From the Research
Statins may have a modest effect on lowering testosterone levels, particularly in females with polycystic ovary syndrome (PCOS), but the impact on males is generally minimal, and the cardiovascular benefits of statins typically outweigh this potential side effect. The most recent and highest quality study, a 2021 systematic review and meta-analysis published in The Cochrane database of systematic reviews 1, found that atorvastatin, a commonly prescribed statin, may reduce total testosterone levels in females with PCOS, but had no significant effect on testosterone levels in males. The study included six randomized controlled trials involving 265 participants and found that atorvastatin lowered total testosterone levels in females by -0.27 nmol/L (95% CI -0.50 to -0.04). In contrast, a 2013 meta-analysis published in BMC medicine 2 found that statins lowered testosterone levels in both men and women, but the effect was relatively small. Another study published in the European journal of endocrinology in 2015 3 found that current use of statins was associated with significantly lower serum total and non-sex hormone-binding globulin-bound testosterone levels in men. However, the 2021 study 1 is the most recent and highest quality evidence, and its findings should be given more weight.
Some key points to consider:
- The effect of statins on testosterone levels may vary depending on the specific statin and the individual patient.
- The cardiovascular benefits of statins are well-established, and the potential effect on testosterone levels should not be a reason to discontinue statin therapy without consulting a doctor.
- If symptoms of low testosterone are experienced while taking statins, such as fatigue, reduced libido, or erectile dysfunction, patients should speak with their doctor about checking their testosterone levels and potentially adjusting their statin dose or switching to a different statin.
- Lifestyle modifications, such as regular exercise, maintaining a healthy weight, getting adequate sleep, and managing stress, can help maintain testosterone levels while on statin therapy.
- The certainty of evidence for the effect of statins on testosterone levels is generally low to very low, and more research is needed to fully understand this relationship.