Common painkillers don’t only kill pain

painkiller hypogonadism Agnes Ryu

The effects of medication on men and potentially their offspring

It is important to note that most drugs are not evaluated for their effects on human fertility before marketing.

There is evidence that some medications are particularly harmful to the male reproductive system, including testosterone, opioids, antidepressants, antipsychotics, immune modulators and even over-the-counter antacid. It is recommended that men who are planning to father a child avoid drugs for several months.

Commonly used over-the-counter painkillers, paracetamol (acetaminophen), aspirin and ibuprofen have long been regarded as safe and mild medicines and these are readily found in medicine cabinets in the home. However, all three drugs turn out to be “anti-androgenic,” meaning they disrupt male hormones and reduce fertility.

The effect of painkillers on adult males

Ibuprofen is among the most commonly used medications. A study published in the journal Proceedings of the National Academy of Sciences in January 2018 found that Ibuprofen has a negative impact on the testicles of young men.

Ibuprofen alters human testicular physiology to produce a state of compensated hypogonadism

Being a non-steroidal anti-inflammatory drug, ibuprofen is often taken by many athletes before an event to numb pain although the health consequences of long term use are not determined.

The research team recruited 31 male volunteers between the ages of 18 and 35. Of these, 14 were given the daily dosage of ibuprofen that many professional and amateur athletes take: 600 milligrams twice a day. The remaining 17 volunteers were given a placebo.

When taking ibuprofen in doses commonly used by athletes, a small sample of young men developed a hormonal condition that would typically start during middle age.

Within 14 days of taking ibuprofen, luteinizing hormones — which are secreted by the pituitary gland and stimulate the testicles to produce testosterone — became coordinated with the level of ibuprofen circulating in their blood. At the same time, the ratio of testosterone to luteinizing hormones decreased, a sign of dysfunctional testicles.

This hormonal imbalance produced compensated hypogonadism, a condition associated with impaired fertility, depression and an increased risk of cardiovascular events, including heart failure and stroke.

Of the three mild analgesics examined, ibuprofen had the broadest endocrine-disturbing properties identified so far in men.

If used only for a short time, these effects could be reversible, however, whether the health effects of long-term ibuprofen use are reversible is currently unknown.

Though this research indicates that ibuprofen disrupts the reproductive hormones in healthy young men, it’s possible to postulate that there’s an even greater negative effect in men with low fertility.

The effect of painkillers on male babies

Studies published in several papers show that, when taken during pregnancy, all three of these mild medicines affected the testicles of male babies.

Prenatal exposure to paracetamol/acetaminophen and precursor aniline impairs masculinisation of the male brain and behaviour.

Ibuprofen results in alterations of human fetal testis development

Maternal exposure to ibuprofen can affect the programming of the hypothalamus of the male offspring


Paracetamol (acetaminophen) is the preferred analgesic for pain relief and fever during pregnancy. Prenatal exposure to paracetamol results in developmental alterations in both the reproductive tract and the brain of the male baby as this painkiller disrupts the production of androgen and prostaglandins.

Prenatal Exposure to Acetaminophen and Risk of ADHD

These drugs even increased the likelihood that male babies would be born with congenital malformations.

When it comes to pregnancy, these 3 groups of mild painkillers could have unexpected far-reaching effects.

Agnes Ryu

Agnes Ryu

Dr. Ryu is a clinician and biochemist specializing in integrative medicine. Her clinical interests include fertility, hormones, metabolism, healthy ageing, menopause, and natural breast cancer care. As an integrative practitioner, Dr. Ryu aims to uncover the root causes of health issues and strives to empower patients with the knowledge and tools to take charge of their own health.

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