Can cholesterol-lowering meds hurt your sex life?

Some patients come to see me and the first question that comes out is about sex. That’s fine—sex is an important topic, and I think that it should be at the top of the list if someone has a question about it. Men often have questions about the sexual side effects of the cholesterol-lowering statin drugs, even though there’s no obvious link between the drug and a man’s sex drive or physical ability to have sex.

Cholesterol has several important functions in the body. It is an important component of the outer “skin” of cells and of the bile acids that digest food in the intestine. It also provides the starting point for making estrogen and testosterone. In theory, lowering cholesterol with a statin could lower testosterone levels, which in turn could dampen the sex drive. In practice, Zocor and other statins seem to have little or no effect on testosterone levels. One small study showed a slight decline in testosterone after long-term statin use, while others show no change. In addition to Zocor (simvastatin), the other statins are Crestor (rosuvastatin), Lescol (fluvastatin), Lipitor (atorvastatin), Mevacor (lovastatin), and Pravachol (pravastatin).

That said, in 2004 Dutch researchers wrote about eight men who reported a decreased sex drive while taking a statin. Problems having an erection have also been reported as an uncommon side effect of statin use.

It is impossible to know if statin therapy caused these sexual side effects, or if they are due to something else. Atherosclerosis, the process that culminates in cholesterol-clogged arteries, can interfere with sexual arousal in men and women. High blood pressure, diabetes, depression, and stress, all of which are common in people with heart disease, can also diminish sexual function.

If a man notices a decrease in sex drive after starting a statin—or anytime—he can certainly ask his doctor to check his testosterone level. If it is abnormally low, then a testosterone patch or gel or injection could improve sex drive. Anyone—man or woman—noticing a change in his or her sex drive or sexual function should have a doctor or pharmacist review a list of the medications being taken. A number of drugs can interfere with sexual function or desire.

Are you on a stating drug? Have you noticed any change in your sex drive or function? How did you handle the change?

Julie K. Silver, M.D., is an assistant professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. She is also the Chief Editor of Books for Harvard Health Publications.

Lowering Your Cholesterol
The Harvard Medical School Guide to Lowering Your Cholesterol provides the most expert, up-to-date advice on reaching and maintaining healthy cholesterol levels. It covers medications for cholesterol, nutrition, exercise, and alternative approaches, as well as how to work best with your doctor to develop the best cholesterol control treatment plan for you.