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How common statins and other prescription medicines, and not age, may be affecting sexual performance and enjoyment

By: – Patricia Bush, PhD, Professor Emeritus, Georgetown University School of Medicine
– Robert Raffa, PhD, Professor of Pharmacology
– Albert Wertheimer, PhD, Professor of Pharmacy Administration

Many ordinary people and their doctors assume that it is because of aging that their sexual libido and performance are diminishing.  In many cases, it would be wrong to assume that and to place the blame strictly on aging, according to Drs. Wertheimer, Raffa and Bush, authors of the recently published book, “YOUR DRUGS AND SEX: How Prescription and Non-Prescription Drugs Can Affect Your Sex Life”.   this book explores how common statin andother prescriptions affect your sext life.

The authors studied male and female sexual performance and how it can be affected by over 400 of the most commonly prescribed drugs, as well as many non-prescription drugs.  In their book, Drs. Wertheimer, Raffa, and Bush explain in simple, easy to understand language, how everyday drugs can affect sexual performance in men and women including: erectile dysfunction, difficulty achieving orgasm, ejaculation failure, impotence, decreased desire, pain during intercourse, lower testosterone, and other side effects.

One example relates to the effects statins have on sexual performance.  Statins are among the most prescribed drugs in the U.S. due to their effectiveness in decreasing cholesterol levels in the blood. Fibrates also lower cholesterol, and in addition triglycerides, but they are not prescribed as often as statins because they are usually reserved for patients who can’t take statins or who have unusually high triglycerides.

Do the statins and/or the fibrates adversely affect sexual function?  The evidence suggests that yes they do, with fibrates more likely doing so, although the risk is low. However, given the very large number of prescriptions written for statins and fibrates, even a low risk means that the number of users is significant. Both kinds can cause impotence and difficulty in achieving orgasm for both men and women.

Given the benefit of the statins and fibrates in preventing strokes and heart attacks, should one stop taking them to avoid rare, but possible, impotence or loss of libido? The answer is usually no, only because one can probably eliminate the problem by switching to a different one. The patient should tell their prescribing physician about the problem and ask for a change.

A review of randomized clinical trials and studies with other research designs supports the existence of statin-associated adverse effects including sexual dysfunction.1

Another systematic review of studies in computerized data bases and Internet sources of almost all of the statins and fibrates on the market concluded that both may cause impotence.2

Another study funded by the government found that both statin-taking men and women reported increased difficulty achieving orgasm. Yes, their LDL cholesterol levels decreased but so did their levels of sexual pleasure.1,3

What causes the adverse effects on sexual function to happen? It turns out that cholesterol is a building-block of testosterone, estrogens, and other sex hormones in the body. So it follows that, when the statins and fibrates do their job and decrease cholesterol, the decrease in cholesterol also decreases the hormones that facilitate sexual functioning.

Not surprisingly, some preexisting health conditions can increase the risk of erectile dysfunction (ED) after statins are taken.  Patients with risk factors for heart disease, including age, smoking, and diabetes, were found in one study to be more likely to develop ED after statin therapy than they were before it.4

Surprisingly, statins can also be used to treat impotence in some cases.  Several studies have reported that statin therapy has helped men with ED.  One of the most recent recruited 173 men who were not being treated for ED and randomized them to simvastin (Zocor) or placebo once daily for six months. At the end of the six months there was no significant difference in their erectile function score, but there was a small (5% vs. 2%) significant improvement in their reported ED-specific Quality of Life (MED-QoL) score.5Another study compared the effect on ED of atorvastatin (Lipitor) to regular tadalafil (Cialis) use.  Although the statin alone improved ED, particularly in men with very high cholesterol, Cialis three times a week was significantly better than the statin alone.6

Statin therapy may help men recover their erectile function more quickly after nerve-sparing prostate surgery7 and atorvastin (Lipitor) may increase the effect of sildenafil (Viagra) in men who have not responded to Viagra alone.8,9
Also, with one of the most frequently prescribed statins, Zocor (simvastin), in patients with ED caused by endothelial dysfunction, there is disagreement as to its effects.  Endothelial dysfunction is associated with most forms of cardiovascular disease, such as hypertension, coronary artery disease, chronic heart failure, peripheral artery disease, diabetes, and kidney failure. Men with ED caused by endothelial dysfunction were randomized to receive simvastin or a placebo for 6 months and then one of the male performance enhancers (Levitra) to take on demand for the next 4 months. There was a significant reduction in cholesterol in the group with the statin but no difference in ED in either the placebo or the statin group. The researchers concluded that their study did not support the use of simvastin for ED.10  In addition, Health News from NHS Choices stated in its April 2013 Behind the Headlines release, that atorvastin (Lipitor) given to men for whom sildenafil (Viagra) had not worked, “helped improve symptoms of erectile dysfunction, but not to such an extent that it could be considered an effective treatment.”

One thing is clear, that ED is common, is variable in severity and has many causes. It behooves men who have it and want to improve their sex lives, to explore the possible reasons they have it or are getting it, and the possibile fixes with their physicians.

In today’s world, drugs are a common part of daily life.  Most people age 50 or older take at least one or two medications.  Most include the common medications for hypertension, blood pressure, cholesterol, diabetes, gout, depression, and inflammatory diseases such as arthritis.  Many are suffering needlessly from sexual performance side effects.  The book, “Your Drugs And Sex: How Prescription and Non-Prescription Drugs Can Affect Your Sex Life can help readers identify the pharmacological source of their issues, as well as explore alternative therapy suggestions that may have less sexual impact.

According to Wertheimer, “Although it is true that aging can affect sexual performance, that is not always the case.  It’s a shame that so many people could be missing out on some wonderful experiences in life, just by changing their drugs.”


Drugs Can Affect Your Sex Life



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