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Best statin for women

Women have unique hormonal and metabolic factors that influence their response to statins
Karen Berger medical writer and reviewer headshot
By | Jul. 17, 2025
Four statins: Best statin for women

Key takeaways

  • Statins are widely used and effective cholesterol-lowering medications that reduce the risk of heart attack and stroke in both men and women.

  • Women have unique considerations when using statins, including hormonal changes after menopause, pregnancy status, and differences in drug metabolism.

  • While higher doses of statins may have greater effects on lowering cholesterol, other important factors—such as muscle-related side effects and impacts on bone mineral density—should also be considered when choosing the right statin and dose.

In this article:

Statins are a commonly prescribed type of cholesterol-lowering medicine. They are also known as HMG CoA reductase inhibitors. According to the American Heart Association, most people who need cholesterol medication are prescribed a statin. They are effective in lowering low-density lipoprotein cholesterol, also known as LDL (“bad”) cholesterol, and reducing the risk of heart attack and stroke. Statins include drugs such as Lipitor (atorvastatin), Crestor (rosuvastatin), and Pravachol (pravastatin). They are typically recommended along with lifestyle changes such as diet and exercise. 

You may have heard that statins can affect women and men a bit differently—some studies have found that there are slight variations in how the drugs work and their side effects between the sexes.

Why women may need a different approach to statins

Medicine is typically not a “one-size-fits-all” approach, and women may need a different approach to statins than men do. Some of the reasons include:

  • Hormonal changes: Women’s hormone levels, notably estrogen, change a lot—especially after menopause. Estrogen is considered protective for the heart, so when estrogen levels decrease, cholesterol levels may increase, along with the risk for cardiovascular disease. 
  • Pregnancy and breastfeeding: Medication use is always a concern if you are pregnant, planning to become pregnant, or breastfeeding. Most patients should not use statins during pregnancy, although there are some exceptions where the benefits of statins may outweigh the risks. You should not breastfeed if you are taking a statin—you can talk with your healthcare provider about the best alternative, which may be temporarily stopping your statin, or continuing your statin and feeding your baby formula. 
  • Drug metabolism: How the body metabolizes, or processes, a drug is also a consideration. Some people, especially women, may have genetic differences that affect how statins are absorbed and broken down. Based on how a drug is metabolized, side effects (especially muscle pains) may be more or less likely.
  • Clinical trials: Many drugs, including statins, were studied primarily in men. This leads to women not being adequately represented in important clinical trials. Women who are candidates for a statin are typically less likely than men to be treated with one. And women who do take statins are more likely to stop taking them, according to research.

Despite these considerations, statins can be very effective for women who need them—they lower cholesterol (including LDL cholesterol and triglycerides) while increasing high-density lipoprotein cholesterol (HDL cholesterol), helping reduce the risk of heart attack and stroke.

Statins work by blocking an enzyme (HMG CoA reductase) needed to make cholesterol, helping to lower LDL cholesterol. This helps reduce inflammation and cholesterol buildup in the arteries, which helps reduce the risk of heart attack and stroke. Only your healthcare provider can determine the best treatment for you. That’s because everyone has individual considerations that must be taken into account to find the most suitable treatment. However, some statins may be recommended more often for women. 

Also, while higher doses may lead to better results in terms of cholesterol, one small study published in Bone Reports found that higher statin doses were linked to lower bone mineral density. The study suggested that using lower statin doses, when possible, may help preserve bone density and reduce the risk of fractures and related complications. Women who may be more prone to muscle-related side effects might benefit from lower doses. Additionally, experts note that the way the drugs are processed is an important consideration as well, as this may affect drug interactions.

Lipitor (atorvastatin)

Lipitor (atorvastatin) is available in both brand and generic forms, in doses of 10 mg, 20 mg, 40 mg, and 80 mg. It’s also available as an oral suspension (liquid). A clinical trial called the STELLAR trial looked at various statins in women with high cholesterol. In this trial, women who took atorvastatin 10 mg daily for six weeks had a 39% reduction in LDL cholesterol. Those who took higher doses had better results—a 47% reduction in LDL cholesterol in women who took 40 mg, and a 51% reduction in those who took 80 mg.

Crestor (rosuvastatin)

Crestor (rosuvastatin) is available in both brand and generic forms, in 5 mg, 10 mg, 20 mg, and 40 mg doses. In the STELLAR trial, women who took Crestor (rosuvastatin) 10 mg had a 49% reduction in LDL cholesterol. Those who took 20 mg lowered their LDL cholesterol by 53%, and those who took 40 mg had a 57% reduction in LDL cholesterol. Additionally, women who took rosuvastatin had greater increases in HDL cholesterol (the good type of cholesterol) than those who took other statins. In this trial, rosuvastatin was found to have the best results in women. 

RELATED: Crestor vs. Lipitor

Pravachol (pravastatin)

Pravastatin is commonly known by the brand name Pravachol, but only the generic is available on the market in the U.S. It is available in 10 mg, 20 mg, 40 mg, and 80 mg doses.

In the STELLAR trial, women who took pravastatin 40 mg lowered their LDL by 30%. In the Bone Reports study noted above, pravastatin may have a more favorable effect on bone mineral density compared to other types of statins. This suggests that pravastatin might be a better choice when considering bone health.

RELATED: Pravastatin vs. rosuvastatin

Zocor (simvastatin)

Zocor (simvastatin) is available in brand and generic versions, at doses of 5 mg, 10 mg, 20 mg, 40 mg, and 80 mg. It is also available as an oral suspension (liquid). 

In the STELLAR trial, women who took simvastatin 20 mg lowered their LDL by 37%.

RELATED: Atorvastatin vs. simvastatin

Comparison of statins

The table below shows the various statins. As you can see, brand-name statins are quite costly, often costing hundreds of dollars for a one-month supply. By switching to generic, where available, and using a SingleCare prescription discount card, you can pay a fraction of the price.

Statin comparison chart
Name Cost*  Cost with SingleCare discount* Savings
Lipitor (atorvastatin) $679 for 30, 40 mg tablets of brand-name Lipitor $8 for 30, 40 mg tablets of generic atorvastatin Get coupon
Crestor (rosuvastatin) $360 for 30, 10 mg tablets of brand-name Crestor $8 for 30, 10 mg tablets of generic rosuvastatin Get coupon
Pravastatin $306for 90, 40 mg of generic pravastatin  $17 for 90, 40 mg of generic pravastatin Get coupon
Zocor (simvastatin) $339 for 30, 20 mg tablets of brand-name Zocor $7 for 30, 20 mg tablets of generic simvastatin Get coupon
Lovastatin $115 for 90, 20 mg tablets of generic lovastatin $15 for 90, 20 mg tablets of generic lovastatin Get coupon
Fluvastatin $182 for 30, 20 mg capsules of generic fluvastatin $44 for 30, 20 mg capsules of generic fluvastatin Get coupon
Livalo (pitavastatin) $444 for 30, 2 mg tablets of brand-name Livalo $45 for 30, 2 mg tablets of generic pitavastatin Get coupon
*Cost at time of publication. Drug prices fluctuate and vary by pharmacy and location.

Side effects of statins in females

Every statin has a slightly different side effect profile; however, they share some similarities. The most common side effects are muscle aches and tiredness. While muscle aches are commonly reported, some research suggests they are not always caused by the statin itself. 

Other, less common side effects of statin medications include headaches, constipation or diarrhea, and trouble sleeping.

Some research has found that more women than men have reported changing or stopping a statin drug based on side effects, notably new or worsening muscle symptoms. Also, women were:

  • More likely to be dissatisfied with their treatment and with how their healthcare provider explained their treatment
  • More likely to try three or more different statins
  • Less likely than men to stick with their treatment

If you have side effects that bother you or do not go away, call your healthcare provider for medical advice. And if you have any serious side effects, such as signs of an allergic reaction (trouble breathing, swelling, or hives), you should get emergency medical help right away.

Bottom line: Do statins work for women?

Statins are commonly prescribed to manage high cholesterol. Women have some different considerations, such as hormonal changes related to menopause, than men do. However, statins are generally used safely and effectively in women. Consult your healthcare provider for individualized medical advice. They will take various considerations into account when determining the best treatment for you, including your medical conditions, risk factors, and family history.