Does Contrave (bupropion and naltrexone) affect sperm count?

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Last updated: May 15, 2025View editorial policy

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From the Guidelines

Contrave, a medication combining naltrexone and bupropion used for weight management, has not been specifically linked to decreased sperm count in clinical research, and men concerned about fertility while taking Contrave can continue the medication as prescribed. The primary mechanisms of Contrave—reducing food cravings through opioid receptor antagonism (naltrexone) and affecting dopamine/norepinephrine pathways (bupropion)—don't directly target reproductive hormones or spermatogenesis processes 1. However, obesity itself can negatively affect sperm quality and count, so the weight loss achieved with Contrave might actually improve fertility outcomes in overweight or obese men.

Some key points to consider:

  • Weight management medications generally have more beneficial than detrimental effects on male fertility through addressing obesity-related hormonal imbalances that can interfere with sperm production.
  • If you're actively trying to conceive and have concerns, it would be reasonable to discuss this with your healthcare provider, who might recommend a semen analysis to assess your specific situation.
  • The medication's effects on fertility are not well-studied, but available data suggest that it does not have a significant impact on sperm count or quality 1.
  • Fertility preservation techniques, such as sperm banking, may be considered for men who are concerned about the potential impact of weight loss medications on their fertility, although this is not specifically recommended for Contrave users 1.

Overall, the available evidence suggests that Contrave is not likely to have a significant impact on sperm count or male fertility, and men who are taking this medication can continue to do so without concern about its effects on their fertility. However, as with any medication, it's always a good idea to discuss any concerns with your healthcare provider.

From the Research

Contrave and Sperm Count

  • There is limited research on the direct impact of Contrave on sperm count.
  • However, a study on bupropion, a component of Contrave, found that it impaired sperm quality in male rats, increasing the incidence of non-progressive sperm 2.
  • Another study discussed the adverse effects of common medications on male fertility, including psychotropic agents like bupropion, but did not provide specific information on Contrave 3.
  • The available evidence on Contrave focuses on its use for weight loss and its effects on female fertility, with no direct mention of its impact on sperm count 4, 5, 6.
  • Further research is needed to fully understand the effects of Contrave on male fertility and sperm count.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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