From the Guidelines
Atorvastatin can potentially cause impotence (erectile dysfunction) as a side effect, though it's not among the most common side effects. Atorvastatin, commonly sold under the brand name Lipitor, is a statin medication used to lower cholesterol levels and reduce cardiovascular risk. The connection between statins and sexual dysfunction is thought to be related to their effects on testosterone production, as cholesterol is a precursor to testosterone. Additionally, statins may affect nerve function or blood flow, which are essential for normal erectile function.
Key Points to Consider
- The evidence from studies 1 suggests that atorvastatin may be associated with erectile dysfunction, but the relationship is not fully understood.
- If you experience impotence while taking atorvastatin, it's essential to discuss this with your healthcare provider rather than discontinuing the medication on your own.
- Your doctor can evaluate whether the erectile dysfunction is likely related to the medication or has another cause, and may consider adjusting your dosage, switching to a different statin, or adding treatments for erectile dysfunction while maintaining your cholesterol management.
Treatment Options
- Sildenafil combined with other ED therapies, such as psychotherapy, dihydroergotamine, cabergoline, atorvastatin, quinapril, and alfuzosin, may result in greater improvements in erectile function and frequency of penile penetration or maintenance of erection than did sildenafil alone 1.
- Hormonal therapy, such as testosterone, may also be considered for patients with hypogonadism 1.
From the Research
Atorvastatin and Impotence
- Atorvastatin may not cause impotence, as some studies suggest it can be an effective treatment for erectile dysfunction (ED) 2, 3.
- A meta-analysis of randomized controlled trials found that atorvastatin therapy was effective in the treatment of ED, with a weighted mean difference of 4.53 in the International Index for Erectile Function-5 (IIEF-5) score compared to the control group 2.
- Another study found that statin use, including atorvastatin, was not associated with an increased risk of new onset of erectile dysfunction in men with established cardiovascular disease or cardiovascular disease risk factors 4.
- However, the effect of atorvastatin on erectile function may depend on various factors, such as the patient's age, diabetes status, and lipid profile 5, 4.
Mechanisms and Effects
- Statins, including atorvastatin, may improve erectile function by reducing endothelial dysfunction, a key etiopathogenetic factor in the onset of ED 6.
- Atorvastatin may also have a synergistic effect with phosphodiesterase-5 inhibitors, which are commonly used to treat ED 6.
- The evidence suggests that atorvastatin can cause a clinically relevant improvement of erectile function, as measured by the five-item version of the IIEF 3.
Study Findings
- A systematic review and meta-analysis of randomized trials and observational studies found that statin use, including atorvastatin, was not associated with an increased risk of new onset of erectile dysfunction 4.
- A meta-analysis of randomized controlled trials found that atorvastatin therapy was effective in the treatment of ED, with a significant increase in IIEF-5 score compared to the control group 2.
- Another study found that cholesterol-lowering using a statin, and blood pressure-lowering using candesartan with hydrochlorothiazide, either alone or in combination, did not improve or adversely affect erectile function 5.