Explore how cholesterol-lowering statins affect erectile function, what causes ED, and practical advice

By Shahed Noor

Statins are among the most prescribed drugs for lowering “bad” LDL cholesterol, because high LDL drives heart attacks and strokes. In fact, about 47 million Americans take cholesterol medication each day – usually a statin – to keep their hearts healthy (yalemedicine.org). Statins work in the liver, blocking the enzyme that produces cholesterol and causing the liver to clear more LDL from the bloodstream (mayoclinic.org). This cholesterol-lowering effect translates into big cardiovascular benefits: statins can cut heart attack and stroke risk by roughly 25% for most patients.

But many men wonder how statins affect sexual health. To see the connection, we first need to understand erectile dysfunction (ED). An erection depends on healthy blood flow to the penis. When sexually aroused, nerves trigger relaxation of smooth muscle and dilation of penile arteries, allowing blood to fill the erectile tissue. This process relies on the vascular system functioning properly, especially on the release of nitric oxide (NO) from healthy endothelium (pmc.ncbi.nlm.nih.gov, my.clevelandclinic.org). In fact, ED is most often a vascular issue: poor blood delivery (from clogged or stiff arteries) is the usual culprit. The Cleveland Clinic notes that circulatory problems – including clogged vessels – are a top cause of ED. Indeed, ED can be an early warning sign of heart disease.

High cholesterol directly contributes to ED by damaging penile blood vessels. Numerous studies show that hypercholesterolemia (high LDL) leads to atherosclerosis in the penile arteries, increasing oxidative stress and uncoupling nitric oxide synthase – basically preventing the blood vessels from relaxing normally. As one research team put it, “hypercholesterolemia resulting in atherosclerosis of the penile vasculature is one of the leading causes of vasculogenic ED”. Elevated LDL has been statistically linked with higher ED risk. In plain terms, clogged and stiff arteries (even if silent elsewhere) can starve the penis of blood, making erections difficult.

This is where statins can actually help ED. By lowering LDL and stabilizing plaques, statins improve overall endothelial health – even beyond their effect on cholesterol levels. Statins reduce the oxidative “attack” of LDL on blood vessels and boost nitric oxide availability. Clinically, this translates into better blood flow. A recent evidence review concluded that statin treatment does improve ED symptoms in men with high cholesterol (journals.lww.com). For example, a meta-analysis (review of trials) found statins raised erectile-function scores significantly compared to placebo. One 2014 review found an average ~24% improvement in ED with statins (verywellhealth.com). In a pilot trial of men who hadn’t responded to Viagra alone, adding atorvastatin (80 mg daily) for 12 weeks significantly improved erections (sildenafil response scores rose by 7.8 points vs. placebo) (pubmed.ncbi.nlm.nih.gov). In fact, combining a statin with a PDE5 inhibitor (like sildenafil) gave better results than Viagra alone. In short, by treating the underlying vascular problem, statins often help men with ED (especially when ED is due to clogged arteries).

That said, some men and media worry statins might cause ED. The data here are mixed. Large reviews have generally not found higher ED rates in statin users. One systematic review (meta-analysis) showed no increased ED risk with statins (healthline.com). Likewise, Mayo Clinic doesn’t even list ED as a common statin side effect. Instead, experts note that if ED occurs on statins, it’s usually the untreated cholesterol (and related atherosclerosis) at fault, not the drug. Indeed, the Mayo Clinic points out that clogged vessels cause ED, so treating cholesterol should help ED rather than harm it. A Healthline review bluntly states: “To date, there is more evidence that statins actually help ED rather than hinder erections”. In rare case reports, some men did develop sexual side effects on statins, but these cases appear to be exceptions, not the rule. Overall, most clinicians believe the cardiovascular benefits of statins far outweigh the small chance of sexual side effects.

One specific concern is testosterone. Statins may slightly lower testosterone levels in some men, which sounds worrying because testosterone drives libido and supports erections. Several recent studies confirm statins do cause a modest drop in total testosterone – on the order of about 10–13 ng/dL on average. For context, normal male testosterone levels are roughly 300–1000 ng/dL. A 2024 analysis found that statins lower testosterone a bit, but “not enough to cause a drop below the normal range” in typical cases. Verywell Health similarly notes the average reduction is small and “may not be clinically significant” for erection quality. In other words, any statin-related testosterone dip is usually minor, and most men remain well within normal hormone levels. By contrast, uncontrolled high cholesterol has clearly negative effects on erections.

Finally, what about drug interactions? Many men on statins may use ED pills (Viagra®/sildenafil or Cialis®/tadalafil) to help with erections. The good news: statins don’t interfere with these drugs. There are no known direct interactions between statins and PDE5 inhibitors. Both statins and Viagra work through different mechanisms (statins by lowering cholesterol, Viagra by boosting NO signaling in penile vessels), so they don’t chemically conflict. That said, patients should always consider underlying heart health: both ED pills and statins affect the cardiovascular system. For example, if you have unstable heart disease or take nitrates for chest pain, ED medications may still be unsafe, but that risk is unrelated to statin use. In summary, from a pharmacological standpoint, it’s generally safe to combine statins with Viagra or Cialis – but always do so under a doctor’s guidance.

Practical Tips for Men on Statins with ED: If you’re taking a statin and experiencing ED, don’t panic – and don’t stop your statin on your own. Instead, try these steps:

• Talk to your doctor. Discuss your symptoms openly. Your doctor can check if your ED is likely due to heart health, medication, or other causes, and can advise safely. Never abruptly stop statins without medical guidance, as this could raise your heart risk.
• Focus on lifestyle. Good cholesterol control and healthy habits help both heart and sexual health. Eat a diet low in saturated/trans fats and quit smoking. Exercise regularly (e.g. 30–45 minutes of cardio most days) – aerobic exercise is proven to improve erectile function in some men. Keep a healthy weight and manage blood pressure and diabetes if present.
• Review your medications. Some blood-pressure or other drugs can cause ED. Work with your doctor to optimize all medications. If muscle aches or fatigue are bothering you, your doctor might try a different statin or dose.
• Consider ED treatments if needed. If vascular ED persists despite managing cholesterol, ask about proven ED therapies. PDE5 inhibitors (Viagra/Cialis) are often effective and safe with statins. Other options include vacuum devices or injection therapies. Always ensure a cardiac clearance first.
• Check hormone levels if indicated. If you have symptoms of low testosterone (low libido, energy), a simple blood test can check your levels. If they’re low, your doctor can discuss treatment – but remember that statin-induced changes are usually very minor.
• Regular health monitoring. Keep up with routine lipid panels and check-ups. Treating underlying conditions (diabetes, sleep apnea, depression, etc.) can also improve ED.

The bottom line: ED and heart health are deeply intertwined. High cholesterol is a major driver of blood-vessel disease that impairs erections, so managing it is key. Statins remain a cornerstone of that management. For most men, statins will help sexual function in the long run by improving vascular health. In the rare event that a statin seems linked to sexual issues, the solution is to work with your healthcare team on alternatives or adjuncts – not to drop the statin cold turkey. Recent research (2022–2025) has reinforced this view. A 2018 evidence summary explicitly stated statins improve ED symptoms in men with cholesterol problems, especially when combined with ED meds. New analyses continue to show only tiny changes in testosterone and generally no increase in ED risk. Leading clinics summarize that statins support vascular and overall health, which “almost invariably” benefits erectile function.

In short, if you’re on a statin and facing ED, recognize that good vascular health underpins erections. Take steps to improve heart health (diet, exercise, control blood pressure) and consult your doctor about ED therapies if needed. Statins themselves are unlikely to be the culprit — and may actually be helping you in more ways than one.

Sources: Reviewed expert articles from Mayo Clinic, Cleveland Clinic, Harvard/Healthline, and recent research (including 2014–2024 studies) on statins, cholesterol, testosterone, and ED yalemedicine.org, mayoclinic.org, pmc.ncbi.nlm.nih.gov, pmc.ncbi.nlm.nih.gov, journals.lww.com, pubmed.ncbi.nlm.nih.gov, pubmed.ncbi.nlm.nih.gov, healthline.com, healthline.com, verywellhealth.com.