Table 2.

Medications that can suppress fertility in men

Medication Class	Examples	Mechanism
GnRH agonists/antagonists	Leuprolide, goserelin	Suppression of gonadotropins
Androgens	Testosterone, nandrolone	Suppression of gonadotropins
Anti-androgens	Ketoconazole, spironolactone, flutamide	Inhibition of testosterone biosynthesis or binding
5α reductase inhibitors	Finasteride, dutasteride	Inhibition of DHT synthesis from testosterone
Opiates	Morphine, methadone	Suppression of gonadotropins
Estrogens	Estradiol, lavender bath oils	Suppression of gonadotropins
Antipsychotics	Chlorpromazine, risperidone	Elevation of prolactin, leading to suppression of gonadotropins
Alpha antagonists	Tamsulosin, silodosin	Retrograde ejaculation
Glucocortocoids	Prednisone, dexamethasone	Suppression of hypothalamus and gonadotropin secretion
Cannabinoids	tetrahydrocannabinol	Possible anti-motility effect
Antidepressants (possible)	Citalopram	Possible direct effect on spermatogenesis
Chemotherapeutics and antimetabolites	Cisplatin, cyclophosphamide, vinblastine, methotrexate	Direct effect on spermatogenesis