How antidepressants affect women’s fertility
One in every ten adults in America report taking a prescription drug for problems with emotions, nerves or mental health, the highest rate of use in the western world. While well-intentioned doctors prescribe these medications to help patients, little attention is paid to the impact these drugs have on a woman’s fertility and overall health.
It is crucial for women to understand the impact psychiatric drugs have on their reproductive system. Further, they need to be informed on healthy alternatives that preserve or even enhance their natural fertility. The use of fertility awareness charting, which allows a woman to know some of the hidden dysfunctions of her body through the signs of her menstrual cycle, is part of this process of achieving fertility health and healing.
This New York Times editorial reported in 2013 that one in four women are taking psychiatric drugs[i], but up to 2/3 of those taking them do not fit the criteria for major depression disorder as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM5)[ii]. These women may experience symptoms of fatigue, anxiety or depression. Primary care doctors, who originate the highest number of anxiety medication prescriptions, may use these drugs to help patients with a temporary option and allow them some daily life functioning.
Any drug entering the body has an “effect” because the chemicals contained in the drug are designed to alter a believed malfunction occurring within a body part or body system. That is what pharmaceutical drugs are supposed to do, right? But because brain functions control and help balance the performance of other body systems, the effects of these drugs tend to reach beyond the intended outcome.
For instance, we know that anti-depressants and some anti-psychotic drugs interfere with the hormonal regulation of ovulation and a brain-produced hormone called prolactin. A recent study showed that women taking antidepressants also known as selective serotonin reuptake inhibitors (SSRIs) took significantly longer to conceive. SSRIs were shown to reduce the efficacy of infertility treatments and were linked to miscarriage and preterm birth[iii]. Another critical fact for couples who are trying to achieve pregnancy: men using commonly prescribed antidepressants risk sperm damage, to the point that fertilizing an egg becomes impossible[iv].
“Because a woman’s menstrual cycle is tightly controlled by the interaction between the brain, ovaries, and uterus, any health problem or medication that disrupts this communication could adversely affect ovulation and make it challenging for women to achieve a pregnancy,” explains Alan Copperman, M.D., director of reproductive endocrinology at the Icahn School of Medicine at Mount Sinai in New York City, in an article for Parents.com.
Fertility awareness based methods (FABMs) of charting the menstrual cycle offer important benefits for women who experience emotional or mental health symptoms and want to preserve their fertility. FABMs teach a woman to recognize simple biomarkers of her body so that she can know the distinct stages of her cycles.
First, FABMs can be used instead of hormonal birth control, which is now proven to increase the risk of depression among women who use them. Second, FABMs can help understand hormonal imbalance that can be at the root of the emotional or psychological symptoms, such as depression, PMS or low energy. Finally, FABMs help couples to achieve or space pregnancies more naturally and in an emotionally more fulfilling way.
So, why take any of the risk of the side-effects caused by psychiatric drugs? We have many other proven ways to evaluate and treat anxiety, depression and other mild to moderate emotional/mental conditions that do not require psychiatric drugs. For example, Cognitive Therapy, Talk Therapy, Health Coaching, and Functional & Integrative Medicine are great options for healing as they best understand the body-mind connection, gut-brain relationship and other health imbalances that may be rooted in detrimental diet and lifestyle habits.
While in a few situations, as is the case with severe depression, psychiatric drugs may be a life-saver, I am convinced that too many times psychiatric drugs not only mask other problems, but they have unintended effects. That’s certainly the case with a woman’s fertility. We need to help women have access to more natural options. It starts with education and awareness. In the coming weeks and months, I am going to expand on this topic and explain further how women can get the help they need.
[i] Adult Utilization of Psychiatric Drugs and Differences by Sex, Age, and Race. Thomas J. Moore, et al, JAMA Intern Med. 2017;177(2):274-275
[ii] Antidepressant use and lifetime history of mental disorders in a community sample: results from the Baltimore Epidemiologic Catchment Area Study. J Clin Psychiatry. 2015 Jan;76(1):40-4. doi: 10.4088/JCP.13m08824.
[iii] 1.Human Reproduction. Jan2013, Vol. 28 Issue 1, p160-171. 12p. Author(s): Domar, A.D.; Moragianni, V.A.; Ryley, D.A.; Urato, A.C. link to study: https://www.ncbi.nlm.nih.gov/pubmed/23117129
- Peer review article appearing in the Year Book of Neonatal and Perinatal Medicine 2013, E-Book
[iv] Effects of selective serotonin reuptake inhibitors on sperm and male fertility, Lauren Riggin, MD and Gideon Koren, MD FRCPC FACMT Can Fam Physician. 2015 Jun; 61(6): 529–530. And http://www.foxnews.com/health/2012/02/06/antidepressants-may-cause-infertility-in-males.html