The association of statin use and gonado-sexual function in women: a retrospective cohort analysis

Abstract

Introduction: It has been hypothesized that statins reduce sex hormone biosynthesis through hepatic inhibition of cholesterol synthesis, which is a precursor of androstenedione and estradiol. Such a reduction has been associated with menstrual irregularities, menopausal disorders, infertility, and low libido, but studies are conflicting. Few studies have evaluated the clinical effects of statins on gonadal-sexual function in women.

Aim: To compare the risk of gonado-sexual dysfunction in statin users vs. nonusers.

Methods: This was a retrospective cohort study of all female, adult patients (30-85 years) enrolled in the Tricare Prime/Plus San Antonio catchment area. 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. Logistic regression was used to determine the association of statin use with patient outcomes.

Main outcome measures: Outcomes included menstrual disorders, menopausal disorders, infertility, and ovarian/sexual dysfunction during the follow-up period. Outcomes were identified using inpatient or outpatient International Classification of Diseases, Ninth Revision, Clinical Modification codes as defined by the Agency for Healthcare Research and Quality's Clinical Classifications Software.

Results: Of 22,706 women who met study criteria, we propensity score-matched 2,890 statin users with 2,890 nonusers; mean age 58 ± 12 years. Statin use was not significantly associated with menstrual disorders (OR 0.97; 95% CI 0.81-1.16), menopausal disorders (OR 0.92; 95% CI 0.83-1.02), infertility (OR 0.79; 95% CI 0.36-1.73), or ovarian/sexual dysfunction (OR 1.18; 95% CI 0.83-1.70).

Conclusions: Statin use was not associated with higher risk of gonado-sexual dysfunction in women.

Keywords: Infertility; Menopausal Disorders; Menstrual Disorders; Ovarian Dysfunction; Sexual Dysfunction; Statin.