Sexual dysfunction, infertility, uterine ruptures and birth defects are among the more notable of the serious reproductive and congenital health conditions that can be induced by pharmaceuticals. Yet clinical research in many of these areas can be difficult to conduct.
The incidence of sexual dysfunction, for instance, is difficult to quantify because patients are frequently unwilling to raise sexual health concerns with health professionals. As sexual health issues become less taboo, on the other hand, under-reporting of sexual health problems is becoming less of a problem.
Research into the extent to which certain drugs can cause birth defects can pose controversial ethical dilemmas. But better tracking by the US Food and Drug Administration (FDA) of possible problems with drugs used by women who are pregnant or breast feeding, has allowed for progress in this area as well.
Despite the research challenges imposed by the sensitivities involved in these areas, and despite the need for more research to be done, our understanding of how medications affect reproductive and congenital health has improved significantly in recent years:
- Sexual dysfunction – although not life threatening, sexual dysfunction can have a major impact on quality of life and the ability to conceive. Classes of drugs that are particularly of note in causing sexual dysfunction include antidepressants, antipsychotics, and antihypertensives.
- Infertility – in nearly a third of cases, a cause of infertility is not found, and the effects of drugs on infertility are not well understood. In most cases in which it is suspected that drugs contributed to infertility, however, it is most likely due to toxicity of the gonads or of a hormone known to stimulate their activity and development.
- Uterine rupture – uterine rupture can pose a serious health threat or death to both the baby and the mother. The use of drugs intended to induce birth can contribute to an increased risk of uterine rupture, especially during vaginal birth after cesarean section (VBAC).
- Birth defects – while most congenital disorders are hereditary, they can be caused by the use of certain drugs during pregnancy. In some cases, women may have been taking these medications prior to realizing they were pregnant.