Use of paracetamol (acetaminophen) as a non-prescription analgesic and semen quality in young men - a cross-sectional study

Tidsskriftartikel - 2022


BACKGROUND: Paracetamol (acetaminophen) is a frequently used non-prescription analgesic with suggested endocrine disrupting properties. Epidemiological evidence on the effect of paracetamol on male fecundity is sparse.

OBJECTIVES: To investigate if use of paracetamol as an oral non-prescription mild analgesic was associated with semen quality in young men.

MATERIALS AND METHODS: This cross-sectional study was based on data from the Fetal Programming of Semen Quality (FEPOS; 2017-2019) cohort of 1,058 young men (18-21 years) included in the Danish National Birth Cohort. Participants completed a comprehensive online questionnaire on health behavior including analgesic use and provided a semen sample. Negative binomial regression models were used to estimate the percentage differences (adjusted mean ratios (aMR)) in semen quality characteristics according to paracetamol use (no; yes) and frequency of use (Almost never; <1/month; ≥1/month; ≥1/week).

RESULTS: In total, 28% of the 913 participants with available data reported use of paracetamol within the last six months. We found a slightly higher total sperm count (aMR 1.13 95% CI (0.99;1.30)) in users compared to non-users but other semen characteristics were unaffected. The frequency of use was suggestive of lower total sperm count and morphologically normal sperm cells primarily among users ≥1/week, however, CIs were wide.

DISCUSSION: We were unable to account for the underlying reason for paracetamol use, which may induce confounding by indication. Exposure misclassification due to recall is likely but probably non-differential due to the participants' young age and unawareness of semen quality. Due to the rapid plasma half-life of paracetamol and few frequent users, it was not possible to conclude on potential high-dose effects.

CONCLUSION: Our findings do not suggest any strong detrimental effect of paracetamol use on semen quality within this sample of young Danish men. However, effects of high-dose and frequent use cannot be excluded. This article is protected by copyright. All rights reserved.


Østergaard CS, Ernst A, Gaml-Sørensen A, Brix N, Toft G, Haervig KK, Hougaard KS, Bonde JP, Tøttenborg SS, Ramlau-Hansen CH. Use of paracetamol (acetaminophen) as a non-prescription analgesic and semen quality in young men - a cross-sectional study. Andrology 2022;10(3):495-504.
doi: 10.1111/andr.13129

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