What Are the Effects of Glucocorticoids on Fertility?
Jul 13, 2022
Source: Cainiu Health
Dr. Pan Yongyuan
Introduction
Long-term use of glucocorticoids—such as cortisol and prednisone—can suppress the hypothalamic-pituitary-adrenal (or gonadal) axis, leading to erectile dysfunction, decreased libido, and reduced sperm production in men; it may also impair sexual function and cause infertility. In women, such use may result in adrenal cortical insufficiency—or even atrophy—menstrual cessation (amenorrhea), and infertility.
Glucocorticoids themselves do not directly impair fertility. Short-term, low-dose use generally has no significant effect on reproductive function. However, prolonged use—spanning several months or years—may adversely affect fertility. A detailed analysis follows:
Effects on male fertility:
Long-term use of glucocorticoids—such as cortisone and prednisone—can suppress the hypothalamic-pituitary-adrenal (or gonadal) axis, leading to erectile dysfunction, decreased libido, and reduced sperm production. Such suppression may also impair sexual function and contribute to infertility.
Effects on female fertility:
In women, glucocorticoid therapy may cause adrenal cortical insufficiency—or even atrophy—resulting in amenorrhea and subsequent infertility. Therefore, women receiving high-dose glucocorticoid treatment should avoid pregnancy, and pregnant women must use glucocorticoids with caution.
Commonly used clinical glucocorticoids include prednisone, methylprednisolone, betamethasone, beclomethasone dipropionate, prednisolone, hydrocortisone, and dexamethasone. While short-term, high-dose administration is effective for alleviating acute symptoms, long-term use may lead to adverse effects including central obesity (manifesting as “moon face” and “buffalo hump”), acne, hirsutism, muscle atrophy and weakness, osteoporosis, avascular necrosis of the femoral head, and psychiatric symptoms. Accordingly, glucocorticoid therapy must be administered under the guidance of a qualified physician.
