Painkillers making women infertile

*’Naproxen, diclofenac significantly inhibit ovulation in just 10 days’
* Why more men are having back pain at younger age 

DOCTORS have warned that drugs regularly taken to alleviate back pain ‘significantly’ reduce a woman’s fertility and men are suffering back pain from an earlier age as fitness standards drop.

Researchers in two separate studies published in DailyMailOnline found that office jobs and lack of exercise mean many men do not have the core muscle strength to properly support their frames even as a group of drugs, known as non-steroidal anti-inflammatory drugs (NSAIDs), ‘significantly inhibit ovulation’.

Chiropractors warned yesterday that the number of patients they see for back pain is rising – and problems are starting at an earlier age. Back pain first hits men at the age of 37 on average, the British Chiropractic Association (BCA) claims – significantly younger than in the past.

According to Wikipedia, a chiropractor is a person who practices chiropractic, specialising in the diagnosis, treatment and prevention of disorders of the neuro-musculoskeletal system and the effects of these disorders on general health.[ Meanwhile, NSAIDs are among the most commonly used drugs worldwide, and are taken by more than 30 million people every day.

Available without prescription, they are largely used for the treatment of pain, inflammation and fever – all common features of conditions involving joint and muscle pain. They include naproxen, diclofenac, ibuprofen and aspirin. According to a new study, medicines regularly taken for joint and muscle pain can reduce a woman’s fertility.

What are non-steroidal anti-inflammatory drugs (NSAIDS)? NSAIDs are a medication widely used to treat a range of conditions. NSAIDs are used to: relieve pain; reduce inflammation (redness and swelling); and bring down a high temperature (fever).

They are used to treat headaches, painful periods, toothache, soft tissue injuries such as sprains and strains and the symptoms of infections, such as the common cold or the flu. They are also prescribed to treat most types of arthritis, including rheumatoid arthritis, other forms of inflammatory arthritis and osteoarthritis, back pain and neck pain.

The researchers analysed the effects of three NSAIDs, diclofenac, naproxen and etoricoxib, on fertility. When taking the drugs, only six to 27 per cent of women ovulated, depending on the type of drug they took.

Doctors said the risk of reduced fertility associated with the drugs, must be communicated to women regularly taking the medication.

And they suggest the drugs could also be researched as a potential contraceptive. Tim Hutchful, a BCA chiropractor who runs a practice in Leicester, said: ‘We are seeing it happen maybe three or four years earlier than in years gone past. ‘The mid-to-late-thirties group are not as active today. People who are in their sixties now had a much, much more active lifestyle when they were in their thirties than the current 30-year-olds.’

A survey of 2,100 British men, commissioned by the BCA, suggests that 82 per cent live with regular neck or back pain. When they carried out a similar survey a year ago, the figure was 75 per cent.

Those who took part in the study were asked the age at which they first suffered back pain, with 37 the average answer. Hutchful said: “People now have lifestyles when part of their life is very sedentary and then another part is manic.

“They might commute to work in their car, they sit on their backsides all day, then play five-a-side football once a week – and that is when the problems happen.” Painkiller study investigator, Prof. Sami Salman, of the University of Baghdad, Iraq, said: “After just ten 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.

“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.” As part of the study, Salman and his team tested three of the most commonly prescribed NSAIDs: diclofenac, naproxen and etoricoxib. They recruited 39 women of childbearing age who suffer from back pain to take part in the study.

The women received diclofenac (100mg once daily), naproxen (500mg twice daily) and etoricoxib (90mg once daily) or a placebo. The drugs were given 10 days after the beginning of their menstrual cycle – the first day of a woman’s period.

Researchers tested whether the women had ovulated by analysing the level of the hormone progesterone, via a blood sample. They also measured the diameter of the dominant follicle, a fluid-filled cavity in the ovaries that contains one undeveloped egg, using ultra sonography – a form of ultrasound.

Rupturing of the dominant follicle, and subsequent release of an oocyte – an unfertilised egg – is essential for ovulation to occur.

Of the women receiving NSAIDs, only 6.3 per cent of those taking diclofenac ovulated, they found. And only 25 per cent of women taking naproxen and 27.3 per cent taking etoricoxib ovulated.

This was compared with 100 per cent of women in the control group, who were not taking medication. Salman concluded: “These findings highlight the harmful effects NSAIDs may have on fertility, and could open the door for research into a new emergency contraception with a more favourable safety profile than those currently in use.”