Some types of medication can impact male fertility and sperm function. Men struggling with fertility who take any of these types of medication should discuss medication adjustments with the prescribing healthcare provider.
Oral hair loss medications. Finasteride and dutasteride are medications that can be taken to prevent hair loss or treat urinary symptoms that result from an enlarged prostate. This medication works by causing changes in the metabolism of testosterone in your bloodstream. A high-quality clinical trial showed that treatment with finasteride and dutasteride resulted in decreased sperm concentration and motility (swimming ability), but these results are reversible within 3-4 months of discontinuing the medication. Sperm morphology (shape) has not been shown to be affected by the use of finasteride or dutasteride. Men who are taking this type of medication are frequently advised to discontinue when attempting conception.
Psychiatric medications. The most common type of antidepressant medication (also used to treat anxiety) belongs to a category called selective serotonin reuptake inhibitors (SSRI). Tricyclic antidepressants (TCA) is another category less commonly used. Both SSRI and TCA can cause hormonal changes which may lead to low testosterone, and this has been speculated (but not proven) to potentially relate to changes in sperm quality. SSRIs have also been associated with decreased sperm count and motility but do not appear to affect sperm morphology. Besides potential direct effects on sperm, antidepressant medications may be relevant to fertility potential by affecting erectile or ejaculatory function. It is important to note, however, that the underlying conditions of anxiety and/or depression are highly correlated with sexual problems so stopping the medication may not improve those conditions (and would leave the anxiety and/or depression untreated). It is therefore critically important to discuss any possible changes in medication with your psychiatrist before acting upon them.
Calcium Channel Blockers. Calcium channel blockers are medications that are used to treat hypertension and certain heart conditions. Some studies have suggested that these medications may adversely impact the ability of sperm to fertilize an egg. Common medications in this class include amlodipine (Norvasc), nifedipine (Procardia), and diltiazem (Cardizem).
Chemotherapy. Chemotherapy is a type of cancer therapy that can cause decreased or absent sperm production. Chemotherapy is designed to target rapidly dividing cancer cells. Unfortunately, the cells that develop into sperm are also rapidly dividing cells and are often inadvertently damaged by chemotherapy as well. This can result in genetically abnormal sperm for the immediate time period after chemotherapy and can cause long-term problems with fertility.
