title: Statins and male sexual health: a retrospective cohort analysis.
abstract: BACKGROUND
  Conflicting reports exist regarding the role of statins in male gonadal and sexual function. Some studies report a beneficial effect, particularly for erectile dysfunction (ED), through statins' anti-inflammatory and cardiovascular protective properties. Others suggest that statins might be associated with sexual dysfunction through negative effects on hormone levels.
  
  
  OBJECTIVE
  This study aims to compare the risk of gonadal or sexual dysfunction in statin users vs. nonusers in a single-payer healthcare system.
  
  
  METHODS
  This was a retrospective cohort study of all male patients (30-85 years) enrolled in the Tricare San Antonio market. Using 79 baseline characteristics, we created a propensity score-matched cohort of statin users and nonusers. The study duration was divided into a baseline period (October 1, 2003 to September 30, 2005) to describe patient baseline characteristics, and a follow-up period (October 1, 2005 to March 1, 2012) to determine patient outcomes. Statin users were defined as those prescribed a statin for ≥3 months between October 1, 2004 and September 30, 2005.
  
  
  METHODS
  Outcomes were identified as the occurrence of benign prostatic hypertrophy (BPH), ED, infertility, testicular dysfunction, or psychosexual dysfunction during the follow-up period as identified by inpatient or outpatient International Classification of Diseases, 9th Revision, Clinical Modification codes. Logistic regression was used to determine the association of statin use with patient outcomes.
  
  
  RESULTS
  Of 20,731 patients who met study criteria, we propensity score-matched 3,302 statin users with 3,302 nonusers. Statin use in men was not significantly associated with an increased or decreased risk of BPH (odds ratio [OR] 1.08; 95% confidence interval [CI] 0.97-1.19), ED (OR 1.01; 95% CI 0.90-1.13), infertility (OR 1.22; 95% CI 0.66-2.29), testicular dysfunction (OR 0.91; 95% CI 0.73-1.14), or psychosexual dysfunction (OR 1.03; 95% CI 0.94-1.14).
  
  
  CONCLUSIONS
  Statin use was not associated with increased risk of being diagnosed with gonadal or sexual dysfunction in men. Further studies using a larger sample may be needed.
authors.affiliation: Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Davis
authors.forename: Kelly R
authors.initials: KR
authors.lastname: Reveles
authors.forename: Sayed K
authors.initials: SK
authors.lastname: Ali
authors.forename: Eric M
authors.initials: EM
authors.lastname: Mortensen
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Frei
authors.forename: Ishak
authors.initials: I
authors.lastname: Mansi
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D006949:Hyperlipidemias / Q000188:drug therapy* / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D054526:Men's Health; D008875:Middle Aged; D016017:Odds Ratio; D057216:Propensity Score; D012189:Retrospective Studies; D012307:Risk Factors; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Benign Prostatic Hypertrophy; Erectile Dysfunction; Male Infertility; Psychosexual Dysfunction; Statin; Testicular Dysfunction