Pain Meds May Affect Sperm Count

Study says Tylenol, Motrin, Advil and other pain relievers may cause a reduction in sperm count

By Deborah Jeanne Sergeant


Want to be a dad? Consider cutting back on certain drugs.

A recently released study in the journal Proceedings of the National Academy of Sciences indicates that over-the-counter pain relievers aspirin, acetaminophen (branded as Tylenol) and ibuprofen, (branded as Motrin and Advil), may hamper fertility.

French and Danish researchers found that the ubiquitous painkillers disrupted participants’ testosterone levels, affecting their ability to produce normal levels of sperm. Low sperm count, also known as oligospermia, represents a common reason for male infertility.

Male fertility matters. Male issues account for about one-third of infertility cases, women’s issues cause another third and the remaining third have unknown or a combination of causes.

J.C. Trussell, urologist and specialist in male infertility and erectile dysfunction at Upstate Urology, found the study interesting, but “not easily explainable.”

“On one hand, using Motrin, in the literature, has been shown to improve sperm motility,” Trussell said. “But this paper shows it reduces testosterone production. It’s amazing stuff. It might be important, as a lot of people use anti-inflammatory drugs. If I were to talk with someone, I’d have them take Motrin only if necessary, but for the shortest time interval.”

Since painkillers disrupt hormone levels, it’s worth abstaining from them to increase the chances of fertility.

It may not be as simple as blaming over-the-counter pain medication. The reason for taking the medication — inflammation caused by a painful injury — may also hold some blame.

“Inflammation will damage the testes, along with every organ of the body,” said physician Rob Kiltz, who is a diplomate of the American Board of Obstetrics and Gynecology and is board-certified in reproductive endocrinology and infertility. He founded and operates CNY Fertility based in Syracuse.

He said that diet can contribute to inflammation, starting in the gut. He recommends the ketogenic diet, which eliminates sources of carbohydrates and processed foods.

“The standard American diet is high in carbohydrates,” he said. “A lack of natural fats contributes to inflammation and high carbohydrates contribute to inflammation, too.”

Men can improve their sperm count through many other means, too. Kiltz advises men to stop smoking cigarettes, drinking excessive alcohol and using marijuana or other illicit drugs.

Some prescription medication may interfere with sperm count, so men should consult with their care providers.

Kiltz added that chemical exposure, such as herbicides used in agriculture, may affect sperm count as well.

Men should also seek treatment for any sexually transmitted diseases, manage stress, lose weight, and control blood pressure and any other illnesses such as diabetes.

“I recommend slowing down and reducing the excess exercise,” Kiltz said. “Yoga, massage, meditation, hypnosis and prayer are necessary to heal our bodies. But the fight or flight exercise activity causes increase in cortisol, friction and heat and stress in our bodies that hurt every cell of our body.”

Trussell said that couples seek help after trying to conceive for a year or longer. Few men appear motivated to check into their fertility.

“When success is difficult to come by, the female is usually more motivated to see if she has reproductive problems,” Trussell said. “The male usually gets a semen analysis and that’s generally what prompts the referral to me. Less than 5 percent of the time, a guy shows up on his own to say, ‘Hey I’m having trouble with fertility.’”

While no intervention directly increases sperm, avoiding things that decrease sperm can certainly help, along with effectively treating low testosterone. Lacking testosterone can cause a lack of sperm during ejaculation.

Simply replacing testosterone may not be helpful. Trussell said that many men on testosterone replacement experience low sperm count and about 30 percent don’t recover adequate sperm production.

“Twenty-five percent of urologists would actually treat guys with testosterone if they’re infertile,” Trussell said. “It makes their sperm count even worse.”

Instead, Trussell treats with Clomid (clomiphene), which he said stimulates the brain into giving more hormone to the testes.

Varicose veins in the groin between the scrotum can bring excess heat near the testicles. Surgically correcting the veins often reduces heat. Trussell said that 70 percent of men having the procedure see sperm count improve.