Effects of sulfasalazine on sperm count

porrig Member Posts: 25

I've recently started taking sulfasalazine after coming off methotrexate due to the side effects (it was knocking me out for more than 24 hours on the day I was taking it).

I was told that sulfasalazine will have a negative effect on my sperm count at first, but then the effects will wear off and after a while everything will be normal. I've done some research and all I can find online is that sulfasalazine damages the sperm, making conception difficult whilst taking the drug. I can't find anywhere that it says the effects are temporary whilst I'm still taking the drug.

Will I need to stop taking the sulfsalazine for my sperm count to recover, or will it sort itself out over time? And if it will sort itself out, how long will it be before it is back to normal? Or if i do have to stop taking the drug, how long will that take for it to get back to normal? I'd like to start a family in the next 12 months. I did tell my rheumatologist this when they changed my medication.

Thanks, Michael.


  • Julie37927
    Julie37927 Bots Posts: 35
    edited 30. Nov -1, 00:00

    Many drugs, when first taken are a shock to your systems. After a while the body's reaction settles down and the shock wears off and your body returns to somewhat normal functions. I beleive this is what is going on with sulfasalazine. If you are really worried about it, I believe your sperm can be tested. Not sure if the temporary effect of the drug kills the sperm completely or diminishes their motility (damages their ability to swim). Some of these things can be tested for in the lab. That will probably tell you exactly the state of your sperm and your sperm count. Also, nowadays if you do have a low sperm count there are many, many ways to still conceive successfully. Hope this is helpful.
  • porrig
    porrig Member Posts: 25
    edited 30. Nov -1, 00:00
    Hi Julie,

    Thanks, that does help.

    I may ask my GP if I can have a test after the drugs have had chance to kick in.

    Kind regards,
  • helpline_team
    helpline_team Posts: 3,180
    edited 30. Nov -1, 00:00
    Dear Michael,

    Thank you for your post to Helplines. Fertility and disease modifying drugs is a specialist subject, so we won't be the best people to give you a detailed answer on this, but I'll try to respond and signpost you.

    NHS Choices says ''this medicine may decrease fertility because it affects sperm count. After stopping the medicine fertility usually returns after some time''

    It may be that you may need to hear more from the rheumatology team on this subject until you've made a fully informed choice. What their perspective often is coloured by is the need to keep you well and arthritis under proper control as a number one priority, as it can do damage which can't be undone. If fertility does turn out to be an issue, that they can address it if need be.

    You may want another conversation with the rheumatologist, so that you feel that your perspective has been heard. Would you like an informal chat with us on the phone, just to be listened to? And if you'd like some peer input you might like to post on the 'living with arthritis' forum.

    Kind regards