Could your pain killers be the reason you're not ovulating?

hormones ovulation ttc
Could your pain killers be the reason you're not ovulating?

Could your painkillers be the reason you’re not ovulating?

Painkillers are a part of a class of drugs called nonsteroidal anti-inflammatory agents (NSAIDs). These medicines reduce inflammation by blocking a group of enzymes called COX. COX enzymes produce hormone-like compounds called prostaglandins which are involved in modulating inflammatory processes.

There are two types of COX enzymes: COX-1 and COX-2. COX-2 is more involved in the female reproductive system and assisting in labor. However, both COX-1 and COX-2 are expressed in the uterine lining and may influence ovulation, fertilization, implantation and early pregnancy growth.

Before ovulation, luteinizing hormone (LH) rises, promoting the production of prostaglandins and other actions. These increased levels of prostaglandin E2 help your follicle rupture so that it can release the egg for fertilization.

NSAIDs reduce the production of prostaglandins that are required for your follicle to rupture, which is essential for a successful ovulation.

The majority of the literature that exists on this topic points to very potent prescription NSAIDs including naproxen, diclofenac and etoricoxib, in some cases reducing ovulation by 93%. However, there is other research that points to high d0s3s of over-the-counter (OTC) NSAIDs like ibuprofen delaying ovulation or stopping it altogether.

Suffice to say, not all inflammation is bad. If you're on potent pain killers and having trouble conceiving, you should talk to your physician.


Not a personal recommendation or medical advice.


Calmels, C. Dubost, J.J. Jasmin-Lebrun, C. Sauvezie, B. (1999). A new case of NSAID-induced infertility. Retrieved from:

Duffy, D.M. Stouffer, R.L. (2002). Follicular administration of a cyclooxygenase inhibitor can prevent oocyte release without alteration of normal luteal function in rhesus monkeys. Retrieved from:

Duffy, D.M. (2015). Novel contraceptive targets to inhibit ovulation: the prostaglandin E2 pathway. Retrieved from:

European League Against Rheumatism. (2015). on-steroidal anti-inflammatory drugs inhibit ovulation after just 10 days. Retrieved from:

Gaytán, M. Morales, C. Bellido, C. Sánchez-Criado, J.E. Gaytán, F. (2006). Effects of selective inhibition of cyclooxygenase and lipooxygenase pathways in follicle rupture and ovulation in the rat. Retrieved from:

Gaytán, M. Morales, C. Bellido, C. Sánchez-Criado, J.E. Gaytán, F. (2006). Non-steroidal anti-inflammatory drugs (NSAIDs) and ovulation: lessons from morphology. Retrieved from:

Kawachiya, S. Matsumoto, T. Bodri, D. Kato, K. Takehara, Y. Kato, O. (2011). Short-term, low-dose, non-steroidal anti-inflammatory drug application diminishes premature ovulation in natural-cycle IVF. Retrieved from:

Micu, M. Micu, R. Ostensen, M. (2011). Luteinized unruptured follicle syndrome increased by inactive disease and selective cyclooxygenase 2 inhibitors in women with inflammatory arthropathies. Retrieved from:

Pomp, E. (2002). [Non-steroidal anti-inflammatory agents and female infertility]. Retrieved from:

Skomsvoll, J.F. Rødevand, E. Koksvik, H.S. Salvesen, K.A. von Düring, V. Rygnestad, T. Østensen, M. (2005). [Reversible infertility from nonsteroidal anti-inflammatory drugs]. Retrieved from:

Stone, S. Khamashta, M.A. Nelson-Piercy, C. (2002). Nonsteroidal anti-inflammatory drugs and reversible female infertility: is there a link?. Retrieved from:

Uhler, M.L. Hsu, J.W. Fisher, S.G. Zinaman, M.J. (2001). The effect of nonsteroidal anti-inflammatory drugs on ovulation: a prospective, randomized clinical trial. Retrieved from:

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Remember: this post is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. While the owner of this website tries to keep the information up to date, there may be things that are out-of-date and out of their control.