Medications, steroids and preconception health

In recent years, there has been a growing concern regarding poor obstetric outcomes, poor knowledge of preconception health, and increased infertility. Sperm counts have been steadily decreasing in the Western world. The reasons for all these issues may be hard to point as they are very complex.

It is important to inform women and men of reproductive age about the role of medication (especially over-counter-counter medication and different herbal medication) to their preconception health. Medication and supplements can affect hormonal balance and sperm quality in unexpected ways.

We are starting to know more about paracetamol, ibuprofen and salicylic acid. We are learning that they can have endocrine disruptive properties capable of altering human reproductive function from fetal life to adulthood in both sexes. Continuous use of painkillers may cause ovulation disorders as anti-inflammatory drugs act as inhibitors of prostaglandins. And for men ibuprofen inhibits steroidogenesis and causes hormonal condition normally seen in older men and smokers.

While pursuing healthier life, people use herbal medication. Natural does not always mean safer. Quality and safety of herbal products is questionable. The addition of heavy metals or other toxic ingredients are sadly quite common.

The use of anabolic steroids, also known as anabolic–androgenic steroids (AAS), is increasing. It all began among professional bodybuilders, but now recreational athletes boost their appearance by using AAS as well. The harms that AAS users cause to their internal organs and hormonal balance might be irreversible. AAS users want to improve their athletic performance by increasing muscle strength and aggressiveness or improve physical appearance, they want to look fit and healthy. Actually, they are hormonally far from that. They end up using “Gym and tonic”. In fact, in order to maintain and improve their results and staying fully functional they have to combine different testosterones, fat burners, post-cycle therapy, side-effect treatment (Viagra) and so on.

By strengthening the knowledge of healthcare professionals and students, we can ensure healthy pregnancies, healthy parents and healthy babies. It is far too late and far too stupid and risky trying to boost fertility with “miracle pills” sold on Amazon.


Marika Mettälä, MHSc, RM, Senior Lecturer, Midwifery

Tampere University of Applied Sciences, Kuntokatu 3, 33520 Tampere, Finland

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