Many over-the-counter and prescription drugs can affect your chances of conceiving. Don’t overlook these fertility-robbers that may be sitting in your bathroom medicine cabinet.
By now we all know that many medications can be harmful during pregnancy. But the medications women take before they’re pregnant might be just as potentially harmful. Some common (and some not-so-common) prescription and over-the-counter drugs can snarl your reproductive system (or your partner’s) and affect your chances of conception. “Over-the-counter and prescription drugs are socommon most people don’t think about them being a problemsays urologist Larry Lipshultz, M.D., a male infertility specialist at Baylor College of Medicine in Houston, Texas. Patients are typically advised to discontinue drugs that might cause birth defects, such as the acne drug Accutane, he adds, but may not be warned about medications that can block pregnancy in the first place. And many drugs have not been well-studied for these effects. “So you have to use common sense and take as few as possible,” advises David Adamson, M.D., director of Fertility Physicians of Northern California in San Jose and Palo Alto.
If you and your partner are hoping to be parents soon, you may want to toss the following drugs—with your doctor’s blessing, of course. If you depend on certain medications for a chronic condition, ask about alternatives that won’t lower your conception odds.
Drugs That Can Affect Female Fertility
Anabolic Steroids
More and more fitness-minded women are turning to anabolic steroids to boost muscle mass, but often with devastating effects on their fertility. Because steroids mimic the male hormone testosterone, high doses and long-term use can affect the hormone-producing adrenal glands, upsetting a woman’s menstrual cycles, sometimes permanently, explains Dr. Adamson.
Antidepressants
Though most of the worry about antidepressants revolves around their potential for causing birth defects, there’s also some concern about their effect on fertility. Tricyclic antidepressants, such as Elavil, may increase levels of the hormone prolactin, says Sandra Carson, M.D., a professor of obstetrics and gynecology at Baylor College of Medicine. Prolactin is the hormone that stimulates milk production in new mothers, but high prolactin levels in any woman may also block ovulation (the reason nursing mothers are less likely to get pregnant). If you’re taking tricyclics or anti-anxiety drugs, check with your doctor about lowering your dose or trying an alternative.
Antihistamines
Benadryl, Allegra, Claritin, and other antihistamines can all interfere with ovulation by blocking the action of histamine, a chemical that not only defends the body against foreign substances and infection, but also plays a role in releasing an egg from the ovary and implanting it in the womb. These drugs are effective at relieving the symptoms of an allergic reaction, but they may also halt conception. “If you’re trying to get pregnant, it’s best to avoid antihistamines from mid-cycle until your period,” notes Marcelle Cedars, M.D., a reproductive endocrinologist at the University of California at San Francisco.
Corticosteroids
When taken orally, injected, inhaled, or used as a cream or ointment, corticosteroids (such as Cortisone and Prednisone) lessen the swelling, redness, and itching of allergies, asthma, and arthritis. Women taking these drugs short term shouldn’t see changes in fertility. But because corticosteroids are closely related to the hormone cortisol, which is produced by the adrenal gland, long-term use could throw off menstrual cycles and ovulation. “Ask your doctor if the dose you’re taking is okay or if there are better alternatives,” advises Dr. Adamson.
{loadposition frboost} Decongestants
Decongestants and cold medicines such as Sudafed, Actifed, and Afrin cut inflammation and congestion by narrowing the blood vessels in nasal membranes and slowing mucus production. However, nasal passages aren’t the only mucus membranes in your body. Your cervix also produces mucus to help sperm swim into the uterus and fallopian tubes to fertilize an egg. If the mucus dries up, the sperm may not be able to complete their journey. According to Machelle Seibel, M.D., a professor at the University of Massachusetts Medical School and editor-in-chief of the scientific journal Sexuality, Reproduction & Menopause, women who are trying to become pregnant should avoid taking decongestants, particularly at mid-cycle, when they are potentially most fertile.
Ibuprofen
Common pain relievers such as the NSAIDs (non-steroidal anti-inflammatory drugs, which include Advil, Motrin, and Aleve) can sabotage conception, particularly if taken regularly. They may block production of prostaglandins, hormone-like chemicals that regulate inflammation and temperature. But they may also throw off the release of an egg each month. If you’re trying to get pregnant, stop taking ibuprofen from right before ovulation. “But it’s perfectly alright to take it for menstrual cramps,” says Dr. Carson. Or try acetaminophen (Tylenol) instead.
Drugs That Affect Male Fertility
Anabolic Steroids/Testosterone Therapy
“Anabolic steroids can actually make men permanently sterile,” warns Dr. Seibel. The reason: Too much testosterone sometimes “feminizes” men, shrinking testicles and cutting sperm count and quality. Another potential fertility blocker is testosterone replacement therapy, including herbal testosterone enhancers. According to Dr. Lipshultz, it may take up to six months for fertility to return after discontinuing use.
Antidepressants
The class of drugs called selective serotonin reuptake inhibitors (SSRIs), which includes Prozac, Zoloft, and Paxil, often alter libido and ability to get an erection or ejaculate, according to Dr. Lipshultz. New evidence also shows these drugs may spur hormonal changes that damage sperm, making them unable to fertilize an egg. Fortunately, switching to another type of antidepressant usually eliminates these problems.
Antihypertensives
Potassium-sparing diuretics with spironolactone (for example, Aldactone) are used to treat high blood pressure by ridding the body of unneeded water and salt. However, they can also cut testosterone production, blunting sexual desire, lowering sperm counts, and causing erection problems. Another group of antihypertensives, called calcium channel blockers (such as Cardizem, Dilacor, and Verelan), can also have an impact on male fertility by diminishing sperm’s ability to penetrate and fertilize an egg. “They’ve actually been investigated as a male contraceptive,” says Dr. Cedars. Ask your doctor about alternatives with less of a fertility impact.
Herbal Supplements
Herbal medicines aren’t monitored by the Food and Drug Administration (FDA), which means the quality and dosage are unregulated. The effects of many herbal remedies haven’t been well-studied yet, either. “You don’t know exactly what’s in them and what effects they could have,” says Dr. Adamson. Though evidence is limited, initial research suggests that echinacea, ginkgo biloba, and St. John’s wort may hamper sperm’s ability to penetrate an egg. Best to be safe and avoid them when trying to conceive.
Ulcer Medications
H2 blockers (histamine blockers) with cimetidine (such as Tagamet), can wreak hormonal havoc in men, slowing sperm production and causing impotence in about 40 percent, says Dr. Lipshultz. See your doctor for an alternative.
Sulfasalazine
Used for inflammatory bowel diseases (such as Crohn’s disease), sulfasalazine (Azulfidine) can have a major impact on male fertility by reducing sperm counts and quality. It may take months for fertility to return, notes Dr. Lipshultz.
Obviously medications have important uses, and not everyone can or should stop taking drugs completely when they’re trying to conceive. Far smarter is to let your doctor know your desire to be pregnant soon, and make sure you get the “okay” for any medications you take. “Not everyone experiences fertility side effects,” says Dr. Seibel. “But people need to think that anything they’re taking could have an impact on their fertility and talk to their doctor before getting pregnant.”
A version of this article originally appeared in the Fall 2006 issue of Conceive Magazine.
Related Topics: Boost Fertility; Fertility Health
