The Status of Statins and Erectile Function
When cholesterol management is no longer achievable through self-improvement measures, including a tweaked diet and lifestyle changes, medicines such as statins can be helpful.
While some information (or misinformation) implies statins may have an effect on erectile performance, reliable data in support of this theory is scarce, according to doctors in the know. Of course, there's always the chance patients who ignore recommendations from their cardiologists put themselves at risk for other health problems beyond erectile dysfunction (ED).
Many cardiologists agree that if there is a relationship between statins and ED, it's more incidental.
"There's no evidence that statins cause erectile dysfunction," said Ron Blankstein, M.D., a cardiologist and a professor of medicine at Harvard Medical School with additional expertise in cardiovascular imaging.
No overnight alternative
Diet can be instrumental in helping to manage cholesterol levels, but even with proper diet and exercise, it takes time to reduce cholesterol levels. Dangerously high levels of cholesterol can persist despite exercise if your diet isn't carefully managed, as well.
The effects of statins have been observed in hundreds of thousands of patients, and known potentially negative correlations, such as muscle weakness or an increased risk of diabetes or liver damage, are generally unverified or exaggerated. The confirmed negative consequences associated with statins affect a small portion of the people who use them.
If you've heard statins can cause memory loss or an increased risk of developing dementia, this isn't necessarily true. As clarified by Johns Hopkins Medicine, statin use is sometimes associated with impaired thinking or fuzzy mental focus, but there's no clear indication these symptoms are statin-induced. Cognitive impairments could just as likely be due to the common age of patients taking statins, or could be related to additional health concerns associated with high cholesterol or the people taking statins.
Similarly, implications about statins being an erectile deterrent don't stand up against the research or scrutiny of urologists.
Don't take our word for it
Some patients make the assumption that improving certain general health factors, such as cholesterol levels or body weight, will lead to improved erectile or sexual performance, said Kevin McVary, M.D., a urologist and a professor with Loyola Medicine in Maywood, Illinois.
"You can't take a cholesterol pill thinking your erection is going to get better," he said.
This common cause-and-effect expectation people form is based on conjecture rather than research, though it is true some cholesterol medications can have a "transient" impact—whether temporary and/or tangential—on erectile performance. McVary referred to cholesterol medications that lower nitric oxide—a critical neurotransmitter that drives erectile function—specifically.
"Statins are the good ones," he said, and the statement is reflected in other literature and sources.
If your doctor determines cholesterol medication is the right choice for you, it's important to weigh the medication's benefits against your concerns relating to erectile performance.
Petar Bajic, M.D., a urologist and men's sexual health specialist with the Cleveland Clinic, said he has always been skeptical of any association between ED and statins. He further implied the culprit, if there is one for cholesterol-related ED, is found not in the medicine but rather in the illness. He said blaming statins never made any sense to him.
"What does make a lot of sense is how the medical conditions, like high cholesterol and, probably more importantly, high blood pressure, how those cause and contribute to erectile dysfunction," Bajic said.
Many different cholesterol medications are in use, and are likely to impact each patient differently. If your doctor determines cholesterol medication is the right choice for you, it's important to weigh the medication's benefits against your concerns relating to erectile performance. As for side effects you have to worry about, the status of statins in regard to ED seems quite clear.
"Specifically relating to cholesterol, I am a little bit skeptical that statins themselves have any meaningful negative effect on [erectile performance]," Bajic said.
Beware misplaced blame
For the doctors who treat us, going by the numbers is generally straightforward and rote. Getting patients to follow their recommendations is often another story.
"Particularly for men getting into the 40s and beyond, usually the ED happens because of high cholesterol, not because of a statin," Bajic said, adding that people often cross their own signals when evaluating their health issues.
Short-term memory is very influential in human beings, and when a new symptom or experience crops up, we tend to think only of the most recent medically relevant factors that could have caused the new health incident. This is why doctors often need extensive records of patients' medical histories to evaluate potential contributors to chronic issues.
Prescriptions make for a convenient target, even though they are frequently less likely to blame than the conditions that necessitate their use.
"I generally caution men to not take home the message of, 'Oh, my medications are the cause of my ED.' Now, that is occasionally the case, but the vast majority of cases are caused by cardiovascular disease," Bajic said.
Heart health and sexual health often go hand in hand in a lot of ways, so it's important to be mindful of your cholesterol, just like you stay mindful of your erections.
The good news for men tracking their cholesterol is that statins—when it comes to their effect on your erection, anyway—seem to be safe.
Even if statins aren't contributing to your erectile issues, something is. It might be a different medication or cardiovascular issues. If taking yet another drug to handle ED issues just doesn't sound appealing, a wearable medical device is a side-effect-free option. Eddie® is an FDA-registered Class II medical device designed to treat erectile dysfunction and improve male sexual performance. In 2021 clinical trials, Eddie was shown to be effective in treating men with physically, psychologically and pharmacologically induced erectile dysfunction. It is a safer treatment that does not have the side effects of prescription pills, nor does it require a prescription to obtain.