If you regularly take naproxen and have questions about its sexual side effects, you’re not alone. Naproxen is one of the most widely used non-steroidal anti-inflammatory drugs (NSAIDs), with over 30 million users contributing to more than half of the global analgesic market. While it’s commonly used for pain relief, many patients wonder whether it could impact sexual health.
We spoke with Dr. Parra, a leading medical expert, to explore the naproxen side effects sexually and what patients should know. He provided relevant studies and medical data for this article, which has also been reviewed for accuracy.
Q: What is Naproxen (Aleve)?
Dr. Parra answers: Naproxen is an NSAID, non-steroidal anti-inflammatory drug, used widely for relieving pain and inflammation. It’s available over the counter and considered generally safe when taken properly. Naproxen works by blocking an enzyme responsible for producing prostaglandins, the compounds that trigger inflammation and pain.
By lowering inflammation, it also eases pain sensations caused by these inflammatory compounds. But while it’s effective, like all medications, naproxen has potential side effects you should be aware of before long-term use.
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Q: What are the side effects of Naproxen sexually?
Dr. Parra answers: Safety studies on Naproxen indicate that most people taking this medication do not experience major side effects. In one of the earliest safety studies on Naproxen, 83% of participants reported no side effects. Among those who did experience side effects, the most common were:
- Headache, reported by nearly 5% in one of the studies.
- Nausea, reported by 3% of patients.
- Somnolence, also reported by 3% of participants.
Studies show that Naproxen may also lead to more serious side effects, such as stomach ulcers, kidney damage, and heart attack. These effects are increasingly common in patients with pre-existing health conditions or those taking very large doses of the medication for extended periods.
For many decades, the incidence of sexual side effects was considered very low. There was only a single case study about a man who experienced ejaculatory problems after using Naproxen. It involved a 66-year-old man with joint pain who took 250 mg of Naproxen daily and started experiencing difficulty ejaculating despite having proper erectile function. After stopping Naproxen, his ejaculatory problems ceased and reappeared when he agreed to a rechallenge test. Since then, many other articles and books have begun to list Naproxen as a likely cause of ejaculatory problems based on this isolated case. Since this has not been reproduced in more recent literature, we don’t really know if it is true, but there’s a possibility that Naproxen causes ejaculatory dysfunction.
More recently, another group of investigators analyzed data from over 80,000 men and found that NSAIDs in general, including Naproxen, can cause erectile dysfunction when consumed regularly. The increase in prevalence between patients exposed to NSAIDs and those with no exposure to over-the-counter pain relievers was 11%. However, further studies should single out Naproxen and other NSAIDs instead of grouping them all together in this statistic to determine which ones are more likely to cause this problem.
Q: What causes sexual side effects?
Dr. Parra answers: The link between naproxen and erectile dysfunction may stem from its suppression of prostaglandins. These compounds are essential not just for inflammation but also for regulating blood flow, including blood flow to the penis, which is critical for erection.
Naproxen can reduce prostaglandin levels, which may compromise erectile function, especially in men who take high doses or use the drug multiple times daily over extended periods. However, this isn’t always the cause.
Many people using naproxen also suffer from chronic inflammatory conditions, like rheumatoid arthritis, that already raise the risk of sexual dysfunction. In fact, studies show that men with RA are 67% more likely to experience ED, regardless of naproxen use.
Additionally, newer studies suggest that occasional or short-term naproxen use may not significantly impact sexual function. In some cases, the underlying condition or age may be the true culprit, not the drug itself.
Q: How to reduce the side effects of Naproxen?
Dr. Parra answers: Here are my recommendations to minimize naproxen’s side effects:
- Always follow your doctor’s instructions for dosage.
- Don’t exceed 660 mg per day unless specifically told to by your provider.
- Only take it when needed, don’t use it unnecessarily.
- Avoid taking other NSAIDs with naproxen.
- Consume naproxen with food or a light snack.
- Stay well-hydrated to help dilute its effects.
- Avoid alcohol to reduce the risk of blood concentration spikes.
- Take adequate rest if you’re experiencing side effects like headaches.
- Watch for new symptoms, and report them to your doctor if they persist or worsen.
Also, be aware of contraindications. Here’s a helpful breakdown:
Absolute contraindications:
- Allergy to NSAIDs
- NSAID-induced asthma
- Pregnancy (third trimester)
- Heart bypass surgery
Relative contraindications (use with caution):
- Elderly age
- First-trimester pregnancy
- Heart disease
- Hypertension
- GERD or ulcers
- Liver or kidney disease
- Coagulopathy
- Tobacco or alcohol use
- Dehydration
Key FAQs on Naproxen Side Effects Sexually
Q: Can stopping naproxen reverse sexual side effects?
Dr. Parra answers: Yes, stopping Naproxen is likely to reverse any sexual side effects that may arise after using the medication. We can refer to the case study mentioned above, which reported data from a 66-year-old man with joint pain who started taking Naproxen to control his symptoms.
He began experiencing ejaculation problems, but the issue was resolved after discontinuing the medication. It took one week for the ejaculatory problems to resolve completely, and after a rechallenge test in which the patient started to experience ejaculatory issues again, it took another week to resolve the sexual side effects after taking Naproxen.
The NSAIDs study mentioned above did not have a clearance phase to evaluate whether discontinuing Naproxen and other NSAIDs is associated with a complete resolution of erectile dysfunction and other sexual problems. However, there is reason to believe that erectile dysfunction may also resolve because Naproxen does not cause any irreversible damage that might otherwise lead to such issues.
Q: Are there alternative pain relievers with fewer sexual side effects?
Dr. Parra answers: Yes, some pain relievers have fewer sexual side effects, particularly those that are not NSAIDs. For example, acetaminophen is less likely to cause sexual side effects because it doesn’t affect prostaglandin levels like naproxen and other over-the-counter pain relievers do.
However, the study on NSAIDs included acetaminophen along with ibuprofen, naproxen, and other pain relievers. Therefore, we still need more evidence to isolate acetaminophen and confirm that it’s not responsible for the increase in erectile dysfunction problems.
One pain reliever that shows no sexual side effects is nefopam and similar medications. It doesn’t belong to the NSAID category, and there are no studies indicating that nefopam causes sexual side effects. However, this medication is not available over the counter; it requires a prescription to obtain from your local pharmacy.
Q: Can naproxen interfere with testosterone levels?
Dr. Parra answers: Studies on the safety of naproxen typically do not measure hormone levels and focus solely on evaluating the signs and symptoms experienced by patients after consuming the medication. Currently, there are no studies directly measuring naproxen’s association with testosterone levels. However, some research has included NSAIDs as a broader category.
For example, one study on over-the-counter NSAIDs (including naproxen and other medications) indicated that a subgroup of males might have their testosterone levels affected by this drug. While the other subgroups were not impacted, inactive men and those with obesity were more likely to see a reduction in their androgen levels (testosterone and dehydroepiandrosterone) after using NSAIDs. This is an association study, which doesn’t imply a causative link, but it marks progress in identifying a possible connection between NSAIDs as a group and lower testosterone levels.
Although lacking comprehensive data for a definitive conclusion, it is not unreasonable to suggest that naproxen and other NSAIDs might lower testosterone levels. Some studies in mice indicate that naproxen may reduce total sperm count and testis weight in rats when administered before puberty. This effect could stem from a decrease in testosterone levels during puberty, but further data has not addressed the issue, and more research is necessary to determine if these results are applicable to humans.
Q: Do women experience sexual side effects from naproxen too?
Dr. Parra answers: There are no direct reports of sexual side effects in women taking naproxen. In fact, it might seem that the opposite is true because lowering inflammation may increase sexual desire in women, according to some authors.
This occurs because cytokines interact with neuronal receptors, and their interactions with dopamine and other neurotransmitters reduce sexual interest in women when inflammation is present. However, chronic use of NSAIDs as a group may lower sexual hormone levels in postmenopausal women, according to studies.
Similar findings have been observed in premenopausal women, and animal trials indicate that ovulation can be affected by such reductions. However, these results have not been reproduced in clinical trials, and more data is required before concluding that naproxen and other NSAIDs affect ovulation and cause infertility in women.
Q: Could naproxen affect fertility?
Dr. Parra answers: Some studies suggest that naproxen and other NSAIDs affect fertility in both men and women. However, there are no large clinical trials that support this notion with strong evidence, and more studies are required to determine whether these effects are also present in humans.
For instance, one study in male rats showed that administering NSAIDs before puberty resulted in smaller testes with decreased weight, and their sperm count was reduced. This may be due to a reduction in testosterone levels during the stage of sexual growth of the male gonads. However, no evidence of similar effects has been found in humans as of now, but this is sufficient reason to recommend limiting NSAID use before puberty and for male patients trying to conceive.
Another study in female rats demonstrates a reduction in ovulation during the follicular phase. In this stage of ovulation, a group of follicles grows under the stimulation of sexual hormones until one of them matures and releases an egg. This process does not occur in mice exposed to NSAIDs, which is why chronic use of NSAIDs is not recommended for women who want to conceive.
Conclusion
Like many medications, naproxen carries some risk of adverse effects, especially if taken frequently or in high doses. While naproxen side effects sexually, such as erectile dysfunction, are not as common, they can occur, particularly in long-term users or those with underlying health conditions.
If you’re concerned about these side effects, talk to your doctor and consider alternatives. Taking naproxen responsibly, only when needed, and avoiding other NSAIDs can go a long way toward reducing potential risks.
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