Non steroidal anti‐inflammatory drug use and levels of oestrogens and androgens in men

Abstract

Objective Studies suggest that regular use of non-steroidal anti-inflammatory drugs (NSAIDs) may lower estrogen levels in women. However, no large, population-based studies have assessed NSAID/hormone associations in men. Our objective was to examine the association between use of prescription and over-the-counter NSAIDs and levels of estrogens and androgens in men. Design The Boston Area Community Health Survey, an observational survey with initial data collection in 2002–2005. Patients 1,766 men who provided a blood sample and data on recent analgesic use. Measurements Adjusted geometric mean levels of androgens, estrogens, SHBG, LH, and FSH for each category of NSAID use and the percent difference in hormone levels for users vs. non-users. Results There was no significant association between prescription or over-the-counter NSAID use and any hormone examined after adjustment for potential confounders. For example, geometric mean testosterone levels were 13.8, 13.6, and 14.2 nmol/L in non-users, prescription, and over-the-counter NSAID users, respectively; the corresponding levels for estradiol were 80.3, 70.4, and 79.9 pmol/L. In stratified analyses, however, prescription NSAID use was associated with lower testosterone, estradiol, and estrone levels in obese men and lower testosterone and dehydroepiandrosterone sulfate levels in inactive men. Conclusions While overall these data do not provide strong support for an association between NSAID use and hormone levels in men, prescription NSAIDs may decrease levels of certain estrogens and androgens in obese and inactive men.

Identification of Drug-Induced Myocardial Infarction-Related Protein Targets through the Prediction of Drug–Target Interactions and Analysis of Biological Processes

“…Other targets in the “medium” category are involved in the following processes and conditions, the disruption of which can increase atherogenesis and risk of thrombosis and MI: hypertension, insulin secretion, , and changes of steroid hormones blood levels. , We found some evidence supporting the relationship between NSAID intake and disruption of these processes in the literature. It is known that NSAIDs decrease the blood level of estrogens in postmenopausal women and the levels of estrogens and androgens in obese and inactive men . Decreased blood levels of estrogens and androgens are associated with increased MI risk .…”

“…It is known that NSAIDs decrease the blood level of estrogens in postmenopausal women and the levels of estrogens and androgens in obese and inactive men. 155 Decreased blood levels of estrogens and androgens are associated with increased MI risk. 66 Some NSAIDs, such as indomethacin and ibuprofen, are associated with glucose 156 and insulin level changes.…”

Cohort profile: the Swedish Prescribed Drugs and Health Cohort (SPREDH)

“…First, we included medications which are known antagonists and modulators of sex hormones and widely used to treat sex hormone-related disorders or diseases in sex hormone dependent organs, that is, (1) sex hormones and modulators of the genital system, (2) drugs used against benign prostatic hypertrophy and (3) hormones, hormone antagonists, and related agents in antineoplastic and immuno-modulating therapy. Second, we selected a group of medications not usually prescribed for treating sex hormone related disease, but known to have substantial effects on sex hormone levels and fertility, including (1) metformin,13 (2) spironolactone,14 (3) statins,15 (4) non-steroidal anti-inflammatory drugs16 and (5) H2-receptor antagonists 17. Third, for comparison purposes, we also included drugs for similar medical indications as the second category, but without any influence on sex hormone levels, that is, (1) medications in the treatment of diabetes other than metformin, (2) diuretics other than spironolactone, (3) lipid modifying agents other than statins, (4) other anti-inflammatory agents, analgesics and platelet aggregation inhibitors and (5) other drugs for peptic ulcer and gastro-oesophageal reflux disease.…”