Statins and erectile dysfunction: a critical summary of current evidence

Recently, it was reported that the administration of statins (lipid-lowering drugs) is associated with reduced levels of testosterone, and this evidence has opened a debate on the consequences these widely used drugs might have on the quality of erection. This is a very important clinical problem because patients with dyslipidemia are at increased risk of developing erectile dysfunction (ED); hence, statins exert a protective effect. At the same time, the administration of these drugs reduce endothelial dysfunction, a key etiopathogenetic factor in the onset of ED. Moreover, statins are universally considered a key element of secondary prevention for vascular events; therefore, several points are opened. In this critical summary, we attempt to evaluate the effects of statins on ED and to understand the mechanisms through which statins improve the quality of erection and the possible synergism with V phosphodiesterase inhibitors, drugs largely used for the treatment of ED.