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Certain medications and treatment can affect a man’s fertility ranging from temporary difficulties in conceiving to permanent subfertility. When thinking about health, sometimes reproductive health...
Certain medications and treatment can affect a man’s fertility ranging from temporary difficulties in conceiving to permanent subfertility. When thinking about health, sometimes reproductive health can get overlooked in men but being aware of how prescription or over-the-counter drugs can affect the body’s fertility is actually quite important. Here at Meds for Less we want to support you in making safer and more informed choices about family planning and your health.
Unfortunately, for a long time problems with fertility were only focussed on women. In recent decades we have learnt more about Male Fertility and how that comes into family planning. When we think about how a medicine affects fertility, researchers typically assess the profile and health of the semen. To cover important areas and explore how can male sperm be affected by drugs, three main factors are analysed: sperm production ability, motility, and morphology.
In addition to medications that affect sperm, another key element to consider in male reproductive health is the influence of hormones on libido and erectile function. The body uses hormones (chemical messengers) such as testosterone to control libido (sexual drive) and erectile function (the ability to achieve and maintain the physical capability for intercourse). The problem arises when certain drugs affect the delicate balance of hormones in the body. This can in turn lead to problems with intimacy and erectile dysfunction which can create additional hurdles to natural conception.
So what medications can affect male fertility? This is not an exhaustive list but it may be helpful to outline some common culprits. If you are taking any of these medications and you have not started your family or you feel you have not yet completed your family, it may be helpful to discuss family planning with your doctor.
As mentioned, testosterone can be quite important in the managing libido and erectile function so it may feel confusing to see testosterone replacement therapy in the category of medicines that can affect fertility. Actually, taking testosterone treatment can tell the brain that there is enough testosterone in the body. This can become problematic as the testes then decrease the natural production of testosterone as well as sperm. Additionally, if you were wondering “do steroids lower sperm count”, current research suggests that yes, taking anabolic steroids can also lead to fertility difficulties in men.
The next category is antidepressants and the most commonly used drug class is selective serotonin reuptake inhibitors (or SSRIs for short). SSRIs are commonly used first-line to manage mood disorders due to its relative safety and effectiveness profile. Among the general concerns about using SSRIs, the question of “do anxiety meds affect male fertility?” often comes up. Indeed, research suggests that the use of certain SSRIs may affect sperm health. However, when assessing questions like “does sertraline affect male fertility”, another factor to consider is the extent to which symptoms of mood disorders (that would be treated with SSRIs or Anxiety Medication) are contributing to intimacy issues such as erectile dysfunction. Reduced libido is another common symptom of depression.
Certain antibiotics and antifungals may also have a negative impact on sperm health. This is because some classes of these anti-infective medicines kill harmful infection-causing bacteria or fungi by disrupting the process of making cells. The problem is that sperm are also cells and may also be affected. So can antibiotics cause low sperm count? Yes, some antibiotics might affect sperm health especially if high doses or long courses of treatment are used.
Some blood pressure medications may affect sperm health in the context of fertilisation. An example of this is the drug class called calcium channel blockers. Another long-term medication linked to the blood is statins. So do statins affect male fertility? Overall the direct impact of statins on sperm health is considered very low and is typically outweighed by the benefits of statins such as decreasing the risk of stroke.
In cases of severe and/or chronic pain, opioids may be prescribed to help manage the pain. The downside to this is the potential disruption to hormonal balance which in turn disrupts the body’s ability to produce sperm and testosterone. This can lead to decreased sperm count as well as decreased libido.
Unfortunately, anybody receiving chemotherapy or other cancer treatments will likely experience subfertility. This is because the goal of cancer treatment is to kill the cancerous cells which divide rapidly. Another type of cell that divides rapidly is the cell that produces sperm. Hence, cancer treatment like chemotherapy can damage or even permanently stop the production of sperm. If you are about to start cancer treatment and you have not completed your family, please consult your doctor about family planning. There are some options to preserve semen samples before cancer treatment but would benefit from a full assessment and discussion with your doctor.
Now that we have discussed some prescription drugs and medical treatment, let’s go through which recreational drugs might affect male reproductive health. Generally, if you are thinking of conceiving or family planning, the medical advice about recreational drugs or other harmful substances like smoking is to stop. Some substances that stand out more when thinking about which drugs cause male infertility are:
| Recreational drug | Effect on male reproductive health |
| Cannabis (or Marijuana) | Although weed or cannabis is widely used and may not be considered a ‘hard drug’, research suggests that habitual use of cannabis can affect hormonal balance, sperm production ability, and sperm health. |
| Cocaine and Amphetamines | Stimulant drugs like cocaine can affect blood supply and cause damage to important cells. This can affect the quality of the sperm as well as production. |
| Anabolic steroids | Anabolic steroids can sometimes be overlooked as a recreational substance due to their use in muscle gain rather than a high or an altered experience. However, these synthetic hormones can be highly toxic and lead to decreased sperm production. |
Another harmful substance that can affect male fertility is alcohol. If someone consumes excessive alcohol, not only can it affect erectile function, it can also affect sperm quality, and decrease the production of key hormones.
If you and your partner are family planning and hoping to conceive soon, it might be helpful to discuss what medications should men avoid when trying to conceive with your doctor. Certain medications can affect libido, sperm count, and/or sperm quality which can then make natural conception more difficult. There are also some specialist medicines that can lead to structural defects in the fetus or baby. Some risky medications in the context of male reproductive health include: chemotherapy drugs, antidepressants, testosterone treatment, biologics, immunosuppressants, as well as recreational drugs. Always consult your healthcare provider before stopping any medication.
When evaluating can medication affect male fertility, you and your doctor will consider your health needs first and then explore options for an alternative treatment that protects your reproductive health.