Rosuvastatin is a commonly prescribed medication in the statin class, primarily used to lower high cholesterol and reduce the risk of heart attacks and strokes. Erectile dysfunction (ED) is the consistent difficulty in achieving or maintaining an erection firm enough for satisfactory sexual activity. Patients sometimes express concerns about a possible link between taking rosuvastatin and experiencing ED.
The Link Between High Cholesterol and Erectile Dysfunction
High cholesterol, the condition rosuvastatin treats, is a significant risk factor for erectile dysfunction. This connection stems from high cholesterol’s impact on blood vessels, including those supplying the penis. When LDL cholesterol levels are high, fatty deposits called plaque can build up within artery walls, a process known as atherosclerosis.
Atherosclerosis causes arteries to narrow and harden, restricting blood flow. Healthy blood flow to the penis is necessary for an erection, as blood fills two spongy cylinders within the organ. When blood flow is compromised due to plaque buildup, achieving and maintaining an erection becomes difficult. High cholesterol also damages the endothelium, the inner lining of blood vessels. This damage impairs the body’s ability to produce nitric oxide, a chemical that helps blood vessels relax and widen.
This vascular damage, inflammation, and reduced nitric oxide directly contribute to ED, often before other cardiovascular symptoms appear. Therefore, ED can be a symptom of the same underlying cardiovascular disease that rosuvastatin manages, rather than a direct side effect of the medication. Addressing cholesterol levels through treatment and lifestyle changes can often improve both heart health and erectile function.
How Rosuvastatin May Influence Erections
While high cholesterol is a known cause of ED, some theories suggest rosuvastatin could influence erectile function through distinct biological pathways. Cholesterol serves as a building block for hormones, including testosterone, which plays a role in sexual function. Since statins like rosuvastatin inhibit an enzyme involved in cholesterol synthesis, a theoretical concern is that they might lead to a decrease in testosterone levels.
Studies on the direct impact of statins on testosterone levels and erectile function have yielded mixed and sometimes contradictory results. Some research suggests statins can slightly lower testosterone levels, but not enough to cause hypogonadism. Other studies found no association between rosuvastatin therapy and changes in erectile function scores, even with similar cholesterol reductions. The overall clinical evidence for a direct negative effect of rosuvastatin on erections through hormone pathways is not conclusively established. Some reviews indicate statins may even improve erectile function in men with high cholesterol and ED.
Managing ED While Taking Rosuvastatin
If you are experiencing erectile dysfunction while taking rosuvastatin, consult your healthcare provider and never stop the medication on your own. Abruptly discontinuing rosuvastatin can lead to serious health risks, including an increased chance of heart attack or stroke, as it helps prevent these events. Your doctor can help determine the underlying cause of your ED, which may be related to your cholesterol levels, other health conditions, or lifestyle factors.
Your healthcare provider can explore solutions, such as monitoring symptoms or adjusting your treatment plan. In some cases, they might consider a different statin medication. Rosuvastatin is generally considered hydrophilic and less likely to cause certain extrahepatic effects compared to lipophilic statins. Many men safely use ED treatments, like phosphodiesterase type 5 (PDE5) inhibitors, while continuing cholesterol-lowering therapy, as there are no known interactions. Lifestyle modifications, including a heart-healthy diet, regular exercise, and avoiding smoking, are also beneficial for both cardiovascular health and improving erectile function.