You should know that certain drugs – both legal and illicit – can negatively affect your fertility.
Urologist Sarah Vij MD walks you through the most common substances which can affect fertility, including antidepressants and opioids.
What are the effects of substance abuse on male infertility?
Both recreational drugs and medications can affect your ability to conceive. Most of the time, these effects will be temporary and can usually be reversed after you stop taking the drug. But this is not always the case and some can cause male fertility.
Dr. Vij says that if you want to have children, whether it’s now or in the future, talk to your doctor about your medications and how they may affect your fertility.
Recreational drugs can have a wide-ranging impact on both your mental and physical health. This puts your health in danger in many ways. Seeking out treatment can be beneficial for you and your child.
Substances that may affect male fertility
What should you do when you see your medication listed? Don’t panic. It’s important to remember that their effects on your fertility are often reversible. Talk to your doctor to learn more about your options.
Dr. Vij advises, “If a medication causes unexpected side effects, such as fertility issues, it may be time to switch medications.” She goes into more detail about some prescription drugs that can make it difficult to get pregnant.
Alpha-blockers
The use of alpha-blockers is used to treat urinary problems caused by an enlarged prostrate. This medication comes in a variety of forms, each with a different effect on your fertility.
“In particular silodosin, tamsulosin, and Rapaflo (r) or Flomax (r), can all cause a drastic decrease in ejaculation volume, or may even inhibit ejaculation entirely,” Dr. Vij states.
You should consult a urologist if you are taking one of these drugs to find out if they may have an impact on your reproductive health and discuss other treatment options.
Antidepressants
If you are planning to have children, it is important to maintain your mental health. However, antidepressants can negatively impact your chances.
Dr. Vij says that SSRIs are commonly prescribed for depression and anxiety. However, these drugs can cause sexual dysfunction.
SSRIs don’t have to be the only option for treating anxiety and depression. Talk to your doctor about other options if you are currently taking an SSRI.
Chemotherapy medication
It’s hard enough to deal with cancer without having to worry about your fertility. All chemotherapy drugs used to treat cancer may cause sperm production to be significantly reduced or even stopped.
According to Dr. Vij, depending on the type and duration of the chemotherapy treatment you received, your sperm may return in two years. But for many, the sperm never returns. This results in infertility.
Talk to your doctor before starting chemotherapy about freezing sperm.
Opioids are narcotics.
Opioids include illegal street drugs as well as prescription medications to treat pain and addiction.
Dr. Vij says that long-term opioid usage can interfere with the signals controlling testosterone production. This can lead to low testosterone levels and a decrease in both quantity and quality of sperm. The extent of the effect depends on what opiates you are taking, how much you take and for how long.
The short-term use of opiates for pain control after surgery or a fracture has not been shown to negatively affect fertility. Opioids are addictive. If you have any questions about short-term use, or if you’ve had addiction issues in the past, talk to your doctor.
Testosterone
Testosterone Replacement (also known as supplemental testosterone), has a negative impact on sperm. Most likely, the semen will have a very low concentration of sperm or no sperm at all.
Dr. Vij explains that when you take testosterone the hormone signals that tell your testicles how to produce testosterone and sperm is blocked. Your natural testosterone production stops. This causes the levels of testosterone in your testicles and sperm to fall sharply.
This effect can be reversed in most cases, but it may take up to 12 months for the sperm to return to its normal level.
Ketoconazole
This medication is used to treat fungal infection. It can be applied as a cream or powder to the skin.
Ketoconazole, when taken in pill form, can cause testosterone to decrease and sperm to be less productive.
5-alpha-reductase inhibitors
These medications, including Propecia(r), and Avodart (r), are used to treat prostate enlargement and hair loss. The impact of these medications on fertility is mild, and it will go away once you stop taking them. However, while you are still taking the drugs, you may find it more difficult to get pregnant.
Dr. Vij states that the evidence is mixed about whether or not these drugs can affect sperm production if you are taking them to treat hair loss. But taking it to treat prostate enlargement may cause a reduction in the total number of sperm and volume of your semen. This can make it harder for someone to become pregnant.
If you are having difficulty getting pregnant, talk to your doctor.
Another thing: they can cause your sexual drive to plummet. In most cases, your sex drive should return to normal once you stop taking medication.
Other medications
Other prescription drugs can also cause fertility issues, but most are reversible. These include:
- Antiepileptic medications like carbamazepine (oxcarbazepine), valproate and oxcarbazepine.
- Antiretrovirals are medications that are primarily used to prevent HIV from reproducing.
- Antibiotics that fight bacterial infections
- like the nifedipine or spironolactone.
- Cimetidine is used to treat ulcers and acid reflux.
- Colchicine is a medication for gout.
- Sulfasalazine is used to treat rheumatoid or ulcerative colitis.
Semen testing is important if you are taking these medications but have trouble getting pregnant.
What is the effect of recreational drugs on fertility?
Various recreational substances such as alcohol, drugs and tobacco can affect your fertility. Dr. Vij explains.
Alcohol
It appears that light drinking does not affect fertility. This is great news for those who enjoy the occasional pint or toast with friends. Heavy alcohol consumption, defined as between 10 and 14 drinks per week or more, is a different story. It could:
- Reduce testosterone production
- You can increase the rate of testosterone clearance from your bloodstream.
- Increase your estrogen levels.
Dr. Vij warns that “all of this can lower testosterone levels which can harm sperm formation.” Learn more about signs of addiction if you suspect you are suffering from alcohol abuse disorder.
Anabolic steroids
Anabolic steroids are sometimes used by athletes and bodybuilders to improve their performance or alter their appearance. They’re dangerous.
Dr. Vij says that anabolic steroids can harm male fertility because they interfere with hormone signals needed to produce sperm. The amount of harm they cause to your fertility will depend on the type of anabolic steroids you use, how much you take and for how long.
Many people recover their sperm production within three to twelve months of stopping anabolic steroid use. The health effects of anabolic steroids can be severe, so you should only take them when your doctor prescribes them.
Be careful when taking supplements for muscle building and fitness. Some products from unreliable sources may contain anabolic steroids you don’t even know.
Marijuana
You (and your partner), should cease all marijuana use during pregnancy due to the adverse effects THC, can have on fertility.
Dr. Vij says that THC can interfere with testosterone production, which in turn weakens the sexual drive and decreases sperm production. It may also restrict the movement of sperm.
Other risks exist. To increase the weight of marijuana, it is often laced with heavy elements like lead or cut with addictive illicit drugs like cocaine. Both are harmful to your health overall and to your fertility.
Tobacco
Tobacco smoking and tobacco use in general are linked to a variety of serious health conditions. You can also add fertility problems to the list.
Dr. Vij warns that smoking can negatively impact sperm movement and production. Quitting smoking can be difficult, but it is worth the effort if you want to expand your family.
Methamphetamine
As it is commonly known, meth is a synthetic stimulant with a high level of addiction. It affects the body in many ways, and none are positive. It can cause high blood pressure, heart and respiratory rate increases, mood disorders and psychosis.
It’s not clear how or if the use of methamphetamine affects male fertility in humans. It has been proven to decrease sperm motility, increasing the chances of infertility.
Men’s health supplements: Beware
Dr. Vij warns, “Be extra careful when buying supplements that promise to increase sexual desire and performance.” They are not approved by the U.S. Food and Drug Administration. Even though they might be advertised as sexual enhancers, these supplements haven’t undergone scientific evaluation and could cause harm.
When to consult a doctor for male infertility
You may need to see a doctor if you are having difficulty conceiving. They will perform a physical as well as a complete medical history. The doctor may refer you to an urologist who will perform a Semen Analysis which measures the quantity and quality your sperm. This is the first step to detecting male infertility issues.
Dr. Vij explains: “If you have spent your entire life thinking that you will easily be able to become a parent at some point, it can be a challenge to discover that it is harder than you thought.” “Urologists, fertility specialists and other professionals are available to assist you in reaching your goal.”
