Study finds some pain medications may harm your fertility

A small, new study shows that taking non-steroidal anti-inflammatory drugs (NSAIDs) can temporarily harm women’s fertility.

“After just 10 days of treatment we saw a significant decrease in progesterone, a hormone essential for ovulation, across all treatment groups, as well as functional cysts in one third of patients,” said study researcher Sami Salman, a professor at the University of Baghdad in Iraq.

“These findings show that even short-term use of these popular drugs could have a significant impact on a woman’s ability to have children.

This needs to be better communicated to patients with rheumatic diseases, who may take these drugs on a regular basis with little awareness of the impact.”

The study included 39 women of childbearing age, who all experienced back pain.

They took either 100 milligrams once daily of diclofenac (also known by the brand names of Voltaren or Cambia), 500 milligrams twice daily of naproxen (also known by the brand names of Aleve or Naprelan), 90 milligrams once daily of etoricoxib, or a placebo, for 10 days, starting on the 10th day of the onset of their menstrual cycles.

Then, at the end of the 10-day period, researchers examined whether the dominant follicle had ruptured in the women. (When the dominant follicle ruptures, an unfertilized egg is released, which is necessary for ovulation.)

The researchers found that the dominant follicle remained unruptured in 75 per cent of the women who took diclofenac, 25 per cent of the women who took naproxen, and 33 per cent of the women who took etoricoxib.

However, this is hardly the first time NSAIDs have been linked with fertility issues, notes Jennifer Ashton, MD, a board-certified gynecologist and Yahoo Health Advisory Board member who was not involved in the new study.

“There are a lot of different types of ‘painkillers,’ but in particular the class known as NSAIDs is known to have an effect on the ovulation process,” she tells Yahoo Health.

“We don’t fully understand why, but the COX-2 and prostaglandin pathways, that are involved with pain and are blocked by NSAIDs, are also involved in ovulation.”
NSAIDs are the only known class of painkillers that have an effect on ovulation, Ashton says — acetaminophen and opioid narcotics do not. However, drugs that work in the same way as NSAIDs might also have a similar effect on ovulation.

The NSAID-fertility link has to do with the ovulation process, Ashton explains. “Each time an egg is released, it is basically a small rupture of a dominant follicle of the ovary,” she says. “Taking NSAIDs can delay, inhibit, or block this rupture of egg release.”

Fortunately, any potential effects of NSAIDs on fertility are not permanent — the changes are totally reversible with discontinuation of use of NSAIDs.

But “women who are trying to conceive should avoid these drugs,” Ashton notes. “Acetaminophen is a safe option.”