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Testosterone recovery and statins

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User
Posted 21 Jan 2025 at 14:01

Does anyone know if statins affect testosterone & ED recovery? It's been 4 months since Gee's last Prostap3 ran out, and he has been looking forward to feeling more like himself. He was prescribed statins last Monday, after a blood test showed that his cholesterol level put him at 10% chance of stroke of heart attack in the next 10 years. But after reading that statins can lower testosterone and cause ED, he is saying that he doesn't want to take it, until his testosterone returns. We know it can take a long time, and may not return at all. 

Any advice would be greatly appreciated.

Elle x

Edited by member 28 Jan 2025 at 17:37  | Reason: Not specified

User
Posted 21 Jan 2025 at 19:08

I'm going to take a step back from your question and raise another one. Has HT increased his cholesterol, and now he is off HT will it come down without statins?

My cholesterol went up when I was on HT not so high that it would be worrying though. My GP commented "Oh that's probably just the HT". Apparently cholesterol is converted in to testosterone, whilst on HT that isn't happening so cholesterol increases. My cholesterol has now came down a little in the four years I've been off HT, but is still at the top of the normal range.

A 10% risk in 10 years is the threshold for considering some intervention i.e. statins, so I think he could probably ignore the statins and see how things pan out. Of course taking advice from a random guy of the internet is not recommended, but if the doctor who prescribed statins was not aware of the HT, his advice may not be optimal. 

I don't want you blaming me if your OH has a heart attack tomorrow, so do your own research, way up the pros and cons and make up your own mind.

 

Dave

User
Posted 23 Jan 2025 at 22:57

Originally Posted by: Online Community Member
At my last oncology review the doc finally acknowledged that my T may never return.

Have you considered asking about testosterone replacement therapy? It might have been frowned on in the past, with the idea being that it could re-start cancer but the risk would have to be much the same if your testosterone came back normally. Given that testosterone helps keep your cholesterol levels down it's a big argument in favour of having it in your system.

Maybe you could have TRT and statins?

It almost comes down to a choice; (very low testosterone = higher levels of cholesterol = significantly higher chance of a heart attack) v (normal testosterone levels = possibly raised chances of recurrence.)

This might be a slightly evil suggestion but I have to wonder if cancer specialists are so narrowly focused on measuring their success with treating cancer, that they tend to disregard mortality caused by treatment for cancer, as against death caused directly by cancer.

Jules

 

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User
Posted 21 Jan 2025 at 19:08

I'm going to take a step back from your question and raise another one. Has HT increased his cholesterol, and now he is off HT will it come down without statins?

My cholesterol went up when I was on HT not so high that it would be worrying though. My GP commented "Oh that's probably just the HT". Apparently cholesterol is converted in to testosterone, whilst on HT that isn't happening so cholesterol increases. My cholesterol has now came down a little in the four years I've been off HT, but is still at the top of the normal range.

A 10% risk in 10 years is the threshold for considering some intervention i.e. statins, so I think he could probably ignore the statins and see how things pan out. Of course taking advice from a random guy of the internet is not recommended, but if the doctor who prescribed statins was not aware of the HT, his advice may not be optimal. 

I don't want you blaming me if your OH has a heart attack tomorrow, so do your own research, way up the pros and cons and make up your own mind.

 

Dave

User
Posted 22 Jan 2025 at 00:35

High cholesterol can certainly cause ED, sometimes 1-3 years before it causes your first heart attack.

User
Posted 22 Jan 2025 at 07:06
I have had External Beam RT in 2007 and then HD Brachytherapy in 2014, on each occasion it took well over a year to get any sort of erection. I finished a short course of Zoladex last July (Had Zoladex January, April & July 2024 as part of intermittent therapy). I am only now starting to get occasional salacious thought and don't expect an erection for some time. I don't take statins.
User
Posted 23 Jan 2025 at 20:37

I was on Zoladex for three years.  I had my last injection January 2023.  Two years on and my testosterone is only up to 4.7 nmol/l, still way short of the bottom of the normal reference range.  I have a very slight libido now but unfortunately combined with total erectile dysfunction.  I had been on statins for years but six months ago, sick and tired of feeling like I was still on HT, I stopped taking them.  God knows what my cholesterol is now but coming off them obviously hasn't had a dramatic effect on my testosterone recovery.  I still have hot flushes and all the other side effects of HT.

At my last oncology review the doc finally acknowledged that my T may never return.

User
Posted 23 Jan 2025 at 22:57

Originally Posted by: Online Community Member
At my last oncology review the doc finally acknowledged that my T may never return.

Have you considered asking about testosterone replacement therapy? It might have been frowned on in the past, with the idea being that it could re-start cancer but the risk would have to be much the same if your testosterone came back normally. Given that testosterone helps keep your cholesterol levels down it's a big argument in favour of having it in your system.

Maybe you could have TRT and statins?

It almost comes down to a choice; (very low testosterone = higher levels of cholesterol = significantly higher chance of a heart attack) v (normal testosterone levels = possibly raised chances of recurrence.)

This might be a slightly evil suggestion but I have to wonder if cancer specialists are so narrowly focused on measuring their success with treating cancer, that they tend to disregard mortality caused by treatment for cancer, as against death caused directly by cancer.

Jules

 

User
Posted 24 Jan 2025 at 09:18

Originally Posted by: Online Community Member

Have you considered asking about testosterone replacement therapy? It might have been frowned on in the past, with the idea being that it could re-start cancer but the risk would have to be much the same if your testosterone came back normally. Given that testosterone helps keep your cholesterol levels down it's a big argument in favour of having it in your system.

Maybe you could have TRT and statins?

 

Yes I asked about TRT when she said normal T may not return.  Her answer was "no, that's never going to happen. It would be too high a risk given the nature of your cancer".  I made the same point about only wanting to return to a normal level which in other men would have happened naturally but it didn't make any difference.

Understandably her position is that I should just be grateful that the HT contributed to saving my life, which I am of course.  It's just that before starting the treatment I didn't realise that it would come at such a cost and potentially effect the rest of my life.

User
Posted 24 Jan 2025 at 10:40

Originally Posted by: Online Community Member
her position is that I should just be grateful that the HT contributed to saving my life

That's telling you. Seems a bit old-school and I wonder if a second opinion would be different. 

Jules

 

User
Posted 28 Jan 2025 at 18:17

Gee has decided not to take the statins for the time being. We did a bit more googling and found this.

Precursor for testosterone:

Cholesterol is the primary raw material for testosterone synthesis in the testicles.

The testicles "consume" cholesterol to produce testosterone.

 

He also contacted PEASS, and this was their reply;

Thank you for getting in touch. I was not aware of this, so I have done some research for you.

Studies have been conducted on the effect of certain statins on men and women's testosterone levels, but no studies specifically on men with prostate cancer.

There is some evidence that statins can reduce testosterone by a very small amount, and in men with normal testosterone levels, this would not lead to a reduction that would cause ED.

However, as we have medically reduced G***'s testosterone, what this will do is just slow the recovery in his testosterone, it will not stop it going up completely. From a prostate cancer point of view, it will not affect his PSA.

It may be worth getting a testosterone level checked now, and if he decides to take the statins, get it checked in 6 months and see how it is recovering and how he feels.

If he chooses not to take the statins, there are lots of lifestyle changes that can be made to help improve cholesterol, we cover these in our health education workshop.  

Gee's PSA test I due next week, and he'll be asking for a testosterone level test as well.

Thanks for reading.

Elle x

 
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