Mrs. Bremner and I are at the American Psychosomatic Society (APS) Annual Meeting in Chicago this week where the most interesting presentation other than our poster and talk on brain and heart mechanisms mediating the increased risk for mortality in people with heart disease and depression, is this late breaking data showing that statins have a negative effect on orgasms.
In “Statins Reduce Orgasm: Results from the UCSD Statins Study” Dr. Beatrice Golomb and colleagues from the University of California-San Diego reported today on their 1,067 men and women without heart disease with a LDL cholesterol of 119-190 mg/dL who were randomized to either pravastatin (Pravachol), simvastatin (Zocor), or placebo for LDL cholesterol reduction with the purpose of prevention of heart attacks. Orgasm was self rated on a scale of 1 (“much worse”) to 5 (“much better”) with 3 for “no change”. Overall statins had a negative effect on orgasms, with a reduction of 0.63 for men and 0.57 for women, which was statistically significant only for men, and only for Zocor.
Previous studies have shown that the more you reduce LDL cholesterol the more you lower your risk of heart attack. It has also been shown that you increase your risk of cancer more, and now this study shows that the more LDL cholesterol goes down the more it messes up your orgasm. So we have a drug that doesn’t reduce overall mortality in men without heart disease (as in the current study) and has no beneficial effect at all for women without heart disease, and that increases risk of cancer, that not only makes you stupid, but that messes up your orgasm.
Dr. Golomb’s quote to USA Today about the study was that:
It takes a lot of energy to have an orgasm.
Nice quote, Beatrice. She says that statins can interfere with Coenzyme Q and do other things that may impair energy utilization.
Mrs. Bremner’s comment on the study is that they probably thought that statins would improve orgasms through their anti-inflammatory effect.
Today I am listening to presentations (and writing as I listen) from the Study of Women’s Health in the US (SWAN) study on women in mid-life, we learn that Chinese women have less osteoporotic fractures (7 year incidence of 4.8) than black (4.5) and caucasian women (8.1), however mid life women in general feel that they are wiser and have a stronger sense of purpose than they did in their younger life, and that going through menopause is associated with a temporary increase in hot flashes and forgetfullness, but no significant increase in depression. Also the Mid Life in the US (MIDUS) National Study, which was funded by the MacArthur Foundation, asked the question, what is well being? And what effect does it have on people throughout the lifespan. Aristotle defined well being, or ”eudaimonia”, thus:
The highest of all human goods is realization of human potential
In the MIDUS study, autonomy, personal growth, feelings of purpose in life, positive relations with other, environmental mastery, and self acceptance, increased over time for people in mid life or did not change for people 55-74, while they didn’t improve or went down for those younger or older than this group. These qualities were also associated with better health outcomes. They also predicted lower lipid levels, better metabolism, and other goodies.
What is well being?
Perhaps the people being studied experienced orgasm interference because they were in a state of mind regarding being studied in the first place.
Regardless of cardiovascular risk with the LDL issue, I prefer to maintain my orgasm abilities, thank you very much:
What Is Believed To Be Qualities Of All Statin Medications:
Statins are a class of medications specifically prescribed to lower LDL- one of five lipid parameters of a person’s lipid profile, which is alto the name of the blood test to measure these parameters. They are known as statins, as all of these types of medications end with the letters, statin.
There are about 6 available statins to choose for lipid management as needed- with three that are combination drugs that have a statin included in these drugs.
There are other classes of medications for lipid management, such as bile acid sequestrants and nicotinic acid, which is known as niacin. Yet the side effect profile is more unfavorable of these classes of medications compared with the statin class of drugs.
One’s cholesterol level is primarily due to how they produce cholesterol in their liver, which is overall genetically determined. This level is also determined by one’s lifestyle and diet as well. If a person has too much cholesterol in their blood, it can lead to hardening and narrowing of their arteries as well as the formation of coronary plaques in the coronary arteries.
If these plaques break off of the arterial wall, this leads to a myocardial infarction, or heart attack. Statins are believed to stabilize coronary plaques so this does not occur.
To measure one’s cholesterol, a blood test called a lipid profile is obtained from a person after they have fasted for at least 12 hours. The test should also be performed only if the person is free of any acute illness, as this may affect true lipid measures.
If the results prove to be abnormal, lipid altering medicinal therapy may be initiated- according to the discretion of the person’s health care provider. This therapy usually involves a statin medication.
Adverse events associated with the statin class of pharmaceuticals are thought to occur more often than they are reported- with high doses of statins prescribed to patients in particular at times that may not be necessary to control their dyslipidemia based on their lipid profile. Side effects may include muscle pain, or possible damage to the patient’s liver.
However, since this class of statin drugs has existed for use for over 20 years, statins are considered to be overall safe and effective for enhancing the clearance of LDL noted to be elevated in the lipid profiles of patients.
Also, they have proven to reduce cardiovascular mortality with one who is treated with a statin that has dyslipidemia. In addition to lowering LDL by up to about 60 percent- depending on the choice of the statin prescribed for the patient, and how high the LDL cholesterol is in a patient.
This class of drugs also has the ability to raise their HDL lipid parameter as well as lower to their benefit their triglyceride parameter of their lipid profile. Both of these additional effects in addition to lowering the LDL parameter from taking a statin drug is ultimately beneficial for the patient on a statin drug for lipid management.
Statin therapy is also recommended for those patients who have a greater than twenty percent risk of developing cardiovascular disease, or those patients that have clinical evidence of this disease.
Additionally, there appears to be no comparable reduction in cardiovascular morbidity or mortality, as well as a difference in the increase of one’s lifespan, if one is on any particular statin medication for their lipid management over another, others have concluded. So caution should perhaps be considered if one chooses to prescribe a statin for a patient if they are absent of, or have only mild dyslipidemia to a significant degree.
Furthermore, research should be done by the health care provider if they are under the belief that one statin medication provides a greater cardiovascular benefit over another. In other words, the health care provider should be assured that any choice of statin therapy for their patients is considered reasonable and necessary if the LDL in their patients need to be reduced, and the statin selection should be determined by the results that have been shown with a particular statin.
There exist abstract etiologies for health care providers at times to choose to prescribe statin drugs on occasion for reasons not indicated with the medicinal treatment of these statin drugs. Examples include the speculated benefits associated with statins- such as reducing CRP levels, or for Alzheimer’s treatment, or other reasons not directly related to cholesterol management.
Statin therapy for such patients may not be considered appropriate, reasonable, or necessary prophylaxis at this point for any patient who does not have the indications for which statins are approved for to treat patients with dyslipidemia. All other benefits that appear to have favorable effects in such areas not involved with a patient’s cholesterol are suggested at this point due to minimal research in these other variables aside from lipid management.
Other reasons for placing a patient on a statin drug at this time require further research for these disease states and dysfunctions that may exist with a patient aside from dyslipidemia.
Statins as a class of drugs seem to in fact decrease the risk of cardiovascular events significantly, it has been proven. Statins also decrease thrombus formation as well as modulate inflammatory responses (CRP) as additional benefits of the medication.
For those patients with dyslipidemia who are placed on a statin, the effects of that statin on reducing a patient’s LDL level can be measured after about five weeks of therapy on a particular statin drug.
Liver Function blood tests are recommended for those patients on continued statin therapy, and most are chronically taking statins for the rest of their lives to manage their lipid profile in regards to maintaining the suitable LDL level for a particular patient presently. Patients should be made aware of potential additional side effects as well, such as myopathy and muscular dysfunctions that occur on occasion when one is on statin therapy.
Yet some have said that about half of all strokes and heart attacks that do occur are not because of increased cholesterol levels of these patients. So it appears clear that high cholesterol may not be an absolute for cardiovascular events for them to occur.
Others believe that it is oxidized cholesterol that causes vulnerable plaques to form on coronary arterial walls, which is the catalyst for a heart attack, and that there is no medicinal treatment for the formation or stabilization of these plaques to prevent heart attacks or strokes.
Some who support statin medicinal therapy for their clinically appropriate patients claim that these drugs, do, in fact, stabilize these plaques as an added benefit, and therefore are beneficial.
As stated previously, in regards to other uses of statins besides just primarily LDL reduction, there is some evidence to suggest that statins have other benefits besides lowering LDL, but not enough evidence yet.
These other disease states include aside from what has been stated already, such as those patients with neurological disease, as well as statins being beneficial for certain cancer patients. Some have suggested that statins interfere with cancer treatment with bladder cancer patients as well. Yet again, these other roles for statin therapy have only been minimally explored and researched, comparatively speaking.
Because of the limited evidence regarding additional benefits of statin medications, the drug should again be prescribed for those with dyslipidemia only at this time involving elevated LDL levels as detected in the patient’s bloodstream.
Yet overall, the existing cholesterol lowering recommendations or guidelines should possibly be re-evaluated. The cholesterol guidelines that presently exist may be over-exaggerated possibly due to tacit suggestions from the makers of statins to those who create these current lipid lowering guidelines.
This is notable if one chooses to compare these cholesterol guidelines with the other guidelines that have existed in the past. The cholesterol guidelines that exist now are considered by many health care providers and experts to be rather unreasonable and unnecessary, as well as possibly have the potential to be detrimental to a patient’s health.
Yet statins are beneficial medications for those many people that exist with elevated LDL levels that can cause cardiovascular events to occur because of this abnormality. What that ideal LDL level is may have yet to be empirically determined.
Finally, a focus on children and their lifestyles should be amplified so their arteries do not become those of one who is middle-aged, and this may prevent them from being candidates for statin therapy now and in the future, regarding the high cholesterol issue. Treating children with a statin drug for dyslipidemia is controversial presently. Dietary management should be the first consideration in regards to correcting lipid dysfunctions that may exist in patients.
http://www.americanheart.org
Dan Abshear
Wow. Thanks Dr. B! Very interesting.
I’ve been shaking my head for a long time over the cardio docs who bring a competitive zeal to reducing cholesterol, as if it’s their golf handicap. “What about the brain???!!!” I want to tell them. “Our brains need cholesterol!!”
Ah, but they didn’t study the brain all that much in school, did they? They studied the heart. And they stick to what they know — or think they know.
Connect the dots, cardio folks! And spare us all more Dick Cheneys!
Don’t worry Doug, I’m certain there are drugs that can resolve these sexual side effects!
Of course, I’m being silly- it’s worrisome that there seems to be a push for the use of statins absent known indications and risk factors.
I can’t help wonder what mechanism would underlie these finding… LDL itself, or co-Q, etc? or perhaps very subtle muscular impairment?
Your poster sounds extremely interesting! Looks like you tried to hyperlink it- but the link does not work.
My male friend was prescribed blood pressure medication which made him impotent. His BP had been in the range of about 140/80. He then complained to the doctor about the impotence and his doctor prescribed Viagra which gives him terrible headaches (plus it leads to an unnatural sexual experience). As a result of the BP meds, this 57-year old feels like he’s over-the-hill and OLD. A good diet and exercise program INSTEAD would have had the effect of making him feel younger, lowering cholesterol and BP, and probably making him more agile in the bedroom. Instead he feels like he’s washed up, and has joined the ranks of the elderly. Prescriptions do not always improve quality of life!
I am highly suspicious of statins having watched my Dad go downhill and die within 2 years of being on statins. My Dad believed in religiously taking whatever a doctor prescribed. Oddly he did NOT have elevated cholesterol and did NOT have clogged arteries at the time he started statins and was under the care of a cardiologist as a result of having a pacemaker implanted. Dad immediately developed muscle pain and muscle weakness on statins and either the doctor did not ask, my dad did not volunteer or the doctor told dad it was insignificant. Dad’s muscle weakness was so bad that he’d stumble and have a hard time doing his normal several mile daily walk outside of the house, so he gave that up. After a year or more on statins he developed congestive heart failure symptoms and liver problems. Still, it was full steam ahead with the statins and in fact the cardiologist kept raising his dose on subsequent visits despite low cholesterol. Dad developed terrible diarrhea that was never diagnosed, and he finally died of liver failure and congestive heart failure. Since statins cause muscle deterioration, couldn’t they logically also deteriorate the heart muscle? If a patient shows worsening heart muscle and liver, why would a doctor raise statin dosage? My Dad continued with statins despite my advice, and he died. He’s not listed a statin casualty I am sure.
A friend of mine was advised to take statins and quit due to muscle pain. Her doctor tried to talk her into staying on the statin. Why not consider the muscle pain as a warning symptom?
Why is it that most doctors would rather prescribe statins than an effective diet and exercise program?
Does Dr. Golomb not see the connection between low cholesterol and low serotonin — and its effect on libido and orgasm? Men with “early ejaculation” often are prescribed serotonin-targeting meds for that reason.
It seems the healthiest old people I know avoid doctors. LOL!
Then again, they were probably smart enough in the first place to keep themselves healthy.
Chicken and egg kinda thing.
Actually, although epidemiological studies show an inverse relationship between LDL levels and incidence of cancer, whether lowering LDL with statins increases the incidence of cancer is in dispute.
Alawi A. Alsheikh-Ali, Thomas A. Trikalinos, David M. Kent, and Richard H. Karas
Statins, Low-Density Lipoprotein Cholesterol, and Risk of Cancer
J. Am. Coll. Cardiol., September 30, 2008; 52: 1141 – 1147.
http://content.onlinejacc.org/cgi/content/abstract/52/14/1141?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&author1=karas&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT
EDITORIAL COMMENT:
Ori Ben-Yehuda and Anthony N. DeMaria
Low LDL-C Levels and Cancer: Reassuring But Still Not Definitive
J. Am. Coll. Cardiol., September 30, 2008; 52: 1150 – 1151.
http://content.onlinejacc.org/cgi/content/full/52/14/1150?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&fulltext=low+ldl+and+cancer+reassuring&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT
It is interesting that you link to a 2004 meta-analysis of statin treatment in women but omit any mention of the JUPITER trial. In JUPITER, there was a clear benefit for women as well as a reduction in total mortality.
Don’t get me wrong, I am not advocating putting statins in the water supply. I just think you should present all the evidence.
Marilyn: I read the Alawi 2008 article and I think the data in that article supports an association, as does an earlier article by that group. The conclusion of the 2008 article that there is no association is not supported by the data in the article. As for Jupiter we have a commentary coming out in the May issue of Circulation journal.
Other comments: Yes, chosterol is needed for neuronal membrances and since sexual function depends on central brain function it makes sense that statins and low LDL might impair that. Also probably why it impairs cognition.
Arrhythmia is not an indication for statins so I am not sure why they were given when cholesterol was normal. I’m sorry to hear about your father!
“has no beneficial effect at all for women without heart disease”
This just goes too far. If it were left up to you, apparently, my daughter and other high risk women would be untreated and would be at risk of early death or disability. My daughter’s pre-treatment LDL was 250-270. Are you saying you would not treat her? Really? What about women with diabetes? Even John Abramson says women with diabetes and without known heart disease should be treated.
Statins are, or should be, prescribed based on individual risk. If someone’s risk of a cardiovascular event is high, why do we care if they are a woman, or left-handed, or have blond hair?
Patients with hypercholesterolemia are a special case and I would grant that they should take statins.
“Even John Abramson says…” the word of a single expert, no matter who that person is, does not negate arguments from the published literature, which I cited on p 266 of my book, regarding lack of evidence to support treatment of diabetics without heart disease with statins.
As for WOSCOPS, apart from the fact that it showed a statistically significant increase in prostate cancer long term (which did not make it into the press release)
http://www.beforeyoutakethatpill.com/2007/10/dont-crow-over-woscops-pravachol-followup-study.html
I would not look to that for evidence that statins help women, as that study was all MEN.
And no I do not believe that studies of men apply to women.
I hope that any treating physician will learn about supplementing with magnesium and B vitamins before prescribing statins for anyone.
You can read magnesium researcher Mildred Seelig’s book, The Magnesium Factor, or check out her papers here: http://www.mgwater.com/seelig.shtml
More studies here:
http://mgwater.com/listd.shtml#hyper
I think that high cholesterol can be treated with supplements, diet, excersise and if that doesn’t work thn head the statin route. I would like to see more doctors prescribing personal trainers and gym memberships and less pill pushing.
Nicepost. ww.beforeyoutakethatpill.com is amazing.