Men and women may experience significant impairment in fertility from using prescription or illicit drugs.

Drug misuse can negatively impact fertility, especially in women. In fact, drug and alcohol use is a major cause of infertility in both women and men.

Drug misuse can directly affect fertility by acting on the body systems that are responsible for reproduction. It also has an indirect effect, due to how drug use and addiction can affect health and lifestyle. Besides affecting fertility, drug use can have negative effects once pregnancy does occur.

Drugs, including nicotine, can have serious adverse effects on the pregnancy and on the baby. These negative effects are most likely to happen during the first three months of the pregnancy when the woman might not even realize that she is pregnant. This is a serious problem, given that the unintended pregnancy rate for women with opioid addiction is as high as 86%.

Substance use disorders are screened for and detectable by routine lab tests in pregnant women. If drug use is detected, these results are reported to child welfare services authorities over concerns for the welfare of the child. Children are two to 13 times more likely to be abused when a parent has a substance use disorder, so there are serious concerns about the parent’s ability to provide a safe and healthy home environment. The baby may be removed from their custody at birth because of these concerns.

How Drugs Affect Women’s Fertility

Female fertility is especially susceptible to disruption and many drugs can disrupt the proper function of the processes involved in conception. With men, it comes down to whether or not they produce viable sperm. With women, however, many factors and systems that must be working properly, such as:

  • Hormone production – multiple hormones from multiple glands (thyroid, pituitary, hypothalamus, adrenals, and ovaries)
  • Menstrual cycles
  • Ovulation
  • The reproductive tract, including the cervix, uterus and fallopian tubes

Even legal drugs can affect fertility in women. In one study, alcohol use was found to decrease women’s fertility by more than 50% and this effect was magnified if they also used caffeine. Even in women who didn’t drink alcohol, consuming the caffeine equivalent of more than one cup of coffee per day was found to reduce the ability to conceive.

In addition, tobacco thickens cervical mucus and blocks sperm from reaching the egg. Tobacco use in women has been shown to delay pregnancy by more than a year on average and cuts the chances of conceiving by more than half.

Data from the U.S. National Survey on Drug Use and Health shows that 55% of women of childbearing age drink alcohol, 23% smoke cigarettes and 10% use illicit drugs. Further, 10% of pregnant women drink alcohol, 15% smoke cigarettes and 5% use illicit substances.

Illicit Drugs and Women’s Fertility

Illicit drugs affect women’s fertility in a variety of different ways. For women who use more than one of these drugs (such as someone who smokes, drinks alcohol and uses marijuana), the effects can add up:

  • Cannabis disrupts the menstrual cycle and decreases ovulation
  • Stimulants, such as cocaine and crystal meth, cause adverse effects at most levels of the reproductive system and cause a high rate of miscarriages
  • Opioids disrupt pituitary and hypothalamus hormone production, causing menstrual irregularities and halting ovulation

Drug misuse is also associated with risky sexual behavior, which can cause unwanted pregnancies. Risky sexual behavior may also lead to sexually transmitted infections that can result in infertility, including pelvic inflammatory disease.

Drug use can also lead to weight loss, poor nutrition, sleep disruption and general physical deconditioning. Each of these side effects can interrupt menstrual cycles and ovulation.

Prescription Drugs and Women’s Fertility

A large number of prescription medications can affect female fertility. These include thyroid medications and medications for mental health disorders. Women who are planning to get pregnant should discuss their medications with their physician.

Many prescription drugs are also misused substances, and they can have serious consequences on the ability to get pregnant, the pregnancy itself and the health of the baby. Commonly misused prescription drugs include opioids (pain medication), stimulants (medication for conditions such as attention deficit disorder) and other psychotropics (medication that affects the brain’s chemistry). Prescribed medications are frequently the “gateway” to addiction and illicit drug use.

How Drugs Affect Men’s Fertility

Infertility in men is much less complicated than it is in women, and it’s often related to sperm production. Drugs can affect the natural production of the male sex hormone testosterone, which negatively affects sperm production. Male fertility may also be affected by erectile dysfunction and the loss of sex drive caused by drug use, as well as the unhealthy lifestyle that often accompanies drug use.

Legal drugs are especially harmful to male fertility. Sperm function is 22% poorer in tobacco smokers compared to non-smokers. In addition, drinking more than 14 ounces of alcohol per week can cut natural testosterone production and increase female hormone (estrogen) levels in males. This reduces sperm production, erectile function, and sex drive.

Illicit Drugs and Men’s Fertility

A number of drugs can have a negative effect on a man’s ability to father a child. Substance use lowers production of testosterone, which negatively affects sex drive, healthy sperm production, and erectile function. About one-quarter of men under age 35 use illicit drugs, including:

  • Anabolic steroids: Steroids are used for enhancing muscle building and have many adverse health effects, including blocking healthy sperm production
  • Stimulants: Stimulants are associated with reduced sperm production and can also cause lifestyle behaviors that reduce fertility
  • Cannabis: Cannabis decreases sperm production
  • Opioids: More than half of opioid users have deficient ability to produce viable sperm

Prescription Drugs and Men’s Fertility

A number of prescription medications can interfere with male fertility, many of which are themselves potential drugs of misuse. These include prescription opioid pain medications, stimulants and psychotropic medications for mental health disorders.

If you or someone you care about has an alcohol or drug addiction and would like help, please call The Recovery Village to confidentially discuss your concerns with one of our trained addiction professionals.

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Editor – Jonathan Strum
Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more
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Medically Reviewed By – Dr. Andrew Proulx, MD
Andrew Proulx holds a Bachelor of Science in Chemistry, an MD from Queen's University, and has completed post-graduate studies in medicine. He practiced as a primary care physician from 2001 to 2016 in general practice and in the ER. Read more

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Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.