June 24, 2015
NSAIDs Found to Have Detrimental Effect on Young
Women’s Fertility

Rome, Italy—Women trying to get pregnant probably should avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs), according to a new study presented recently at the European League Against Rheumatism Annual Congress 2015.

Researchers from the University of Baghdad in Iraq report that diclofenac, naproxen, and etoricoxib significantly inhibit ovulation in women with mild musculoskeletal pain. In fact, of the women receiving NSAIDs, only 6.3% of those using diclofenac, 25% using naproxen, and 27.3% using etoricoxib experienced ovulation, compared with all of the control group taking no NSAIDs.

“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,” said study investigator Professor Sami Salman, Department of Rheumatology, University of Baghdad, Iraq. “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.”

Effects of NSAIDs on ovulation were studied because of “recent concerns as to their use in females at child bearing age, as many animal studies showed unfavorable effects on ovulation,” according to the presentation abstract. Study authors suggested their findings also potentially could be used to develop emergency contraception with fewer side effects.

The study involved 39 women of childbearing age who suffer from back pain. Participants were given either a placebo or NSAIDs diclofenac (100 mg once daily), naproxen (500 mg twice daily), or etoricoxib (90 mg once daily) from Day 10 of the onset of the menstrual cycle. Progesterone levels were measured using blood samples, while follicle diameter was assessed with ultrasonography.

At the end of the NSAID treatment period, the authors report, the dominant follicle remained unruptured in 75%, 25%, and 33% of patients receiving diclofenac, naproxen, and etoricoxib. Rupturing of the dominant follicle and subsequent release of an oocyte is essential for ovulation to occur, the presenters pointed out.

“These findings highlight the harmful effects NSAIDs may have on fertility,” Salman said, “and could open the door for research into a new emergency contraception with a more favorable safety profile than those currently in use.”

U.S. Pharmacist Social Connect