Abstract

RIBEIRO, Ricardo Pinto; CAVALEIRO, Isa; JESUS, Joana  and  SALTA, Emília. Can statins cause erectile dysfunction in adult men?. Rev Port Med Geral Fam [online]. 2019, vol.35, n.6, pp.489-495. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v35i6.12412.

Introduction: Erectile dysfunction (ED) is defined as a persistent inability to initiate and maintain a sufficient erection to allow satisfactory sexual performance. This may have a neuropathic, vascular, psychogenic or endocrine etiology, and several factors contribute or aggravate ED. Statins, drugs used in the treatment of dyslipidemias, may decrease the production of steroid hormones (by lowering cholesterol, the precursor of most sex hormones) and therefore lead to lower testosterone levels, thus causing erectile dysfunction. Objective: To review existing evidence on the impact of statins on erectile function. Methodology: Research of systematic reviews, meta-analysis, randomized controlled clinical trials and clinical guidelines published in the main databases (National Guidelines Clearinghouse, Guidelines Finder, CMA Infobase, The Cochrane Library, Bandolier, Embase and MEDLINE/PubMed) in Portuguese, English, Spanish and French, with the terms MeSH ‘Erectile Dysfunction’ AND ‘Hydroxymethylglutaryl-CoA Reductase Inhibitors’ on 05/23/2017. The evaluation of the quality of the evidence was made using the SORT scale. Inclusion Criteria: Studies with males aged ≥ 18 years under the terms of the survey. The research excluded all articles previous to the last systematic review of the literature found in each database. Results: Of the 52 articles found, after excluding articles that did not fit the theme, repeated articles and articles previous to the last systematic review of the literature in each database, three articles met the inclusion criteria: one systematic review and meta-analysis, one meta-analysis and one original article). Although the articles are heterogeneous, most seem to indicate that statins may improve ED or reduce the risk of ED. Conclusions: From the research, we conclude that statins seem to decrease symptoms of erectile dysfunction (Strength of recommendation B). However, the studies included in the systematic reviews and meta-analysis analyzed are short-lived and most do not assess testosterone levels at the beginning and at the end of the study, preventing the correlation of statin intake with drug-induced hypogonadism that could aggravate or manifest the DE. Further randomized clinical trials with more clinical and laboratory data and a longer follow-up time will be needed to better elucidate the effects of statins in ED.

Keywords : Erectile dysfunction; Statins; Hydroxymethylglutaryl CoA reductase inhibitors; Hypogonadism.

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