Sexual Health Q&A

Can prescription medications affect testosterone levels?

Yes, a decrease in testosterone levels can be a side effect of certain prescription medications, such as the following:

  • Ketoconazole (Extina, Nizoral, Ketoderm) is used to treat infections caused by fungi or yeast (e.g., athlete’s foot, yeast infection of the skin, seborrheic dermatitis, or dandruff.) Ketoconazole can be taken as a pill or used as a cream, foam, gel, or shampoo.
  • Cimetidine (Tagamet) is often prescribed to people with ulcers or gastroesophageal reflux disease (GERD). It’s also available in an over-the-counter form to treat heartburn. It comes in tablet and liquid forms.
  • Spironolactone (Aldactone) may be used with other medicines to treat high blood pressure and heart failure. It may also help people who have too much aldosterone, a hormone, or people who have edema (fluid retention) from heart, liver, or kidney disease.
  • Certain antidepressants may lower testosterone levels. A doctor can advise a patient on which antidepressant is most suitable.
  • Chemotherapy drugs have been shown to lower testosterone levels, possibly because they can damage the testes, the organs that produce testosterone in men.

Recent studies have also shed some light on drugs’ effects on testosterone:

  • Opioids are pain relievers like morphine, codeine, hydrocodone (Vicodin), and oxycodone (OxyContin, Percocet).

Opioids are also classified as short-acting or long-acting. Short-acting opioids release medication quickly and are usually taken every four to six hours. In contrast, long-acting opioids release medication slowly and are generally taken every eight to twelve hours.

A recent study published in The Clinical Journal of Pain examined the relationship between opioid length of action and low testosterone (defined as less than or equal to 250 ng/dL). In a group of 81 men, 74% of the participants who took long-acting opioids had low testosterone. For men who took short-acting opioids, the rate was 34%.

The researchers also found that the risk of developing low testosterone was almost 5 times higher for men taking long-acting opioids than for men taking the short-acting kind.

  • Statins are another type of drug that might lower testosterone levels in both men and women. Statins are prescribed to lower cholesterol.

Recently, researchers analyzed a variety of studies to learn more about statins’ effects on testosterone. They found that statins do lower testosterone a bit, but it’s unclear how significant this is for patients. For example, normal testosterone levels for men cover a wide range - 300 ng/dL to 800 ng/dL. So, a decrease may affect one man more than another. More research is needed to investigate the full effects statins may have.

Follow this link for more information on low testosterone, including its symptoms and treatment.