Gay men tend to take certain medications and supplements at higher rates than the general population. Some of those have direct or indirect effects in fertility that future fathers should be aware of!
Most people take daily medications and/or supplements for a multitude of reasons, including treatment of chronic medical conditions, cosmetic reasons, or to boost their health, help with relaxation, or for recreation. Gay men tend to use medications, supplements and other substances or drugs at higher rates than the general population.
The most commonly used substances in the U.S. and across the world, are alcohol and tobacco. While both are used very widely, gay men use both at higher levels than straight men. This trend is reflected at all levels of use, from casual use to problematic use, or abuse. Many reasons contribute to these facts, but overall there is an established link between acceptance of homosexuality and substance abuse, i.e. the less accepted gay men feel by their families, their society and even themselves, the more they smoke and drink. This varies by age, location, socioeconomic status, etc. For example, younger gay males may drink at higher rates before coming out, to alleviate some of the psychological stress they feel from lack of support by family and friends who may not be aware of their struggle. Lower socioeconomic status men may drink more and in more unhealthy ways, like binge drinking, than wealthier gay men who may drink socially. Heavy alcohol consumption (more than 15 drinks per week) is known to directly impact sperm in multiple ways: first, it can lower testosterone and raise estrogen levels, each of which reduces sperm production, with the combination of both having a more pronounced effect. Second, it can affect the testes and cause impotence or infertility. Third, it can affect ejaculation and reduce the quality of the sperm. Thankfully the effects of heavy drinking can be reversed in as little as 3 months, if alcohol consumption is stopped or significantly reduced. Similar issues are faced by men who smoke heavily. Tobacco can lead to lower sperm concentration, abnormal sperm shape and reduced motility (movement). Smoking is also associated with higher incidence of erectile dysfunction. Again, studies have shown that it only takes a few months after smoking cessation to mostly recover sperm function.
Hormone replacement therapy or supplementation can also have a negative effect on sperm health. Many gay men, especially middle-aged and older men, take testosterone in many forms, like injectables, gels, patches or even implantable pellets, to improve their sex drive and performance, and to maintain their physique. Although testosterone is crucial in sperm production, exogenous testosterone (i.e. testosterone therapy – not the body’s own testosterone) can affect other hormones which play a key role in sperm production and lead to lower sperm production, with a negative effect for fertility. Other anabolic steroids can have a similar effect. The effects of these drugs may not be fully reversible depending on age and duration of use.
As is the case with alcohol and tobacco, gay men tend to use recreational drugs at higher rates than straight men, for similar reasons. Among them, cocaine and marijuana are known to decrease sperm production and the quality of the sperm. Hard drugs that are an increasingly common problem among gay men, like methamphetamine, also have a negative effect on sperm count and physiology, and can lead to lower fertility or infertility.
While some of the medications, drugs or supplements mentioned above are well known to reduce sperm counts and quality, and potentially cause or contribute to infertility, others may not immediately strike one as potentially causing problems. In most cases, removing the substance from one’s daily routine can fully reverse the negative effect in a matter of months. It is very important, therefore, to speak to a doctor about all medications and supplements you may be taking, and to be honest about alcohol consumption, smoking, and even recreational drug consumption. Then, it’ll be easier to identify the source of any potential problems at the earliest stage possible, remove that source and make sure that the highest quality and quantity of sperm will be available to use for having children!