Painkillers and Testosterone: Ibuprofen, Aspirin & Co.

By Ali Kuoppala | Last reviewed Tue 25 September 2018

Medical Review by Dr. Stefano Pizzo, MD

In this day and age, painkillers from mild to super strong, are being popped like candy. This is not good, especially when there’s some evidence suggesting that certain types of painkillers can significantly lower your testosterone levels.

Have a slight headache? Pop a pill! Fever? Pop lots of pills! Thinking you might be catching something? Take few to be on the safe side!

Sure there’s a legitimate reason for the existence of painkiller drugs, but taking them for nearly every little aching joint, or minor headache, or as a preventive measure is pretty dumb. Every drug has some side effects, especially when taken for longer periods of time, and unfortunately painkillers are not an exception. Of course, as in everything, the dose makes the poison…

…Which is why you should be cautious about the kind of painkillers you’re using, the duration, and if the use is actually damaging your health just for the sake of short-term pain relief:

Painkillers and Testosterone

opiates can increase DHTThe drug industry is massive, and as you might guess, there are painkillers of all kinds around the market. Some require a prescription, some are available over-the-counter.

For the sake of clarity (and not to make this article incredible lengthy and boring) we’ll focus on the research that is available on the 3 most common types of painkillers…

…Including the types of:

  • NSAID’s (non-steroidal anti-inflammatory drugs) such as: aspirin, paracetamol, ibupofein, and naproxen.
  • Opioids (opiate-based drugs) such as: codeine, hydrocodone, hydromorphone, oxycodone, and morphine.
  • Corticosteroids (steroid-based drugs) such as: hydrocortisone, dexamethasone, fludrocortisone, etc.

NSAID’s, aka. your everyday over-the-counter painkillers (the most used and abused) work by inhibiting the production of the enzymes that signal pain in the body (prostaglandins and thromboxanes).

There’s research suggesting that short-term use of a broad range of over-the counter NSAID’s (ibuprofein, aspirin, naproxen, etc) is not going to lower your testosterone levels, whereas the use of prescription NSAID’s can have a significant T suppressing effect (averaging at -19% for total-T and 18% for free-T). Unfortunately the study does not include the names of those prescription non-steroidal anti-inflammatory painkillers.

One study on aspirin showed that moderate doses of the drug can reduce sperm motility in men without having significant effects on testosterone production. In a rodent study, a moderate dose of aspirin given to male rats for 30 days first increased testosterone levels during the first 15 days, but after that produced a reverse effect (lowered testosterone) for the remaining 15 days.

Opioids (opiate-based drugs) which tend to be much “stronger” painkillers, are well known for having a testosterone lowering effect. In this study, 74% of the men who used long-acting opioid painkillers had clinically low testosterone levels, whereas 34% of the guys on short-acting opioids had the same problem. Similar results were seen in this study of 54 male subjects. In a study that only had six male subjects receiving spinal injections of opioids for back pain, all of the subjects were found to have clinically low T.

It’s not completely understood why opioids lower testosterone levels, but at least one mechanism is the inhibition of the gonadotropin secretion (LH and FSH) from the brain. Conversely opiate-antagonist drugs that work in a reverse manner to opioids, have been found to increase testosterone levels.

Corticosteroids are used for a variety of ailments, but for pain relief, they’re most common among people with chronic joint pain or inflammation. The corticosteroids used as painkillers are synthetically made steroid hormones, similar to the ones that your body makes naturally, most commonly its the principal stress hormone; cortisol (hydrocortisone, etc).

Since high cortisol in itself is directly linked to lowered testosterone levels, it’s only natural to believe that synthetic corticosteroids – such as the hydrocortisone – would also have a testosterone lowering effect. Research seems to indicate this too. In a study of 35 male subjects using long-term inhaled corticosteroids, a trend towards lowered testosterone levels (-18%) was noted. Another study with 17 male subjects using corticosteroids for chronic inflammation, found out that corticosteroid therapy causes significant reductions in total- and free-testosterone levels.

NOTE: This is not medical advice, and none of the claims made here have been evaluated by the FDA.


As a person who suffered from terrible migraine headaches as a kid, I know that working painkiller medication can be life changing, and I have tremendous respect for the people who have invented them…

…But with that being said, mindlessly popping painkillers for any small ailment, can drive down your hormones, especially if you do it with inappropriate doses and for long periods of time.

over-the-counter NSAIDs can be considered the safest type of painkillers for T production, whereas strong opiate-based ones seem to be the worst.

Ali Kuoppala

Ali Kuoppala is the founder of Anabolic Men. He has authored and co-authored multiple men's health books and focuses on uncovering the methods of optimizing hormonal health. To date, his articles on various websites have been read more than 15-million times. To read more about Ali, visit his Medium article.