Can Certain Medications Affect Your Sperm Health?

Man rethinking taking medication.

Often, infertility is assumed to be a woman’s problem. However, male infertility is also significant, and sperm quality can heavily impact the chances of conception. Many factors can affect male fertility, including excess weight, cigarette smoking, excessive drinking, and use of recreational drugs. While all of these factors are commonly known, what is less well known is that certain medication can interfere with male fertility.

How can medications affect a man’s fertility? Often, medication will decrease the production of sperm, but in some cases, medications will affect the function of the sperm itself. Decreased production leads to low sperm count, which means fewer sperm will be available to fertilize an egg. If a medication impacts the motility of the sperm, that means the sperm won’t move as efficiently and will have difficulty reaching the egg. Generally, once a man stops taking medication, it takes at least two or three months for his sperm to recover, since it takes that long for sperm to form and mature. With certain medications, however, it can take months or years for fertility to return to normal, and it might not return at all.

So, what types of medications have a negative impact on sperm? Over-the-counter medication does not usually cause an issue, as long as it’s taken correctly and in the proper dosage. However, it’s important to be cautious when you’re trying to conceive, so it’s wise to discuss any OTC medications with your doctor. Certain OTC medicines warrant particular caution:

• Non-steroidal anti-inflammatory drugs (NSAIDs) sometimes reduce fertility. According to a recent study, men taking 1,200 mg of ibuprofen daily can develop a hormonal condition that causes a problem, especially if the man is older. What was not made clear in the study is whether lower doses of ibuprofen can have the same effect. Additionally, while the effects are reversible when the medication is taken for short periods of time, it’s unclear whether they’re reversible if taken long-term.
• Natural or herbal remedies can cause problems for men trying to conceive. Because herbal remedies are not held to the same regulatory standards as medications, it’s better to stay away from them to protect fertility. Supplements that contain testosterone can be particularly problematic, so avoid anything that uses terms like “male enhancement,” “andro booster,” or “T-booster.”

There are prescription medications that can have a significant impact on fertility.

• Steroids and testosterone therapy can have a strong negative impact on sperm production. In fact, testosterone supplements will completely stop sperm production. Whether the man is taking anabolic steroids, herbal supplements with testosterone, or a prescription testosterone replacement from the doctor, the effect is the same. Testosterone blocks the body’s natural hormonal signals that cause the testicles to make sperm. The result is that the semen will either have a very low concentration of sperm or will have no sperm at all. This effect is reversible, but it takes a long time for the sperm to recover. In fact, it can take six to 12 months for sperm count to get back to normal.
• Chemotherapy can wipe out your sperm count. This is because chemo works by killing rapidly dividing cells, like cancer cells, but also, unfortunately, sperm cells. After cancer treatment, it’s common for men to have no sperm in the semen. However, natural fertility can return one to five years after the treatment is discontinued. If you’ve been through chemo, it’s best to wait at least two years before attempting to conceive. For some people, though, fertility never recovers. If you are about to start chemotherapy, talk to your doctor about freezing your sperm for later use.
• Blood pressure medications can decrease semen volume, sperm concentration, and sperm motility. These medications, especially calcium channel blockers, can also cause decreased libido and erectile dysfunction.
• Opioids can interfere with sexual performance and fertility. Long-term use, in particular, can disrupt the signals that control testosterone production. If you’ve only used opioids short-term, as for the treatment of a broken bone or when recovering from surgery, you may not need to worry.
• Antidepressants can cause a drop in libido and may negatively affect sperm production. Selective serotonin re-uptake inhibitors (SSRIs) are the most common medications used to treat depression and anxiety, and they can hinder your chances of conception. However, there are other medications your doctor or mental health provider can prescribe that won’t have the same impact.
• Other medications may be problematic if you’re trying to conceive. Antibiotics can interfere with testosterone and sperm production, especially an antifungal antibiotic called Ketoconazole. Biologics, used to treat autoimmune disorders, can reduce sperm count, and alpha-blockers, prescribed to treat the symptoms caused by an enlarged prostate, can inhibit ejaculation. 5-alpha-reductase inhibitors like Propecia® and Avodart®, used for hair loss and prostate enlargement treatment, can make it hard to conceive, but the effect goes away when you stop taking them. Anti-epilepsy medications, antiretrovirals, blood pressure medications, and some other medications can also cause fertility problems.

At the Center for Vasectomy Reversal, we are concerned with every aspect of men’s health, and we pride ourselves on helping men improve their fertility through uncompromising, concierge-level patient care. Under the direction of Dr. Joshua Green, our team provides state-of-the-art treatment for men who need a reversal of their vasectomy or have other fertility concerns. To learn more, contact us through our website or call 941-894-6428.