Medications that can impact male fertility: what you need to know

Many men are unaware that commonly prescribed medications can negatively impact fertility. If you and your partner are trying to conceive, understanding how certain drugs affect sperm production, quality, and reproductive health is crucial. Below, we break down several categories of medications that may affect male fertility—and what to do about it.

1. Blood Pressure Medication: Spironolactone

Spironolactone is a diuretic used to treat high blood pressure and fluid retention. It can reduce testosterone levels and suppress sperm production.

What to do:
If you're taking spironolactone and planning to conceive, talk to your doctor about alternative blood pressure treatments that are more fertility-friendly.

2. IBD Medications: Sulfasalazine

Sulfasalazine, commonly used to manage inflammatory bowel conditions like Crohn’s disease and ulcerative colitis, may interfere with sperm development and function.

What to do:
Mesalamine-based medications may offer a safer alternative without compromising sperm health. Always consult your specialist before switching medications.

3. Gout Treatments: Colchicine and Allopurinol

Medications like colchicine and allopurinol, used for gout management, have been associated with impaired sperm function and reduced fertilization capacity.

What to do:
Men concerned about fertility should speak with a urologist or reproductive health specialist to explore treatment alternatives.

4. Antibiotics That May Affect Sperm Quality

Certain antibiotics—especially in high doses or with prolonged use—can lower sperm count, impair motility, or interfere with normal development. These include:

• Tetracyclines

• Gentamicin

• Neomycin

• Erythromycin

• Nitrofurantoin

What to do:
Fertility effects are typically reversible once antibiotics are stopped. However, if you're undergoing long-term antibiotic therapy, discuss this with your doctor.

5. Heartburn Medications: Cimetidine

Cimetidine (Tagamet), used for acid reflux and ulcers, has been linked to erectile dysfunction and abnormal sperm quality.

What to do:
Fertility-safe alternatives such as famotidine (Pepcid) and ranitidine (if available) are usually recommended. Talk to your doctor about switching.

6. Immunosuppressants: Cyclosporine

Cyclosporine is an immunosuppressant often prescribed following organ transplants. It can significantly affect sperm quality and fertility.

What to do:
If you are on long-term cyclosporine, consider a fertility consultation and a sperm analysis to assess reproductive health.

Don’t Leave Fertility to Chance—Review Your Medications

If you're experiencing fertility challenges or planning to start a family, reviewing your medication list is a smart, proactive step. Even temporary changes can improve your chances of conception.

At Bastion Health, we make it easy to take control of your reproductive health. We offer virtual consultations with men’s health urologists, fertility testing, and personalized treatment plans—all covered through your employer-sponsored benefits.