The potential impact of 1st and 2nd generation antihistamines on male fertility

Abstract

Histamine antagonists are medications used to block the action of histamine at histamine receptors. H1 antagonists are mainly taken to reverse the effects of histamine during allergic reactions. Cetirizine hydrochloride and pheniramine maleate are the most clinically used H1 antihistamines; they have common tolerable side effects such as sedation, dizziness, fatigue, dry mouth, and nausea. The effect of H1 antagonists on male hormones and its outcomes on male fertility are still unclear. The aim of the present study was to evaluate the possible effects of both cetirizine and pheniramine maleate on male fertility. Measurement of prolactin, FSH, and LH serum levels and sperm count during chronic use. Cetirizine hydrochloride significantly increased prolactin levels compared with pheniramine maleate and control groups. Hyperprolactinemia significantly decreased FSH and LH levels and sperm count in the cetirizine hydrochloride treated group. In conclusion, this study reports that the second-generation antihistamine cetirizine hydrochloride has potent and significant effects on male fertility compared with the first-generation H1 antihistamine pheniramine maleate through its changes in prolactin, LH, and FSH levels. These hormonal changes decreased spermatogenesis and sperm count.