Naproxen is a widely used nonsteroidal anti-inflammatory drug (NSAID) effective for reducing pain, inflammation, and fever [1.3.6]. While beneficial, it's essential for men to be aware of its potential side effects, which range from mild to life-threatening. The majority of naproxen's side effects are not exclusive to men, but certain risks and considerations are particularly relevant.
How Naproxen Works and Why It Has Side Effects
Naproxen functions by inhibiting cyclooxygenase (COX) enzymes, which are responsible for producing prostaglandins [1.3.6]. Prostaglandins are compounds that contribute to inflammation and pain. However, they also play a protective role, particularly in the stomach lining and in maintaining kidney function [1.4.3]. By blocking these enzymes, naproxen effectively reduces pain but also removes these protective mechanisms, leading to potential side effects.
Common Side Effects
Most men who take naproxen, especially for short periods, may experience mild side effects. These are generally not dangerous but can be uncomfortable [1.4.5].
- Gastrointestinal Discomfort: The most frequent complaints are stomach-related. This includes indigestion, heartburn, stomach pain, nausea, constipation, diarrhea, and gas [1.2.1, 1.2.2]. Taking naproxen with food or milk can help minimize this irritation [1.9.2].
- Central Nervous System Effects: Dizziness, drowsiness, and headaches are also commonly reported [1.2.3]. It is advisable to understand how your body reacts to the medication before driving or operating heavy machinery [1.2.1].
- Other Common Issues: Some may experience skin itching, bruising, or ringing in the ears (tinnitus) [1.2.1, 1.4.5].
Serious Side Effects and FDA Warnings
The U.S. Food and Drug Administration (FDA) has issued boxed warnings—its most serious alert—for all NSAIDs, including naproxen, regarding two major risks [1.4.2].
Cardiovascular Risks
Naproxen can increase the risk of serious and potentially fatal cardiovascular events, such as heart attack and stroke [1.5.4]. This risk can occur even in the first few weeks of use and may be higher with longer duration and higher doses [1.5.4].
- Who is at risk? The risk is elevated for everyone, but it is particularly concerning for men with pre-existing heart disease or risk factors like high blood pressure, high cholesterol, or diabetes [1.4.2, 1.5.4].
- Symptoms to Watch For: Seek immediate medical attention if you experience chest pain, shortness of breath, sudden weakness on one side of the body, or slurred speech [1.5.4].
- Blood Pressure: Naproxen can also cause new-onset high blood pressure (hypertension) or worsen existing hypertension [1.2.2].
Gastrointestinal Bleeding, Ulceration, and Perforation
The second major warning involves a significant risk of serious gastrointestinal (GI) events. Naproxen can cause ulcers, bleeding, and perforations (tears) in the stomach and intestines, which can be fatal and occur without warning symptoms [1.4.2]. The risk of upper GI bleeding for naproxen users is estimated to be over five times higher than for non-users [1.6.3].
- Increased Risk Factors: The risk is greater in older adults, those with a prior history of ulcers or GI bleeding, those who drink alcohol, smokers, and individuals on long-term therapy [1.2.2, 1.4.2].
- Signs of GI Bleeding: Stop taking naproxen and contact a doctor immediately if you notice bloody or black, tarry stools, or vomit that looks like coffee grounds [1.3.3].
Specific Considerations for Men's Health
While most side effects are universal, some research points to potential impacts on male-specific health, though evidence varies.
- Fertility: There is no definitive evidence that naproxen reduces fertility in men [1.8.1]. However, one animal study on rats showed that naproxen sodium decreased sperm count and motility and caused damage to seminiferous tubules without affecting plasma hormone levels [1.8.3, 1.8.4]. While animal studies do not always translate to humans, it is a point of consideration for men trying to conceive.
- Testosterone: The same rat study noted no statistical differences in plasma hormone levels, suggesting naproxen did not directly impact testosterone in that context [1.8.3, 1.8.4]. General studies on analgesics suggest some NSAIDs can impact testosterone synthesis, but specific data on naproxen in humans is limited [1.8.5].
Comparison of Side Effects: Naproxen vs. Ibuprofen
Both naproxen and ibuprofen are popular NSAIDs with similar side effect profiles. The key differences often relate to their duration of action and specific risk profiles [1.7.4].
| Feature | Naproxen | Ibuprofen |
|---|---|---|
| Duration of Action | Longer-acting (dosed 2-3 times/day) [1.7.4] | Shorter-acting (dosed every 4-6 hours) [1.7.4] |
| Gastrointestinal Risk | May have a higher risk of GI bleeding and ulcers compared to ibuprofen [1.7.3, 1.7.4]. | May have a lower risk of GI bleeding than naproxen [1.7.4]. |
| Cardiovascular Risk | Some data suggests naproxen may have a lower cardiovascular risk than other NSAIDs, but this is not definitively established [1.7.4, 1.5.3]. | The risk of heart-related side effects may be greater with ibuprofen compared to naproxen [1.7.2]. |
How to Minimize the Risks
If you need to take naproxen, several strategies can help lower the risk of side effects:
- Use the Lowest Effective Dose: Take the smallest amount of medication needed to relieve your pain [1.9.4].
- Use for the Shortest Possible Time: Avoid long-term use unless directed by a healthcare provider [1.4.1].
- Take With Food: Always take naproxen with food or a glass of milk to protect your stomach [1.9.2].
- Avoid Alcohol: Drinking alcohol increases the risk of stomach irritation and bleeding [1.4.1, 1.9.3].
- Do Not Mix NSAIDs: Do not take naproxen with other NSAIDs like ibuprofen or aspirin, as this significantly increases side effect risks [1.9.1].
- Discuss with Your Doctor: Before starting naproxen, inform your doctor about your health history, especially any heart, kidney, or stomach problems, and all other medications you are taking [1.2.1].
Conclusion
Naproxen is an effective pain reliever, but for men, its use requires a careful balance of benefits and risks. The most significant dangers are serious cardiovascular events and gastrointestinal bleeding, as highlighted by FDA warnings. While concerns about specific impacts on male fertility exist, they are less established than the systemic risks. Adhering to the principle of using the lowest effective dose for the shortest duration and consulting with a healthcare professional are the best strategies for using naproxen safely.
For more information, you can visit the FDA page on NSAID safety.
