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Meta-Analysis
. 2024 Mar-Apr;50(2):119-135.
doi: 10.1590/S1677-5538.IBJU.2023.0578.

Do statins decrease testosterone in men? Systematic review and meta-analysis

Felipe Placco Araujo Glina  1 , Leonardo Lopes  1 , Rodrigo Spinola E Silva  1 , Eduardo Augusto Correa Barros  1 , Bruno Biselli  2 , Sidney Glina  1
Affiliations
Meta-Analysis

Do statins decrease testosterone in men? Systematic review and meta-analysis

Felipe Placco Araujo Glina et al. Int Braz J Urol. 2024 Mar-Apr.

Abstract

Purpose: Statins are one of the most prescribed classes of drugs worldwide to treat hypercholesterolemia and dyslipidemia. By lowering the level of cholesterol, the use of statin could cause a reduction in testosterone levels. The objective was to evaluate whether the continued use of statins in patients with hypercholesterolemia causes a deficiency in testosterone and other sex hormones.

Materials and methods: Systematic Review with Meta-analysis, performed in Embase, Medline and Cochrane databases, until May 2023; PROSPERO CRD42021270424protocol. Selection performed by two independent authors with subsequent conference in stages. Methodology based on PRISMA statement. There were selected comparative studies, prospective cohorts (CP), randomized clinical trials (RCT) and cross-sectional studies (CSS) with comparison of testosterone levels before and after statin administration and between groups. Bias analysis were evaluated with Cochrane Tool, The Newcastle-Ottawa Scale (NOS), and using the Assess the Quality of Cross-sectional studies (AXIS) tool.

Results: There were found on MedLine, Embase and Cochrane, after selected comparative studies, 10CP and 6RCT and 6CSS for the meta-analysis. In the Forrest plot with 6CSS, a correlation between patients with continuous use of statins and a reduction in total testosterone was evidenced with a statistically significant reduction of 55.02ng/dL (95%CI=[39.40,70.64],I²=91%,p<0.00001).In the analysis with 5RCT, a reduction in the mean total testosterone in patients who started continuous statin use was evidenced, with a statistical significance of 13.12ng/dL (95%CI=[1.16,25.08],I²=0%,p=0.03). Furthermore, the analysis of all prospective studies with 15 articles showed a statistically significant reduction in the mean total testosterone of 9.11 ng/dL (95%CI=[0.16,18.06],I²=37%,p=0.04). A reduction in total testosterone has been shown in most studies and in its accumulated analysis after statin use. However, this decrease was not enough to reach levels below normal.

Conclusion: Statins use causes a decrease in total testosterone, not enough to cause a drop below the normal range and also determines increase in FSH levels. No differences were found in LH, Estradiol, SHBG and Free Testosterone analysis.

Keywords: 5-alpha Reductase Inhibitors; Meta-Analysis [Publication Type]; Testosterone.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1. Flowchart of selected articles.
Figure 2
Figure 2. Total testosterone - Cross-sectional studies.
Figure 3
Figure 3. Total testosterone - Before and After - All Prospective Comparative Studies: Prospective Cohort and Randomized Clinical Trial.
Figure 4
Figure 4. Total Testosterone - Statin X Control - Prospective Cohort.
Figure 5
Figure 5. Free Testosterone - Cross-sectional Studies.
Figure 6
Figure 6. Free Testosterone - Before and After - Prospective Cohort.
Figure 7
Figure 7. FSH - Before and After - All Prospective Comparative Studies: Prospective Cohort and Randomized Clinical Trial.
Figure 8
Figure 8. LH - Cross-sectional studies.
Figure 9
Figure 9. LH - Before and After - All Prospective Comparative Studies: Prospective Cohort and Randomized Clinical Trial.
Figure 10
Figure 10. Estradiol - Cross-sectional studies.
Figure 11
Figure 11. Estradiol - Before and After - All Prospective Comparative Studies: Prospective Cohort and Randomized Clinical Trial.
Figure 12
Figure 12. SHBG - Cross-sectional studies.
Figure 13
Figure 13. SHBG - Before and After - Prospective Cohort.
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References

    1. Cholesterol Treatment Trialists’ (CTT) Collaborators. Mihaylova B, Emberson J, Blackwell L, Keech A, Simes J, et al. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet. 2012;380(9841):581–590. - PMC - PubMed
    1. Brugts JJ, Yetgin T, Hoeks SE, Gotto AM, Shepherd J, Westendorp RG, et al. The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: meta-analysis of randomised controlled trials. BMJ. 2009;338:b2376–b2376. - PMC - PubMed
    1. Cheung KK, Luk AO, So WY, Ma RC, Kong AP, Chow FC, et al. Testosterone level in men with type 2 diabetes mellitus and related metabolic effects: A review of current evidence. J Diabetes Investig. 2015;6:112–123. - PMC - PubMed
    1. Miller WL. Steroidogenic enzymes. Endocr Dev. 2008;13:1–18. - PubMed
    1. Araujo AB, Esche GR, Kupelian V, O’Donnell AB, Travison TG, Williams RE, et al. Prevalence of symptomatic androgen deficiency in men. J Clin Endocrinol Metab. 2007;92:4241–4247. - PubMed

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