Dathe and Schäfer consider the use of clotrimazole and ibuprofen (up to the 28th gestational week) safe during pregnancy (1). This seems questionable.
Clotrimazole is a potent neuroendocrine disruptor, which can affect the synthesis of female sexual hormones. Numerous environmental ecotoxicological studies in amphibians found that sexual maturation and differentiation were impaired as a result of clotrimazole and similar antimycotic drugs (2, 3). When clotrimazole is used vaginally, 3–10% is absorbed. The resultant serum concentrations are far above the clotrimazole levels in the ecotoxicological studies mentioned above.
Furthermore, it is not known at all whether clotrimazole applied vaginally concentrates in the amniotic fluid, entering via the cervical canal. In theory, if 0.001% of the individual vaginal dose of 500 mg is absorbed, relevant concentrations of toxic substances develop in the amniotic fluid. Has this ever been studied?
Similar reservations exist with regard to ibuprofen. A 2018 study (4) implies that this substance can drastically reduce the germ cells of female fetuses in the early developmental stages.
The topic of increases in cases of gender dysphoria and impaired fertility has reached the wider public. These observed phenomena will have many different causes, but medications whose effects go in that direction should definitely not be used in pregnancy under any circumstances.
References
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