USA: Prescriptions and Fertility

A recent article from Consumer Reports began with this simple observation: “If you’re like most Americans, you probably start your day with a hot shower, a cup of coffee—and a handful of pills.”

The article went on to note that more than 50 percent of Americans at any given time are taking prescription medications. And not all of those pills prove as helpful as intended.

On the contrary, nearly 1.3 million people paid a visit to their local emergency rooms because of negative side effects from taking prescription medications; sadly, roughly 124,000 of those ER visits resulted in fatalities.

Hard as it may be to fully grasp, the problem gets even thornier.

A 2017 Pew Research report said that just over three in four Americans saw prescription drug abuse as “an extremely or very serious public health problem”. And WebMD cited a 2015 study indicating that doctors continue to overprescribe highly addictive opioids to their U.S. patients; other studies included in the article suggested that opioids were being prescribed at a rate 400 percent greater than that of 15 years earlier.

Clearly, America continues to grapple with myriad drug problems – some of which involve males wishing to protect and preserve their fertility.

It goes without saying that drug abuse of any kind, including alcohol abuse, does not produce positive health results.

But what about drug use that falls generally within the bounds of a doctor’s care and instructions?

In 2017, the National Institutes of Health released a study entitled, “FDA-approved medications that impair human spermatogenesis”, which refers to the development of mature sperm.

The NIH listed more than 65 drug labels of many different classes that had demonstrated the potential for impacting human sperm production. Among them: Various forms of anti-depressants, anti-inflammatory agents, anti-viral agents, hormone substitutes, immunosuppressants, and cardiovascular agents.

The Cleveland Clinic went a step further, breaking down various classes of potentially harmful drugs and providing common-sense explanations for their effects. The Clinic strongly suggested that a man who plans on starting a family should have a frank discussion with his doctor before undergoing any new treatments or starting any new medications.

According to the Clinic, the following substances may affect male fertility:

·       Replacement Testosterone: Also known as “supplemental testosterone”, this substance is said to have “a strong negative effect on sperm production”. This is because when supplementyal testosterone is administered to a man, it blocks the natural hormonal messages being sent to the testicles to create sperm – and also testosterone. When testosterone levels drop too low, strong sperm production can’t be supported.

·       Anabolic Steroids: These drugs, which are used to decrease body fat as well as to increase muscle mass, also interfere with hormonal signals that are required to create sperm. Because of these and other harmful effects, the Clinic says, men shouldn’t use anabolic steroids at all.

·       Marijuana: The active ingredient in this drug, known as THC, cuts down sperm production and, by interfering with the creation of testosterone, also impairs sexual drive. THC also has a debilitating effect on how effectively sperm can swim. Marijuana also could be tainted with impurities and can serve as a so-called “gateway drug” to the use of more potent, harmful substances, such as cocaine.

·       Narcotics/Opiates: These include both illegal drugs sold on the street and prescription pain killers. Used over a long period of time, opiates can also disturb the body’s natural signals to create testosterone as well as hinder the number and integrity of sperm.

Perhaps most notably, the Clinic also provides information on the harmful effect of other prescription medications – ones that men may be taking to treat or alleviate another medical condition.

These include alpha blockers, which are prescribed to treat urinary problems brought about by an enlarged prostate; selective serotonin reuptake inhibitors (SSRIs), which are often prescribed for the treatment of anxiety and depression; and, Ketoconozole, which is used to treat fungal infections. The Clinic notes that the pill form of this last drug, not the cream, ointment, or powder varieties, harms testosterone production.

As previously discussed here, all chemotherapy medications will inhibit sperm production. Furthermore, the Clinic advises, “If you are preparing to go on chemotherapy, talk to your doctor about freezing sperm before starting the chemotherapy.”

Special mention should also be made here concerning a relatively new phenomenon: Recreational drug abuse of legal drugs.

According to another study from the NIH entitled “Nonmedical use of prescription drugs in emerging adulthood: differentiating sex from gender”, men, particularly those of college age, are more likely to engage in non-medical use of prescription drugs – an activity that the NIH classifies as “particularly dangerous”, with emergency room visits due to such use having recently risen by a rate of 115%.

Of course, even the healthiest among us will likely have a need to take certain medications over his lifetime.Doing so responsibly includes taking proactive steps to protect your assets from any potential harm.