Preconception Care for Men Includes Complete Medication Review by Compounding Pharmacists
While many couples discuss family planning, preconception care for men is not often at the forefront of the conversation. Of course, people know that the health of the mother matters, especially once she’s pregnant, but many times no one stops to consider the father—until they have a hard time conceiving. It’s understandable because attention has historically focused on women, but in recent years efforts have been made to include men, especially since a variety of factors, such as medication, can affect their fertility. Compounding pharmacists can make a difference to men and their future children by including preconception counseling during medication reviews.
Why Do Men Need Preconception Care?
One of the most compelling reasons to involve men in the discussion regarding preconception care was illustrated in a survey of 1,796 men and 940 women. Many knew that women should avoid cigarettes, alcohol and illegal drugs, which was great, but the good news stopped there, according to the extreme lack of communication demonstrated by the answers to these questions:1
- Did they have a plan for having a baby? Fourteen percent of men said no, while 11 percent of women said yes.
- Did they talk with their partner about when to have a baby? Only 13 percent of men and 28 percent of women said yes.
- Did they talk about how many children they wanted? Yes, but only a third of the men and not even half of the women.
- Would they be happy with an accidental pregnancy? One-third of men and 13 percent of women said no.
- Have they talked about how to prevent a pregnancy? Just 29 percent of men and 42 percent of women had this discussion.
Another telling statistic came from an April 2016 study published by a group from Johns Hopkins School of Medicine. Out of about 10,000 men, only 26 percent consistently used condoms, 41 percent said their partners consistently used contraception and fewer than 19 percent ever received family planning services.2
The most important reason to engage men in preconception care comes down to minimizing risks to the baby. Many men and women don’t realize that aspects of the father’s health and lifestyle habits can affect the ability to conceive and the baby’s well-being.
Components of Men’s Preconception Care
The Centers for Disease Control and Prevention suggest a plan for men’s preconception care. It begins by having them make a reproductive life plan, so that they begin to think about when or if they want to have children. Beyond a plan, the significant health components include:
- Prevent and treat sexually transmitted diseases: Men need to know that STDs affect the ability to conceive and the baby’s health. Trichomoniasis can damage the fallopian tubes, gonorrhea and chlamydia may result in ectopic pregnancies and infertility, syphilis causes miscarriages and several STDs may cause stillbirth, premature birth or low birth weight. Viral infections such as HIV can also be transferred to the baby.3
- Reach and maintain a healthy weight: Excessive weight is associated with hypogonadism, a greater number of pregnancy losses, and possibly impaired spermatogenesis. Evidence suggests that the genetic content of sperm may be altered.
- Stop smoking, using street drugs and drinking alcohol: Alcohol may impact gonadotropin levels. The field of epigenetics is young, but some evidence suggests that parental use of drugs and alcohol prior to conception may affect the baby’s genetic profile and cause developmental disorders.
- Prescription and OTC medications: Men who take two or more medications have a below average sperm count compared to men who don’t take meds.4 Specific medications associated with male infertility include antidepressants, calcium channel blockers, alpha-adrenergic blockers, anti-epilepsy and anti-retroviral drugs.5
- Age awareness: After men reach the age of 35 to 40, increasing age is associated with infertility, birth defects, low birth weight and miscarriages.
- Other assessments: Male preconception care should also include blood pressure screening because patients with hypertension may have lower sperm quality. It’s also important to assess mental health, the potential for violence in the family, and family history that indicates the need for genetic counseling.
Roles of Compounding Pharmacists
At first glance, it may seem that compounding pharmacists do not have a big role in preconception care for men, but in reality you’re the most significant source of information. You have many opportunities to open the conversation for men who won’t get the info from any other health care providers.
- Medication management: A complete medication review isn’t just the obvious place to begin, it’s essential. It’s vital for male patients who take medications that might impact fertility, but don’t hesitate to bring the topic up with all men and have a handout available. In addition to the classes of medications already mentioned, make sure men know that steroids, opioids, oral ketoconazole and OTC products such as cimetidine can harm fertility.
- Connect with other professionals: Collaborate with health care professionals and offer to talk about the role of medications in preconception care for men and women or create a resource center in your pharmacy with information about their preconception services.
- Appeal to both sides: When you think about implementing preconception outreach, appeal to the desire to avoid unplanned pregnancies and the role of men’s health.
- Avoid the same clichés: The quickest way to lose the attention of your male patients is by repeating the same lines they’ve heard many times and tune out, such as “take responsibility for birth control.”
- Take the nutrition angle: Following a low-fat diet and certain micronutrients—folic acid, selenium, zinc, and vitamin C and E—have been linked with sperm quality.6
- Come up with alternative terminology: Let’s face it, “preconception care” or “preconception counseling” isn’t likely to attract most men, so it may benefit to get creative. You could put up posters in the condom aisle, near OTC products such as antacids and vitamins, at the checkout or in the aisle with women’s products. Then come up with a few attention-grabbing sentences that are slanted to the location of the poster. For example, “Buying condoms? It’s time to talk about male health!” or “Men’s health affects the baby—let’s talk.” In the women’s contraceptive section, your poster might ask if they’ve talked with their partner. The final line should be something like “Come talk with the pharmacist.”
From Medication Review to Promoting Healthy Families
Preconception counseling should alert men to their role in conception and protecting their baby’s health, but it’s also important to encourage all sexually active men to talk with their partners. Compounding pharmacists have the advantage because they can use medication reviews, or products they sell, to break the communication barrier. That simple opening lays the groundwork for parents and babies to live a well-planned, healthy and stable future.
Pharmaceutica North America provides bulk pharmaceuticals, OTC dietary supplements and compounding kits that meet the highest safety, purity and stability standards. Contact us today—we’re here to answer your questions and support your compounding pharmacy.
- “Preconception Health,” January 2012, http://www.medscape.com/viewarticle/756598 ↩
- “National Needs of Family Planning Among US Men Aged 15 to 44 Years,” April 2016, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4815999/ ↩
- “Sexually Transmitted Diseases (STDs) and Pregnancy,” August 2015, http://americanpregnancy.org/pregnancy-complications/stds-and-pregnancy/ ↩
- “Multiple Meds May Undermine Male Fertility,” March 2015, http://www.pharmacytimes.com/news/multiple-meds-may-undermine-male-fertility ↩
- “Effects of Pharmaceutical Medications on Male Fertility,” January 2012, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3719368/ ↩
- “Improving Male Fertility – Research Suggests a Nutrient-Dense Diet May Play an Integral Role,” June 2013, http://www.todaysdietitian.com/newarchives/060113p40.shtml ↩