Effect of atorvastatin on testosterone levels

Area of Science:

• Endocrinology
• Pharmacology
• Reproductive Health

Background:

• Statins, like atorvastatin, are widely prescribed cholesterol-lowering drugs.
• Atorvastatin may reduce androgen levels by impacting cholesterol synthesis.
• This effect could be detrimental generally but potentially beneficial in conditions with excess androgens, such as PCOS.

Purpose of the Study:

• To evaluate the effect of atorvastatin on total and free testosterone levels in males and females.
• To assess changes in other androgen-related markers, including SHBG, androstenedione, DHEAS, and FAI.
• To determine the incidence of adverse events leading to study withdrawal.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs).
• Searched multiple databases for RCTs comparing atorvastatin with placebo or no treatment for at least three weeks.
• Included studies assessing testosterone level changes in adult males and females.

Main Results:

• No significant difference in total testosterone was observed in males (MD -0.20 nmol/L).
• In females with PCOS, atorvastatin significantly reduced total testosterone (MD -0.27 nmol/L), FAI (MD -2.59 nmol/L), androstenedione (MD -1.37 nmol/L), and DHEAS (MD -0.63 μmol/l).
• Atorvastatin increased SHBG in females (MD 3.11 nmol/L); evidence certainty was low to very low.

Conclusions:

• Atorvastatin does not significantly affect testosterone levels in males.
• In females with PCOS, atorvastatin demonstrates a potential to lower androgen levels.
• Further RCTs are needed to confirm these findings and explore effects on free testosterone.