Vol 69, No 6 (2018)
Original paper
Published online: 2018-09-19

open access

Page views 4807
Article views/downloads 1516
Get Citation

Connect on Social Media

Connect on Social Media

The effect of atorvastatin on sexual function and depressive symptoms in young women with elevated cholesterol levels — a pilot study

Robert Krysiak1, Agnieszka Drosdzol-Cop2, Violetta Skrzypulec-Plinta2, Bogusław Okopień1
Pubmed: 30259501
Endokrynol Pol 2018;69(6):688-694.

Abstract

Introduction: Statins were found to improve erectile function in men. No previous study has prospectively investigated sexual functioning in women receiving these agents. The aim of this study was to evaluate the impact of atorvastatin therapy on female sexual function, and depressive symptoms in young women with elevated cholesterol levels. Material and methods: The study included 14 women with elevated cholesterol levels and 14 matched women with normal plasma lipids. Hypercholesterolaemic women were then treated with atorvastatin (20–40 mg daily) for 24 weeks. Apart from measuring plasma lipids, at the beginning and at the end of the study, all participants of the study completed questionnaires evaluating sexual function (Female Sexual Function Index — FSFI) and the presence and severity of depressive symptoms (Beck Depression Inventory–Second Edition — BDI-II). Results: The mean total FSFI score was insignificantly lower, while the BDI-II score was higher in women with hypercholesterolaemia than in the control group. Both groups significantly differed in domain scores for arousal and orgasm. Atorvastatin decreased the domain score for desire, increased the domain score for orgasm, but did not affect the total FSFI score and the remaining domain scores. Moreover, atorvastatin tended to reduce the BDI-II score. Treatment-induced changes in desire, orgasm, and the BDI-II did not correlate with the effect of atorvastatin on plasma lipids. Conclusions: Atorvastatin treatment produces a relatively mild effect on sexual functioning and mood in women, affecting only selected elements of female sexual behaviour.

Article available in PDF format

View PDF Download PDF file

References

  1. Mosca L, Barrett-Connor E, Wenger NK. Sex/gender differences in cardiovascular disease prevention: what a difference a decade makes. Circulation. 2011; 124(19): 2145–2154.
  2. Roger VL, Go AS, Lloyd-Jones DM, et al. American Heart Association Statistics Committee and Stroke Statistics Subcommittee, American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics--2011 update: a report from the American Heart Association. Circulation. 2011; 123(4): e18–e209.
  3. Babelova A, Sedding DG, Brandes RP. Anti-atherosclerotic mechanisms of statin therapy. Curr Opin Pharmacol. 2013; 13(2): 260–264.
  4. Blum A, Shamburek R. The pleiotropic effects of statins on endothelial function, vascular inflammation, immunomodulation and thrombogenesis. Atherosclerosis. 2009; 203(2): 325–330.
  5. Krysiak R, Okopień B, Herman Z. Effects of HMG-CoA reductase inhibitors on coagulation and fibrinolysis processes. Drugs. 2003; 63(17): 1821–1854.
  6. Fung MM, Bettencourt R, Barrett-Connor E. Heart disease risk factors predict erectile dysfunction 25 years later: the Rancho Bernardo Study. J Am Coll Cardiol. 2004; 43(8): 1405–1411.
  7. Tikkanen MJ, Jackson G, Tammela T, et al. Erectile dysfunction as a risk factor for coronary heart disease: implications for prevention. Int J Clin Pract. 2007; 61(2): 265–268.
  8. Kostis JB, Dobrzynski JM. The effect of statins on erectile dysfunction: a meta-analysis of randomized trials. J Sex Med. 2014; 11(7): 1626–1635.
  9. Cai X, Tian Ye, Wu T, et al. The role of statins in erectile dysfunction: a systematic review and meta-analysis. Asian J Androl. 2014; 16(3): 461–466.
  10. Cui Y, Zong H, Yan H, et al. The effect of statins on erectile dysfunction: a systematic review and meta-analysis. J Sex Med. 2014; 11(6): 1367–1375.
  11. Gokce Mİ, Gülpınar Ö, Öztürk E, et al. Effect of atorvastatin on erectile functions in comparison with regular tadalafil use. A prospective single-blind study. Int Urol Nephrol. 2012; 44(3): 683–687.
  12. Schooling CM, Au Yeung SL, Freeman G, et al. The effect of statins on testosterone in men and women, a systematic review and meta-analysis of randomized controlled trials. BMC Med. 2013; 11: 57.
  13. Krysiak R, Kowalska B, Żmuda W, et al. The effect of aggressive rosuvastatin treatment on steroid hormone production in men with coronary artery disease. Basic Clin Pharmacol Toxicol. 2014; 114(4): 330–335.
  14. Miller W. Steroidogenic Enzymes. Endocr Dev. 2008: 1–18.
  15. Banaszewska B, Pawelczyk L, Spaczynski RZ, et al. Effects of simvastatin and metformin on polycystic ovary syndrome after six months of treatment. J Clin Endocrinol Metab. 2011; 96(11): 3493–3501.
  16. Celik O, Acbay O. Effects of metformin plus rosuvastatin on hyperandrogenism in polycystic ovary syndrome patients with hyperlipidemia and impaired glucose tolerance. J Endocrinol Invest. 2012; 35(10): 905–910.
  17. Raja-Khan N, Kunselman AR, Hogeman CS, et al. Effects of atorvastatin on vascular function, inflammation, and androgens in women with polycystic ovary syndrome: a double-blind, randomized, placebo-controlled trial. Fertil Steril. 2011; 95(5): 1849–1852.
  18. Gao L, Zhao FL, Li SC. Statin is a reasonable treatment option for patients with Polycystic Ovary Syndrome: a meta-analysis of randomized controlled trials. Exp Clin Endocrinol Diabetes. 2012; 120(6): 367–375.
  19. Krysiak R, Okopien B. The effect of metformin on androgen production in diabetic women with non-classic congenital adrenal hyperplasia. Exp Clin Endocrinol Diabetes. 2014; 122(10): 568–571.
  20. Krysiak R, Kowalcze K, Bednarska-Czerwińska A, et al. The Effect of Simvastatin on Plasma Steroid Hormone Levels in Metformin-Treated Women with Non-Classic Congenital Adrenal Hyperplasia. Exp Clin Endocrinol Diabetes. 2016; 124(4): 215–219.
  21. Davis SR, Wahlin-Jacobsen S. Testosterone in women — the clinical significance. Lancet Diabetes Endocrinol. 2015; 3(12): 980–992.
  22. Ali SK, Reveles KR, Davis R, et al. The association of statin use and gonado-sexual function in women: a retrospective cohort analysis. J Sex Med. 2015; 12(1): 83–92.
  23. Rosen R, Brown C, Heiman J, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000; 26(2): 191–208.
  24. Wiegel M, Meston C, Rosen R. The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores. J Sex Marital Ther. 2005; 31(1): 1–20.
  25. Beck AT, Steer RA, Brown GK. BDI-II: Beck Depression Inventory Manual. 2nd ed. Psychological Corporation, San Antonio 1996.
  26. American Psychiatric Association. Diagnostic and statistical manual of mental disorders — DSM-IV-TR. 4th ed. American Psychiatric Publishing, Washington 1994.
  27. Jasińska M, Owczarek J, Orszulak-Michalak D. Statins: a new insight into their mechanisms of action and consequent pleiotropic effects. Pharmacol Rep. 2007; 59(5): 483–499.
  28. Wåhlin-Jacobsen S, Pedersen AT, Kristensen E, et al. Is there a correlation between androgens and sexual desire in women? J Sex Med. 2015; 12(2): 358–373.
  29. Izquierdo D, Foyouzi N, Kwintkiewicz J, et al. Mevastatin inhibits ovarian theca-interstitial cell proliferation and steroidogenesis. Fertil Steril. 2004; 82 Suppl 3: 1193–1197.
  30. Kodaman PH, Duleba AJ. HMG-CoA reductase inhibitors: do they have potential in the treatment of polycystic ovary syndrome? Drugs. 2008; 68(13): 1771–1785.
  31. Jacobson JR. Statins in endothelial signaling and activation. Antioxid Redox Signal. 2009; 11(4): 811–821.
  32. Hernández-Ojeda J, Román-Pintos LM, Rodríguez-Carrízalez AD, et al. Effect of rosuvastatin on diabetic polyneuropathy: a randomized, double-blind, placebo-controlled Phase IIa study. Diabetes Metab Syndr Obes. 2014; 7: 401–407.
  33. Leis AA, Stokic DS, Olivier J. Statins and polyneuropathy: setting the record straight. Muscle Nerve. 2005; 32(4): 428–430.
  34. Papakostas GI, Ongür D, Iosifescu DV, et al. Cholesterol in mood and anxiety disorders: review of the literature and new hypotheses. Eur Neuropsychopharmacol. 2004; 14(2): 135–142.
  35. ElBatsh MM. Antidepressant-like effect of simvastatin in diabetic rats. Can J Physiol Pharmacol. 2015; 93(8): 649–656.
  36. Ormiston T, Wolkowitz OM, Reus VI, et al. Hormonal changes with cholesterol reduction: a double-blind pilot study. J Clin Pharm Ther. 2004; 29(1): 71–73.