How Medications Can Affect Testosterone Levels

By Mandy Armitage, MD

If you’ve been reading about low testosterone, you probably already know that it can affect your body composition, bone health, and energy levels, among other things. You’re probably also aware that testosterone levels decrease as men age. But here’s something that may surprise you: medications can interfere with testosterone, too. 

The process hasn’t been well understood to date, but just recently, a new study out of the University of Virginia Health System may have uncovered a critical piece of this puzzle. Namely, testosterone appears to bind to a protein called serum albumin, which allows it to be carried through the body. Because many common drugs seem to bind to albumin in the same way, this could potentially lead to competition for transport in the bloodstream and thereby lower the total amount of testosterone in the body. 

Research is ongoing, and doctors don’t have all the answers yet, but it’s an important issue to be aware of. Here's a list of common medications to have on your radar.

  • Opioids

    • A large study in 2015 of hundreds of men across the US found lower testosterone levels in individuals who had recently taken opioid pain medication when compared with those who had not taken opioids. This effect seemed to be exaggerated in participants with other medical issues. 

  • Statins 

    • While these cholesterol-lowering medications are important to cardiovascular health, they may also lower testosterone. Researchers think this is because cholesterol is a building block for testosterone production. In other words, decreased availability of cholesterol means less testosterone can be produced. 

  • Antidepressants 

    • A large review of studies was performed to evaluate how some (though not all) selective serotonin reuptake inhibitors affect fertility. (Also known as SSRIs, these are a common class of antidepressant and anti-anxiety medication.) The research showed lower testosterone levels in those who received certain SSRIs than those who did not.

  • Chemotherapy

    • Low testosterone is found in 40% to 90% of people with cancer, and the prevalence increases with age. This is thought to be due to inflammation related to either the cancer, the treatments (such as chemotherapy or steroids), or both. 

  • Ibuprofen

    • A 2018 study suggested that ibuprofen may affect testosterone production in the testes. Participants were given large doses of ibuprofen for six weeks. This time frame is longer than recommended, but considering how common ibuprofen use is, the outcome is worth knowing about.

So What Do I Do?

If you have low testosterone (or suspect you do), and you’re taking medication(s), talk to your prescribing doctor. Get tested for low testosterone! Each situation is different, and there’s no one right answer for everyone. But there may be alternative medications available or other types of treatment options. It’s up to you and your doctor to decide the appropriate course of action based on your health goals. 

Contact Vault today if you want to learn more about low testosterone. Men’s health is our priority, and we can help to identify and treat low testosterone.

This article was reviewed by Aaron Grotas, MD

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