Cholesterol-lowering class of drugs
If you are over the age of 50, there is a very good chance that your doctor has asked you to consider taking a statin drug. Highly effective at lowering cholesterol levels, this cholesterol-lowering class of drugs works by stopping the action of an enzyme in the liver called hydroxymethylglutaryl-coenzyme-A-reductase. What anyone needs to know about this enzyme is that it is essential to enable the liver to make the body's own cholesterol. About 85 per cent of the cholesterol in the body comes not from food, but from inside the body itself.
The benefits of statin drugs for increasing longevity and even for preventing cardiovascular disease continue to be debated. For some people, however, statins also pose serious side effects.
How this cholesterol-lowering class of drugs works
Since statins paralyze an enzyme pathway in the liver, it is no surprise that these cholesterol-lowering drugs sometimes damage the liver. They can also cause breakdown of muscle tissue (although this only happens after the muscle has also been stressed, for example, by lifting weights or taking a hike), and the byproducts of muscle decomposition triggered by the statin drug can cause kidney problems.
Many people suffer some degree of memory loss when they start taking cholesterol medication—but they forget to report this to their doctors! And some men experience lower sex drive, too.
The best documented evidence of the role of statins in male sex drive and in testosterone levels comes from a study conducted at the Netherlands Pharmacovigilance Centre Lareb, a European center that compiles reports of adverse reactions to drugs. Since these reports are based on patient experience rather than on research protocols, they are rich in detail.
First week on the Statin - lowered sex drive for men
Typical presentations of lower male sex drive. In the cases reported to the Netherlands Pharmacovigilance Centre, most men who had problems with sex drive began experiencing them the first week they started taking the statin drug. Testosterone levels fall precipitously, and with them the desire for sex disappears, too. When the statin drug is discontinued, sex drive returns almost immediately, and testosterone levels go back up a day or two later.
Why lowering cholesterol lowers male sex drive. LDL cholesterol is often misunderstood as some kind of toxin. The fact is that some LDL is essential for life, and the problems with LDL cholesterol only occur when the lining of the arteries have become inflamed and cholesterol has become trapped. When there is no inflammation, there is no atherosclerosis, and LDL exists primarily as a building material for the water-proof outer lining of cells and as a building block of hormones.
The Leydig cells in the testicles use LDL cholesterol to make testosterone. These cells are very resourceful at obtaining a supply of LDL. They can absorb it from the bloodstream, and they can also even make their own LDL cholesterol to be turned into testosterone.
When men take statin drugs, their bloodstream LDL levels go down. The Leydig cells can absorb less LDL cholesterol from the bloodstream. Moreover, Leydig cells use the same enzyme to make cholesterol that is used by the liver. Smaller amounts of the statin drug reach these cells in these testicles than are absorbed by the liver, but enough of the medication reaches the Leydig cells that they cannot make their own LDL cholesterol, either. Without LDL, they cannot make testosterone.
The statin drug simvastatin, also known as Zocor, has an additional effect on cholesterol production. It not only prevents the absorption and production of LDL cholesterol in the testicles, it also interferes with the process that converts two intermediate products, dehydroepiandrosterone (DHEA) and dehydroandrostenedione, into androstenediol and testosterone, respectively.
DHEA, dehydroandrostenedione, androstenediol, and testosterone are not just important in men's sexual desire. They are also important in women's sexual desire. This is why some women may also suffer loss of libido when they take Zocor.
Does taking statin drugs always result in loss of male sex drive?
The reality is, not every man who takes Zocor or any other statin drug suffers loss of sex drive. That is because a very wide range of testosterone levels in men is considered "healthy." The best indication of how statin drugs affect your sex drive is to compare your testosterone levels after taking the cholesterol-lowering medication with your testosterone levels 10, 20, or 30 years ago. Most men, however, do not have this information.
There are at least three ways for men to deal with lowered sex drive after taking cholesterol-lowering medication. One is to continue taking the drug, and also take testosterone injections. This is something that only should be attempted under a doctor's supervision. Too much testosterone can cause prostate problems, mood swings, aggression, and acne. Men who have prostate cancer absolutely should not take testosterone injections.
Another way to deal with the problem is to continue taking the cholesterol-lowering medication and also to take steps to conserve body testosterone. Some ways men can maintain their testosterone levels, and also their sex drive, include:
- Getting more sleep. Testosterone levels increase during REM (rapid eye movement) sleep.
- Lifting weights—without indulging in excessive protein. Resistance training helps maintain testosterone levels, although in older men, eating too much protein cancels out this effect. Eat a light snack after your workout, but don't go out for a 24-oz (650 g) steak.
- Asserting yourself. Men in positions of power and dominance tend to maintain their testosterone levels.
A third way to deal with this issue is to consider natural alternatives. Herbal formulas from Traditional Chinese Medicine that contain licorice help conserve testosterone, although the herbal formula that is most appropriate varies from man to man. See a trained practitioner of Traditional Chinese Medicine to get the right formula.
Also, some natural alternatives to statin drugs for lowering cholesterol are appropriate—and some are not. Red yeast rice contains a naturally occurring form of lovastatin, the chemical in Mevacor. If you have a problem with a statin drug, you will also have a problem with red yeast rice.
Plant stanols, on the other hand, lower cholesterol without interfering with testosterone production. Many men find that taking a plant stanol supplement lowers LDL and total cholesterol as effective as a statin drug. Consult your physician before discontinuing any prescription medication.