Medications That Can Impact Male Fertility: What You Need to Know

Many commonly prescribed medications can affect male fertility—sometimes without patients realizing it. If you and your partner are trying to conceive, it’s essential to understand how certain drugs might influence sperm production, quality, and overall reproductive health.

1. Blood Pressure Medications: Spironolactone

Spironolactone, used to treat high blood pressure and fluid retention, may reduce testosterone levels and impair sperm production. If you're taking this medication and planning to start a family, talk to your doctor about alternative treatments.

2. IBD Medications: Sulfasalazine

Sulfasalazine, prescribed for irritable bowel syndrome (IBS), colitis, and Crohn’s disease, is known to disrupt normal sperm development. Fortunately, mesalamine-based alternatives may offer similar relief without compromising fertility.

3. Gout Treatments: Colchicine and Allopurinol

Both colchicine and allopurinol, commonly used for gout management, can affect sperm’s ability to fertilize an egg. If fertility is a concern, consult with a urologist to evaluate your options.

4. Antibiotics That Affect Sperm Quality

High doses or prolonged use of certain antibiotics—including:

• Tetracyclines

• Gentamicin

• Neomycin

• Erythromycin

• Nitrofurantoin

can lower sperm count, reduce motility, and impair development. These effects are usually reversible once the medication is stopped.

5. Heartburn Medications: Cimetidine vs. Alternatives

Cimetidine (Tagamet), used for acid reflux and ulcers, may cause erectile dysfunction and abnormal semen in some men. Safer alternatives like ranitidine and famotidine do not appear to impact male reproductive health.

6. Immunosuppressants: Cyclosporine

Cyclosporine, used to prevent organ transplant rejection, has been linked to reduced sperm quality and fertility issues. Men on long-term cyclosporine therapy should consider sperm analysis and fertility consultations.

Takeaway: Review Your Medications with a Fertility Expert

If you’re experiencing difficulty conceiving or planning to start a family, reviewing your current medications with a men’s health urologist is a crucial step. At Bastion Health, we offer comprehensive male fertility evaluations from the comfort of your home—including lab testing, expert consults, and personalized treatment plans.

Join Bastion Health for a virtual visit with a male fertility specialist.