Statins cause a small but noticeable decrease in testosterone, with no real way to know how much or how little you might be affected by these cholesterol-lowering drugs.
If you have found yourself with less libido after starting statins, less sex hormones in your system may be why. Statins may be given to women suffering from polycystic ovarian syndrome (PCOS) for this very reason.
Interestingly, there is evidence that statins actually increase aggression in women, particularly postmenopausal women. Aggression in men, however, decreases, which is attributed to the testosterone reduction. Low cholesterol levels have been linked with violent deaths (suicide, homicide, accident), and in primate studies.
Cholesterol supports cell energy, with many varieties of cell energy problems related to aggression. Statins have the potential to increase cell energy, just to confuse the issue, so statin use does not necessarily go alongside low cholesterol. Aggressive responses were higher in women on lipid-lowering medications. Sleep was also found to be worse on some statins.
Statins seemed a good solution to the cholesterol conundrum, but it has emerged over time and with immense global use that statins come with their own issues, for example, diabetes, along with a decrease in testosterone that may cause lowered libido.
Clinical trials are very good at pointing out the benefits over risks of treatments – they trial a drug to see if it works in the desired way, but side-effects of these drugs can sometimes take a long time to appear. Libido – in the face of a heart attack – seems insignificant, but when we think about just how many people are on statins, quality of life becomes an issue that is not being addressed adequately, or in fact at all.
About cholesterol and how statins work
Cholesterol is a precursor of sex hormones (like testosterone), with statins inhibiting an enzyme involved in the production of cholesterol. This – in theory – shouldn’t matter, since enough cholesterol was believed to be sent to these cells by the low-density lipoprotein (LDL – ‘bad’ cholesterol) pathway.
Real-life, however, does not conform to our models. In men, testosterone was lowered by doses that were believed to be ‘atypical’ (low to moderate) by about four per cent and about 11 per cent in women. This is significant.
The benefits of statins in lowering cholesterol depends entirely on who they are given to and their potency, so they naturally affect everyone differently. The outcomes – averages – of studies are not what’s important when considering whether statins affect libido, but the individual.
References
- Schooling CM, Au Yeung SL, Freeman G, Cowling BJ. The effect of statins on testosterone in men and women, a systematic review and meta-analysis of randomized controlled trials. BMC Medicine. 2013;11:57. doi:10.1186/1741-7015-11-57.
- Sniderman AD, Thanassoulis G. Do statins lower testosterone and does it matter? BMC Medicine. 2013;11:58. doi:10.1186/1741-7015-11-58.
- Golomb BA, Dimsdale JE, Koslik HJ, et al. Statin Effects on Aggression: Results from the UCSD Statin Study, a Randomized Control Trial. Lobaccaro J-MA, ed. PLoS ONE. 2015;10(7):e0124451. doi:10.1371/journal.pone.0124451.
- Beatrice A Golomb, Edwin K Kwon, Michael H Criqui and Joel E Dimsdale, Simvastatin but Not Pravastatin Affects Sleep: Findings from the UCSD Statin Study, 2007;116:II_847, originally published December 19, 2015
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