Confortably numb

You might’ve noticed on this site we’re very much of the opinion natural is always best. But we’ll admit that sometimes, when you’ve just asked too much of your body, you need to crack the medicine cabinet for help. There are some sprains, strains, breaks and tears where an ice pack, a hot bath or a rain dance just won’t cut it.

Since appearing in the 1960s, over-the-counter anti-inflammatory Ibuprofen has become many people’s chosen get-out-of-pain-free card. Literally millions of us reach for it each year.

Not just athletes or fitness fans who have overdone it either. Ibuprofen is equally used for every day complaints such as headaches, cramps, toothache. Even to calm fevers. It also plays a vital part in the pain management of those with conditions such as arthritis.

Used correctly, Ibuprofen is considered safe, but a new study from Europe suggests prolonged use could spell trouble for our hormones. It may successfully lower our pain levels, but there’s now evidence that it takes our testosterone down with it.

So how worried should we be by this? Maybe the only thing we should be putting in our mouths when we’re in pain is a broken chair leg to bite down on. Just like the good old days.

Me, myself & Ibuprofen

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) available to buy or, in a stronger form, on prescription. It works by blocking production of prostaglandins, which are triggered by the body in response to injury or illness. These cause the pain, swelling and inflammation which we’ve doubtless all been familiar with at one time or another.

A typical dose for adults is around 200-400mg taken every 4 to 6 hours. The max amount, given on prescription is 3200mg a day with medical guidance. While painkilling effects usually kick in immediately, it can take days or weeks to effectively calm any inflammation.

Like any pharmaceutical meds, there are a chance of side effects. Issues with T aside, Ibuprofen may cause stomach upset, nausea and vomiting or dizziness amongst other things.

You should avoid Ibuprofen if you are sensitive to NSAIDs, have had major heart failure or a peptic ulcer. Also use carefully if you have asthma, narrowing of the arteries or any kind of mild heart problem.

Worries for T

The small trial from University of Copenhagen recruited 31 men under 35 years old, from France and Denmark and collected their hormone samples. The men were then split into two groups, with one taking 600mg of Ibuprofen twice a day and the other taking a placebo.

1200mg is quite a high amount not normally seen in day to day use. In cases of sports rehab and chronic pain though, it’s not unusual to be given this much or higher.

As early as two weeks into the experiment, scientists saw the T levels of men taking the drug drop in line with the amount of Ibuprofen in their bloodstream growing. Notably though levels of luteinizing hormone – usually a forerunner of T production – did rise. This lack of normal conversion suggests a problem in the testicles.

This drop resulted in the 14 men who were taking Ibuprofen developing compensatory hypogonadism (a milder form of full blown hypogonadism, aka clinically low T).  Such an imbalance can cause poor fertility, depression and a higher instance of heart attack and stroke.

Lead author Bernard Jégou:

“We normally see this condition in elderly men, so it raises an alarm. We are concerned about it, particularly for healthy people who don’t need to take these drugs. The risk is greater than the benefit.

Happily however, their levels returned to normal after the study. The real worry then is probably for people with long term issues, such as arthritis, who use Ibuprofen more often or rely on it indefinitely. Co-author, David Møbjerg Kristensen explains,

“Our immediate concern is for the fertility of men who use these drugs for a long time. These compounds are good painkillers, but a certain amount of people in society use them without thinking of them as proper medicines.”

Recently research found that low T is a fairly common feature in arthritis. It’s possible the use of pain medication has a role to play in that.

Global problem

This is just one smaller piece in what some are calling a crisis of male fertility. An analysis from late 2017 for example, which looked at 185 studies, involving nearly 43,000 men from 1973 to 2011, reported a 52% decline in sperm concentration and a 59% decline in total sperm count.

A separate 2015 work on infertility around the globe also found that men were solely to blame in 20 to 30% of cases and at least partly responsible in half of cases.

There are different theories why this is. Poor diet, lazy lifestyle, air pollution, snug briefs putting the squeeze on us, laptops slowly microwaving our spuds. Whatever the reason, heathy T is key to good fertility so any steps we can take to naturally improve it are well worth it.

Abstain in pain?

So far this is only one small study. It’s far too early to draw any solid conclusions. So despite what we’ve read here, if you have a condition which means you rely on Ibuprofen for pain free mobility, you should absolutely not stop taking it until we know a lot more.

The people Jégou and Co trying to warn are those of us who reach for Ibuprofen for anything. If you stub your toe, or think you might, possibly have a headache coming on, maybe. There are certain types of fleeting, non-serious pain that we could just tough out for the good of our T.

That said, don’t be a hero. If you have a painful injury, Ibuprofen might suppress T while you’re healing, but it’ll bounce back.

One of the worse things for male hormone is lack of sleep, so you’re either going to reduce your levels briefly with well-deserved with pain relief or drive everyone else’s down with your constant, round the clock screaming. Take one (every 4 to 6 hours) for the team.


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