Anti-cholesterol statins do not reduce reproductive hormones in women of child-bearing age

Physicians have been concerned that relatively new prescription medications called statins, which are being increasingly prescribed to reduce blood cholesterol levels, might also decrease reproductive hormone levels and cause women of child-bearing age to be less fertile.

A study headed by researchers at Cedars-Sinai Medical Center in Los Angeles found that neither the use of statins nor low blood cholesterol levels significantly affected reproductive hormone levels in pre-, peri-, or postmenopausal women. These findings are the subject of an article appearing in the current issue of the American Journal of Medicine.

Specialists in heart disease and stroke typically urge patients to maintain low levels of low-density lipoproteins (LDL) and total cholesterol in the blood, but a certain amount of cholesterol is necessary. In fact, reproductive hormones are derivatives of cholesterol, which led researchers to wonder if statins, which reduce blood cholesterol, might also reduce reproductive hormones.

According to C. Noel Bairey Merz, M.D., the report’s first author and the primary investigator of the WISE Study, “Although statins have been shown to be safe in clinical trials, fewer than 20 percent of trial participants have been women, and previous studies of the impact on reproductive hormones did not include premenopausal women of childbearing age.”

Dr. Bairey Merz is director of Cedars-Sinai’Medical Center’s Preventive and Rehabilitative Cardiac Center, and director of the Women’s Health Program. She also holds the Women’s Guild Chair in Women’s Health at Cedars-Sinai.

The new study included 453 women with coronary risk factors who were undergoing coronary angiography for suspected ischemia – lack of oxygen to the heart – at four academic medical centers in the United States. Of the total, 114 women were premenopausal. Data analyzed were drawn from an ongoing study, the Women’s Ischemia Syndrome Evaluation (WISE), sponsored by the National Heart, Lung and Blood Institute.

“Neither blood lipoprotein level nor use of statins was a significant independent predictor of reproductive hormone levels in models that adjusted for age, menopausal status, menstrual phase, and body mass index,” according to the article.

Although the results offer more reassurance that statin use is safe, Dr. Bairey Merz noted that the women in this sample were undergoing testing for suspected myocardial ischemia and may not be representative of the general population. She said additional large-scale studies that would further reduce potential variables should be conducted, focusing particularly on women in their child-bearing years.

The work was supported by The Women’s Guild of Cedars-Sinai Medical Center; The National Heart, Lung and Blood Institute (contracts N01-HV-68161, N01-HV-68162, N01-HV-68163, and N01-HV-68164); a General Clinical Research Center grant MO1-RR00425 from the National Center for Research Resources, Bethesda, Md.; a grant from the Gustavus and Louis Pfeiffer Research Foundation, Danville, N.J.; and a grant from The Ladies Hospital Aid Society of Western Pennsylvania, Pittsburgh.

Cedars-Sinai Medical Center is one of the largest nonprofit academic medical centers in the Western United States. For the fifth straight two-year period, it has been named Southern California’s gold standard in health care in an independent survey. Cedars-Sinai is internationally renowned for its diagnostic and treatment capabilities and its broad spectrum of programs and services, as well as breakthrough in biomedical research and superlative medical education. Named one of the 100 “Most Wired” hospitals in health care in 2001, the Medical Center ranks among the top 10 non-university hospitals in the nation for its research activities.

IRB #2398 Women’s Ischemic Symptom Evaluation (WISE) – Blood Hormone Level Determination

CITATION: American Journal of Medicine, December 2002, Volume 113, Number 9, “Cholesterol-Lowering Medication, Cholesterol Level, and Reproductive Hormones in Women: The Women’s Ischemia Syndrome Evaluation (WISE).”