Hypogonadism, a defect of the reproductive system that often leads to deficiency of reproductive hormones, is common among men with type 2 diabetes. Cholesterol is needed for the synthesis of testosterone, so statin therapy could potentially decrease testosterone levels by decreasing the availability of cholesterol. In the April 2009 issue of Diabetes Care, researchers from the United Kingdom report that statins are associated with lower total testosterone levels in diabetic men.

Using a study sample of 355 men with type 2 diabetes, the investigators evaluated the association of testosterone levels and symptoms of hypogonadism with the use of statins. They found that, compared with no treatment, atorvastatin therapy was associated with reduced total testosterone. Increasing doses of atorvastatin seemed to be associated with lower total testosterone levels, but simvastatin had no significant effect on testosterone levels. Although total testosterone was decreased with atorvastatin, atorvastatin therapy did not appear to affect bioavailable testosterone, free testosterone, or hypogonadal symptoms.

Based on these findings, the study authors conclude that assessing hypogonadism using total testosterone in diabetic men treated with statins could potentially lead to errors in diagnosis. They recommend using bioavailable testosterone or free testosterone levels to evaluate diabetic men for hypogonadism and consideration of hormone treatment.

Source

Diabetes Care. 2009;32:541-546.