Some Pain Relievers May Decrease Fertility in Young Women: Study

New research suggests that young women taking common over-the-counter pain medication may face an increased risk of suffering fertility problems. 

In a study presented at the recent European League Against Rheumatism Congress in Rome, researchers found women taking nonsteroidal anti-inflammatory drugs (NSAIDs) were more likely to experience decreased fertility, reducing their chances of getting pregnant. The findings are considered preliminary, because they have not been peer reviewed or published.

Researchers focused on 39 women of child bearing age who had minor back pain. They were given one of four NSAID treatments, either naproxen, diclofenac, etroicoxib or a placebo. Each woman was given an ultrasound to check the size of their ovaries and progesterone levels were measured. Progesterone is essential for ovulation and for helping a fertilized egg attach to the lining of the uterus.

Women began receiving the treatments on day 10 of their menstrual cycle to make sure a follicle had developed in preparation for releasing an egg. After 10 straight days on NSAIDs women received another ultrasound to check the effects.

Researchers found ovulation was far less frequent in patients who were on NSAIDs.

In the patients who were taking Cataflam or Voltaren, ovulation was reduced by 93%. Patients who took Aleve and etroicoxib, which is not approved in the U.S., experienced a 75% reduction in ovulation..

NSAIDs Pregnancy Concerns

Nonsteroidal anti-inflammatory drugs (NSAIDs) include some of the most widely used painkillers in the U.S., including the over-the-counter medications Advil and Aleve. Despite the widespread use of the drugs, they have been linked to several potential risks impacting pregnancy and fertility.

A study published in 2012 revealed NSAIDs may increase the risk of several types of birth defects when taken by pregnant women. The over-the-counter drugs were linked to up to three times the risk of developing cleft palate, spina bifida, amniotic bands, isolated pulmonary valve stenosis and other defects.

Researchers in this latest study suggest the medications may hinder ovulation and lower levels of progesterone. It is believed that the way NSAIDS affect fertility is by preventing follicles from releasing eggs each month, potentially causing women to develop ovarian cysts. One-third of women who develop a cyst do so because of ruptured follicles.

“This process is reversible, a woman is not going to get pregnant if she continues to take NSAIDs, and doctors need to advise women to stop taking these drugs if they want to be fertile,” said lead researcher Sami Salman, MD, from the University of Baghdad.

Half of the women returned the following month to check how ovulation developed after they stopped taking NSAIDs. Those who did stop the medication regimen did ovulate during the next cycle.

Researchers emphasize it is important to be knowledgeable about uncommon side effects of drugs that are frequently used, like Aleve and Advil.

Most people who take NSAIDS use them occasionally, are postmenopausal women or both. Yet, many younger women with inflammatory disease will use them regularly, during a time when fertility is typically most important.

“These findings highlight the harmful effects NSAIDs may have on fertility and may open the door to new emergency contraception methods,” said Salman.