Non-steroidal anti-inflammatory drugs (NSAIDs) may inhibit ovulation after just 10 days
Short-term use of over-the-counter drugs could negatively impact fertility, according to a small study presented at the European League Against Rheumatism Annual Congress.
A total of 39 nine women of childbearing age who have back pain took part in the study, and received diclofenac (100mg once daily), naproxen (500mg twice daily) and etoricoxib (90mg once daily) or placebo. Treatment was given for 10 days from day 10 of the onset of the menstrual cycle. Progesterone level and follicle diameter were conducted via blood sample and ultra sonsography.
At the end of the NSAID treatment period, the dominant follicle remained unruptured in 75%, 25% and 33% of women receiving diclofenac, naproxen and etoricoxib respectively. Rupturing of the dominant follicle and subsequent release of an egg, is essential for ovulation to occur.
So diclofenac, naproxen and etoricoxib were found to significantly inhibit ovulation in women with mild musculoskeletal pain. Of the women receiving NSAIDs only 6.3% (diclofenac), 25% (naproxen) and 27.3% (etoricoxib) ovulated, compared with 100% of the control group.
These findings suggest that readily available NSAIDs could have a harmful effect on fertility, and should be used with caution in women wishing to start a family.
NSAIDs are among the most commonly used drugs worldwide, and are taken by over 30 million people every day. Available without prescription, NSAIDS are largely used for the treatment of pain, inflammation and fever, all common features of rheumatic conditions.
“After just 10 days of treatment we saw a significant decrease in progesterone, a hormone essential for ovulation, across all treatment groups, as well as functional cysts in one third of patients,” explains study investigator Prof Sami Salman. “These findings show that even short-term use of these popular, over-the-counter drugs could have a significant impact on a women’s ability to have children. This needs to be better communicated to patients with rheumatic diseases, who may take these drugs on a regular basis with little awareness of the impact.”
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Image credit: Jens Bergander
