attack and stroke risk.

Next Steps

Before considering any medication, Kotis recommends for men with erection problems to have their hearts checked. Doctors will often first recommend the following lifestyle changes:

  • Improve the diet, choosing low-cholesterol foods;
  • Exercise regularly; and
  • Lose excess weight.

If cholesterol is still too high, statins may be prescribed.

Even so, anyone on statins should also keep up the lifestyle habits to improve cholesterol as much as possible, he says.

For Caregivers

If a partner suddenly has problems with erections, suggest a physical checkup to evaluate his overall health, including cardiovascular health and specifically cholesterol levels.

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