Statins Erections

confidencequest

Anyone else notice changes in erections after starting a statin? I just got put on one for high LDL and I’m trying to figure out what’s what. Some people say statins help ED by improving blood vessel function; others say they can blunt testosterone or libido. I’m getting mixed signals and a bit of anxiety isn’t helping.

A few things I’m curious about:

Did your morning wood or erection quality change in the first few weeks, and did it level out over time?
If you switched statins (atorvastatin vs rosuvastatin vs simvastatin vs pravastatin), did one affect erections less? Do hydrophilic vs lipophilic types make a difference?
Dose matters? Did going from high- to moderate-intensity help ED without wrecking your cholesterol goals?
Timing matters? Taking it at night vs morning-any difference for sleep, libido, or performance?
Anyone track hormones after starting? Total/free testosterone, SHBG, etc.-did numbers actually change in a meaningful way?
Did erections improve months later as cholesterol and endothelial health improved, or was it worse overall?
CoQ10 or other supplements-placebo or real help for statin-related sexual side effects?
Any issues using PDE5 meds (sildenafil/tadalafil) while on a statin? Better response, worse, or no change?
If you’re also on blood pressure meds, did the combo make a difference?
Anyone get a penile Doppler or other vascular testing before/after statins and see objective changes?

Trying to separate what’s the drug, what’s underlying vascular stuff, and what’s just nerves. Would love real-world experiences, what your clinicians suggested, and what actually worked.

couragecrest

I went down this rabbit hole recently and found a few nuggets that helped me make sense of the mixed stories:

Big picture: meta-analyses show a small but real average bump in erectile function scores on statins (about +3-4 IIEF points) within 1-3 months, likely from better endothelial nitric oxide. Not everyone feels it, but it’s not all doom and gloom.
Testosterone: pooled data shows a slight drop in total T on average, with little to no change in free T or symptoms. If numbers tank or you feel hypogonadal, that’s a flag to look for another cause or adjust meds.
Hydrophilic vs lipophilic: no consistent winner, but if you’re sensitive, rosuvastatin or pravastatin (more hydrophilic) are the usual “try next” options. Alternate‑day rosuvastatin is a common workaround.
Dose strategy: if libido/erections dip on high‑intensity, stepping to moderate‑intensity and adding ezetimibe often hits LDL targets with fewer side effects. PCSK9s are another LDL hammer if needed.
Timing: matters for short half‑life agents (simvastatin tends to be night), otherwise doesn’t seem to affect libido or sleep in any consistent way.
CoQ10: can help statin myalgias; not great evidence it fixes sexual side effects.
PDE5s: safe with statins. Response can improve as lipids/endothelium improve; daily low‑dose tadalafil (5 mg) is a nice bridge.
BP meds: thiazides and older beta‑blockers can drag erections; ARBs/ACEi are neutral or positive; nebivolol is the most ED‑friendly beta‑blocker.
Objective data: small studies show improved penile peak systolic velocity after a few months of statin in dyslipidemic guys.

If it were me talking with a clinician: baseline and 8-12 week check on lipids, A1c, TSH, total/free T + SHBG; review other meds (SSRIs, finasteride, antihypertensives); if issues, trial a switch to rosuvastatin/pravastatin or alternate‑day dosing, and consider adding ezetimibe rather than pushing dose. Meanwhile, PDE5s can keep confidence up while the vascular benefits of the statin kick in.

positivesteps

Yeah, that clinician rundown is spot on-don’t skip the hormone check, it saved me from chasing ghosts. One thing not mentioned: if you’re lifting weights or doing cardio, ramp it up now; the combo with statins often juices endothelial function faster than the pill alone, and it beats popping more supps. Hang in there, anxiety’s the real boner-killer here.