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Statin & Erectile dysfunction, what is recent update?

Erectile dysfunction (ED) is a common type of male sexual dysfunction. Erectile dysfunction (ED), also called impotence. It is a condition in which a man regularly finds it difficult to get or keep a firm erection & the inability to get and maintain an erection that is sufficient for satisfactory sexual intercourse.

Causes:
Physical causes of erectile dysfunction:

  • Heart disease
  • Clogged blood vessels (atherosclerosis)
  • High cholesterol
  • High blood pressure
  • Diabetes
  • Obesity
  • Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
  • Parkinson’s disease
  • Multiple sclerosis
  • Certain prescription medications
  • Tobacco use
  • Peyronie’s disease — development of scar tissue inside the penis
  • Alcoholism and other forms of substance abuse
  • Sleep disorders
  • Treatments for prostate cancer or enlarged prostate
  • Surgeries or injuries that affect the pelvic area or spinal cord
  • Low testosterone

Psychological causes of erectile dysfunction:

  • Depression, anxiety or other mental health conditions
  • Stress
  • Relationship problems due to stress, poor communication or other concerns

Risk factors:

  • Medical conditions, particularly diabetes or heart conditions
  • Tobacco use, which restricts blood flow to veins and arteries, can — over time — cause chronic health conditions that lead to erectile dysfunction.
  • Being overweight.
  • Certain medical treatments, such as prostate surgery or radiation treatment for cancer.
  • Injuries, particularly if they damage the nerves or arteries that control erections.
  • Medications, including antidepressants, antihistamines and medications to treat high blood pressure, pain or prostate conditions.
  • Psychological conditions, such as stress, anxiety or depression
  • Drug and alcohol use

Analysis of all 11 studies combined found a statistically significant effect of statins on erectile function in men who had both high cholesterol and erectile dysfunction.

  1. Erectile dysfunction now considered as an early sign of silent cardiovascular disorder and hidden atherosclerosis and important parameter of vascular health.
  2. Many Diabetic and cardiac patients (especially who GOOGLE or related to medical profession) stop taking statin or take less than the prescribed dose with a fear that statin may cause erectile dysfunction.
  3. Some previous studies reported that statin might induce erectile dysfunction through reduction of circulating testosterone level, induction of peripheral neuropathy and cognitive deficits.
  4. But most of recent studies illustrated that statin lead to a significant improvement in erectile function through amelioration of penile endothelial dysfunction, penile neuronal reflexes which are interrelated during sexual excitation and penile erection.
  5. Statin advanced endothelial nitric oxide concentration through activation and upregulation of endothelial nitric oxide synthase which increase penile blood flow and improved erectile function.
  6. In a press release by American College of Cardiology based upon meta-analysis including 11 randomized controlled trials state that statins are associated with a significant (24.3%) improvement in erectile function (https://www.acc.org/about-acc/press-releases/2014/03/29/09/00/kostis-erectile-function).
  7. In my clinical practice, sometimes I conusel my patients regarding benefit of statin on sexual health to make him compliant with lipid lowering medications!

Dr. M Saifuddin
MBBS (DMC, K-56)
FCPS (Med), MD (Endo), FRCP (Ireland)
Assistant professor (Endocrinology)
Dhaka Medical College &
Author, FAQs in Diabetes, Endocrinology and Metabolism

Platform Academic Division / Ariful Islam Neloy

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