Pain Killers And Testosterone

In this modern era when everyone is so busy, dealing with pain, headaches or joint aches are the last thing you want to deal with. Solution?

Pop some Advil or Tylenol and numb those irritating nerves down!! However, like every other drug, excessive use of pain killers also come with certain side effects, including significant reduction in T levels.

Pain killers And Testosterone – What Is The Association?

Market is flooded with tons of pain killer choices including prescription and over the counter medications, among which the most common groups include:

• NSAID’s (non-steroidal anti-inflammatory drugs): Ibuprofen, Aspirin, Paracetamol, and Naproxen.
• Corticosteroids: Fludrocortisone, Hydrocortisone, Dexamethasone, etc.
• Opioids: Hydrocodone, Oxycodone, Codeine, Hydromorphone, Morphine, etc.

Clinical Evidence Of Testosterone Suppression With Painkiller Abuse

NSAID’s exert their action by inhibiting the enzymes that are responsible for signaling pain in your body. As per research, a short-term use of over the counter pain killers won’t do any harm to testosterone. However, prescription NSAID’s may have a remarkable testosterone suppressing effect. Some other studies that further validated this relationship are briefly discussed as under:

• Another study suggested, moderate doses of aspirin can decrease sperm motility without having any notable effect on the production of testosterone (1, 2)
• In another study, male rodents were given aspirin in moderate doses for 30 days. In the first 15 days, testosterone levels were found to be raised but after that (last 15 days) there was a significant reduction in T levels (3)

Corticosteroids are used for numerous purposes, but as pain killer they are mostly used for joint pain and inflammations. The corticosteroid used for pain are synthetic steroids, principally the stress hormone “cortisol”. Cortisol is directly associated with reduction in T levels which clearly explains why this group of pain killers have negative impact on testosterone.

• A study conducted on 17 males who were using corticosteroids for chronic inflammation showed noteworthy reduction in both free and total testosterone levels.
• Another study was carried out on 35 males who were taking inhaled corticosteroids, results showed 18% decrease in testosterone levels.

Opioids are the strongest pain killers and they have much potency to lower down testosterone. Though, mechanisms are not clearly understood but one mechanism which makes sense is the inhibition of gonadotropins from brain.

• As per one study, 34% of men who were taking short acting opioids had clinically low T levels. Same problem was observed in 74% of men who were on long acting opioids.
• Another study conducted on men who were taking opioid injections in spine for back pain, had significantly low levels of testosterone.

No doubt pain killers are blessing when you’re suffering from throbbing pain but, popping pills very often for minor ailments and in improper doses is not good at all, especially for hormonal health!

References

• Ajo, R., Segura, A., Mira, L., Inda, M. D. M., Alfayate, R., Sánchez-Barbie, A., ... & Peiró, A. M. (2016). The relationship of salivary testosterone and male sexual dysfunction in opioid-associated androgen deficiency (OPIAD). The Aging Male, 1-8.
• Ramsey, S. (2013). Opioids for back pain are linked to increased risk of erectile dysfunction.
• Dean, A., Mungall, W., McKinnell, C., & Sharpe, R. M. (2013). Prostaglandins, masculinization and its disorders: effects of fetal exposure of the rat to the cyclooxygenase inhibitor-indomethacin. PloS one, 8(5), e62556.
• Ray, J. A., Kushnir, M. M., Meikle, A. W., Sindt, J. E., & Strathmann, F. G. (2017). An Exploratory Study Evaluating The Impact Of Opioid And Non‐Opioid Pain Medications On Serum/Plasma Free Testosterone And Free Estradiol Concentrations. Drug Testing and Analysis.