Crohn's in Men

Men and Fertility

Zinc deficiency in men with Crohn's disease may contribute to poor sperm function and male infertility

None of the medications used to treat inflammatory bowel disease have been shown to be teratogenic, which means to cause birth defects, when used by men. However, some of the medications have been shown to decrease sperm count and reduce sperm motility. For this reason, it is suggested that a man being treated for Crohn's disease go off medication when he and his partner are trying to conceive. He should resume his regimen as soon as a pregnancy has been confirmed.

Sulfasalazine is well known to effect sperm motility. Within 2 months of commencing the medication the patient's sperm count decreases, the presence of the abnormal spermatozoa increases and sperm mobility is decreased. All these changes are dose related and reversible. It is therefore suggested that the prospective father should be changed to either mesalazine or olsalazine 3 months before attempting to conceive by which time the sperm will have returned to normal.

The results of a small retrospective review of 140 pregnancies among fathers taking azathioprine (AZA) and 6-mercaptopurine (6-MP) suggests that these medications may increase the number of spontaneous abortions and congenital abnormalities. The small sample size, the retrospective nature of the study, the lack of information about disease activity and the lack of a normal control group, however, limit the findings. These findings are also in contrast to the numerous studies where the mother has been taking AZA and 6-MP without any associated increase in fetal risks. Despite this, however, it is still recommended that these medications should if possible be ceased at least 3 months prior to conception.

Men and Osteoporosis

Think osteoporosis only affects women? Think again! NIH data suggests 1-2 million men in the US have osteoporosis, and an additional 8-13 million have low bone mass, with prevalence among white males. Few realize their risk for osteporosis-realted fracture is greater than their risk for prostate cancer. Osteoporosis is also a complication of Crohn's.

Men over 55 who have inexplicably lost two or more inches in height be tested immediately for bone density, especially if they have Crohn's Disease. So, too, should any man who has sustained a fracture in his adult life since the presence of a fracture is a very potent risk factor. After such a diagnosis is made, the first step in treatment is to remove any contributory factors, such as kidney stones, underlying factors such as alcohol, or improve other factors, such as diet and calcium intake should be improved. Then aggressively treat osteoporosis, such as Vitamin D along with using first line therapies to treat the disease such as Fosamax®.

On behalf of learning, and use as teaching tools for those of us who need to know about our disease, I have tried to supply you with as much information as I could find on all of the drugs, treatments and disorders associated with Inflammatory Bowel Diseases. I have tried to blend all facts supported by research and also from personal experiences of other IBD sufferers into one readable webpage, and any and all information presented here is not entirely from one source. Most information contained within these pages is found in the public domain. At times you may find information used from another site, and as with all copyrighted materials you may find on these pages, I claim fair use under sections 107 through 118 of the Copyright Act (title 17, U.S. Code). Click here for more info

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