Factors that affect erectile function include the presence of cardiovascular disease, high blood pressure, high cholesterol, diabetes, obesity, smoking, depression, and stress. If a doctor believes that a treatable physical condition is contributing to a patient’s erectile dysfunction, then often, treating that underlying condition will improve erectile function, even if the patient continues using ED medications like Viagra.
Doctors are starting to look at ED as a sort of “canary in a coal mine” situation, and will often recommend tests of cardiovascular function, blood glucose levels, and cholesterol levels to determine if any underlying health conditions could be contributing to the ED. Recommendations that smokers quit smoking and sedentary men increase exercise are also common when men seek medical help for ED.
Approximately 15 million Americans take drugs called statins, which are medications prescribed for lowering cholesterol levels by blocking the action of a chemical in the liver that’s necessary for making cholesterol. Several new studies have indicated that taking statins can improve erectile function, whether patients take Viagra for ED or not.
Study by Robert Wood Johnson Medical School
Dr. John Kostis, director of the Cardiovascular Institute at Rutgers Robert Wood Johnson Medical School, performed a systematic review and meta-analysis of studies assessing statin therapy and ED. Systematic reviews are overviews of primary studies, while meta-analysis is mathematical analysis of results of the studies that are reviewed.
Using a standard measure of erectile function called the International Inventory of Erectile Function (IIEF), researchers found that men taking statins had improved erectile function equivalent to about one-third the improvement that typically occurs with ED drugs like Viagra. Eleven trials were included in the analysis, and 713 men in total were represented in those trials. Doctors aren’t likely to prescribe statins off-label as a less embarrassing treatment for treating ED, however. The results were notable, but nowhere near as impressive as the results with drugs like Viagra that were designed specifically for ED.
West China Hospital Study
A study carried out by researchers at the West China Hospital in Chengdu, China included a systematic review of the available literature on the effects of statins on ED. The studies in this overview were all randomized controlled trials that used the IIEF as their measure of erectile function, and a total of 586 patients were included in all the trials.
Meta-analysis showed that statins were correlated with a significant increase in IIEF scores by an average of 3.27 points on a 25-point scale. (Total cholesterol, triglycerides, and LDL profiles improved significantly too.) Researchers summarized the results by saying, “[O]ur study revealed positive consequences of these lipid-lowering drugs on erectile function, especially for nonresponders to phosphodiesterase type 5 inhibitors.”
Beijing Tian-Tan Hospital Study
Yet another study of statins in men with ED was carried out by researchers in Beijing using meta-analysis. Researchers first identified published randomized placebo-controlled, double-blind trials for statins in men with ED. Six studies covering a total of 462 patients were selected for analysis. Three of the studies were randomized controlled trials comparing statins with a placebo and the other three were randomized controlled trials comparing statins-plus-Viagra with placebo-plus-Viagra. The IIEF was used to measure erectile function in these studies as well.
The analysis found that statins plus Viagra improved erectile function more than a placebo plus Viagra, indicating that statins had a role in improving erectile function. Researchers concluded that statins, whether or not used in conjunction with Viagra, can improve erectile function compared with a placebo.
What About Statins and Testosterone Levels?
There is some research indicating that statins are associated with lower testosterone levels, so the correlation between statin use and improved erectile functioning was especially intriguing. Researchers are calling for further studies on statins and erectile functioning to help elucidate how statins improve erectile function and the connection between statins and testosterone levels.
Medical researchers speculate that improved erectile function in men who take statins may have to do with lower levels of LDL cholesterol (also commonly known as “bad” cholesterol, in contrast to HDL, which is considered “good” cholesterol.). Lower LDL cholesterol levels may improve the functioning of the endothelium, which is the tissue that forms a single cell layer lining the organs and blood vessels of the body. Better endothelium functioning could improve flow of blood to the penis, but in a different way than Viagra does.
Paying Attention to Cardiovascular Health Is Important
Men with ED should not hesitate to bring up their concerns with their doctors, since so many doctors are looking at ED as a signal for possible underlying cardiovascular disease. Even if their doctors prescribe Viagra for treating ED, addressing any underlying cardiovascular disease improves overall health, and may help the Viagra work better as well.
If you have ED, learning more about your risk factors for cardiovascular disease, high blood pressure, and diabetes can help you make lifestyle changes that can lead to improved erectile health. You may still need to take Viagra, but you will get the best possible results if your general health is good.
An article by the Arizona Center for Advanced Medicine recommends that treatment of ED start with the underlying state of health, recommending that men “clean up the filters (the liver), make sure the fuel pump is working well (the heart), make sure the fuel lines are clear (the arteries) and make sure that the computer is loaded with the right software (the brain).” That’s also a recipe for improved overall health, which can’t hurt when men are dealing with erectile dysfunction.
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