Which painkillers to choose when you are trying to conceive

Did you know that common over-the-counter painkillers can reduce your ability to get pregnant, cause miscarriages, and lead to severe birth defects in your baby?

Luckily, there are a few safe options, but it’s important to understand the differences between safe and unsafe drugs.

Also, don’t forget that it takes two to make a baby. Painkillers can affect both women’s and men’s fertility, so make sure that both future parents make informed choices about pain treatment.

At the end of this article, you’ll find a few tips for alternative ways to manage pain.

Which type of painkiller?

Most painkillers (analgesics, in medical speak) belong to one of three main categories:

  • Paracetamol
  • Opioids
  • Non-steroidal anti-inflammatory drugs (NSAIDs)

These different types of drugs have quite different properties. This is why some of them are safe to use when you are trying for a baby, while others may have serious negative effects on your fertility. We’ll look at the differences in detail below.

Like other drugs, all painkillers have both generic names and brand names, and it isn’t always easy to figure out which category a given brand belongs to. To further complicate matters, manufacturers may sell identical products under different brand names in different countries.

If you’re currently taking a painkiller and you wonder what kind of drug it is, you’ll find lists of common brand names for all the three categories below.

Paracetamol: The safest option

Paracetamol is the most commonly used painkiller in the world. It’s used to treat mild to moderate pain, and can help reduce fever. However, paracetamol doesn’t have significant anti-inflammatory properties.

At recommended doses, paracetamol is generally considered safe for women who are trying to conceive. It’s even considered safe for pregnant women, although some recent studies have raised concerns about possible negative effects on the baby.

If you must take painkillers while you are trying to conceive, choose paracetamol. Take it only when necessary, at the lowest effective dosage, and for the shortest possible time.

While paracetamol appears not to impact women’s ability to get pregnant, some studies suggest that high doses may have a negative effect on male fertility.

The lead author of one such study stated that there’s no cause for alarm: the paracetamol levels in some men in the study were more consistent with environmental exposure than with taking medication.

In recommended doses and for short periods of time, paracetamol is probably safe for men who want to become fathers, too. But if long-term pain treatment is required, discuss with your doctor whether other options would be preferable.

Paracetamol is considered safe when you are trying to get pregnant

Opioids: Risk of birth defects and fertility issues

Opioids are commonly used in the treatment of moderate to severe pain, both acute and chronic. Opioids block the transmission of pain signals from the body to the brain, and are generally very effective.

Opioids are narcotic drugs, however, and overuse can have very serious side effects.

Taking opioids in early pregnancy can cause important complications, including neural tube defects and congenital heart defects in the baby. It can also cause miscarriage. If you’re currently using opioids, it’s important that you stop taking them before you get pregnant.

Opioids also affect fertility in both sexes. In men, long-term use of opioids reduces testosterone, and therefore the quantity and quality of sperm. Short-term use, for example to control pain for a few days after surgery, is probably safe.

The effect of opioids on female fertility is less understood. However, a recent study of painkiller use and time to pregnancy indicated that women who used opioids had slightly lower fecundability (pregnancy rates) than women who didn’t use painkillers at all.

Combined with the risk of birth defects if taken during pregnancy, this is good reason to stay away from opioids when you are trying to conceive.

By the way, a common side effect of opioid painkillers is reduced libido (sex drive), both in women and in men. Who needs that when you’re in the business of making a baby?

NSAIDs: Risk of miscarriage and reduced fertility

The third type of painkillers, NSAIDs (nonsteroidal anti-inflammatory drugs), are used to treat inflammation, pain and fever. NSAIDs work by reducing the production of prostaglandins, a type of body chemicals. Ibuprofen and Naproxen are examples of widely used NSAIDs.

It’s well known that using nonaspirin NSAIDs during early pregnancy significantly increases the risk of miscarriage, and pregnant women should never self-medicate with NSAID painkillers.

But how about taking them before ovulation, for example to treat menstrual cramps?

Unfortunately, it’s not advisable to use NSAIDs before ovulation either, because they may interfere with ovulation. A 2015 study found “significant inhibition of ovulation” in women who took NSAIDs for just ten days.

In men, Ibuprofen has been linked to a condition called “compensated hypogonadism,” which is associated with reproductive (fertility) disorders.

To reduce the risk of fertility problems, avoid NSAIDs completely … with one possible exception.

The special case of aspirin

Aspirin (acetylsalicylic acid) is one the most widely used drugs in the world. Aspirin is also an NSAID, and it’s not recommended during pregnancy.

However, baby aspirin (very small doses of aspirin) have been found to improve fertility rates in women with chronic inflammation.

We strongly advise against self-medication with baby aspirin — it’s not a miracle fertility drug. But if you know or suspect that you’re suffering from inflammation, you may want to ask your doctor about baby aspirin as a possible treatment option.

Herbal and other natural painkillers: Are they safe?

If you’re trying to adopt a healthy lifestyle to prepare yourself for pregnancy, herbal painkillers or other natural remedies may seem like better alternatives to over-the-counter drugs.

For example, willow bark has been used to alleviate pain for centuries, and it’s still used today to treat headaches, fever and inflammation. Arnica is another popular herbal remedy for inflammation, and it’s also used to treat muscle pains.

Certain essential oils, such as lavender, chamomile, or bergamot, are also considered effective against pain and muscle soreness.

Are essential oils safe for pain relief when you are trying to conceive?

However, “herbal” and “natural” aren’t synonyms for “safe”. Plants can have hundreds of active compounds, and any substance with an effect on your body can also have side effects.

Willow bark, which we just mentioned, contains a chemical (salicin) which is similar to aspirin. Arnica might stimulate uterine contractions, leading to miscarriage or premature delivery.

If you want to try a herbal remedy for pain relief, consult a medical professional for advice before starting any treatment.

Reducing pain through lifestyle changes

Besides avoiding painkillers when possible and choosing paracetamol when it isn’t, what can you do to live as pain-free as possible without compromising your chances for a happy, healthy pregnancy?

One thing to consider is how you might prevent pain, instead of treating it once it’s there. Of course, not all sources of pain can be eliminated, but certain lifestyle and dietary changes can go a long way to helping you feel better.

Here are a few things you can try that are mostly cheap or entirely free, and relatively easy to adopt:

  • Get enough sleep. Sleep deprivation can worsen chronic pain and increase the perception of pain. Try to get at least 7 hours of sleep every night, and ideally a bit more than that.
  • Check your magnesium levels. Magnesium deficiency is extremely common, and can be a contributing factor to both muscle pain and nerve pain. Magnesium is found in beans, nuts and seeds, whole grains, and green leafy vegetables. A magnesium supplement can help restore healthy levels faster.
  • Eat Omega-3 fatty acids. Omega-3 is known to lower inflammation, which may help reduce back pain, joint pain, and menstrual cramps. Canola (rapeseed) oil is an excellent source of Omega-3, as are fatty fish such as salmon, tuna and mackerel. If you’re not fond of any of these foods, you can use an Omega-3 supplement instead.
  • Spice your food with ginger and turmeric. The anti-inflammatory properties of ginger and turmeric are well documented. Ginger has also been found to reduce heavy menstrual bleeding.
  • Eat probiotics. Probiotics are microorganisms (bacteria and yeasts) that live in your body. They’re important for a healthy gut ecosystem, and can help reduce inflammation. Fermented foods such as yogurts, kimchi, and sauerkraut are high in probiotics. You can also take a probiotic supplement.

Summary

We recommend that you reduce your consumption of painkillers to a minimum while you are trying to conceive, and during pregnancy.

A healthy lifestyle with a balanced diet, enough sleep, and regular exercise can help prevent many types of pain.

If you do need to take a painkiller, paracetamol is a reasonably safe option both for women and for men when used in recommended doses and for short periods of time. Long-term use can be associated with reduced fertility, and should be discussed with a medical professional. Opioids and NSAIDs should be avoided altogether.

Herbal or other natural remedies may not be safe to use while you are trying to conceive, and you should seek competent medical advice before taking any such remedies.

Always read the package leaflet of any medication you take. Be proactive when you discuss pain relief with your doctor, and make sure both your doctor and your pharmacist know that you are trying to get pregnant.