Should You Avoid Pain Relievers When Trying to Conceive?

Women who are trying to become pregnant often want to know what they should do to improve their chances for success. Some research suggests that those trying to conceive should avoid taking pain relievers such as ibuprofen, naproxen or other NSAIDs. Last year, pregnant women were alarmed by a warning that taking acetaminophen (Tylenol, for example) might put their babies at risk for autism. The most recent research has quieted those concerns.

No Link Apparent Between Acetaminophen and Autism:

Last fall the administration warned pregnant women to avoid acetaminophen because of worries about autism. A new systematic review in the British journal The Lancet included 43 studies (Lancet, Obstetrics, Gynaecology, & Women’s Health, Jan. 16, 2026). Because the journal is British and the authors mostly European, they refer to acetaminophen by the term paracetamol. They assessed each study for quality (risk of bias) as well as for any connection between women taking acetaminophen during pregnancy and their children developing autism, ADHD (Attention Deficit Hyperactivity Disorder) or intellectual disability. Analysis prioritized studies that included sibling comparisons, so that the familial component of autism spectrum disorder or ADHD could be accounted for.

The results should be reassuring for people who have been worried about an earlier study that had a worrisome message for those trying to conceive (JAMA Pediatrics, Feb. 24, 2014).

The authors of The Lancet review noted:

“This study is, to our knowledge, the first systematic review and meta-analysis to prioritise sibling-comparison designs and to apply the QUIPS tool to assess prognostic-factor bias across the entire evidence base. It provides a clear hierarchy of evidence, by separating analyses of sibling-comparison studies, low-risk-of-bias studies, and all adjusted studies. Across all analyses, most notably in sibling-comparison studies, prenatal paracetamol exposure was not associated with increased risks of autism spectrum disorder, ADHD, or intellectual disability.”

Pain Relievers for Women Trying to Conceive:

Research shows that women who took NSAIDs while trying to conceive were more likely to miscarry in the early weeks of the pregnancy (American Journal of Obstetrics & Gynecology, Sep. 2018). Approximately 1,000 pregnant women participated in the study. Of these, 241 took NSAIDs around conception and during the first five months of pregnancy. An additional 391 took acetaminophen, a non-NSAID pain reliever, instead. There were 465 women who did not use pain relievers during this time.

Nearly one-fourth of the women taking NSAIDs had a miscarriage during the first five months. In contrast, about 17 percent of the women who did not take medication miscarried. There were other differences, though, so the investigators had to make some statistical corrections. Even so, they found that women who took such meds while trying to conceive were more likely to experience difficulties.

Why Might NSAIDs Cause Problems with Early Pregnancy?

The explanation might lie with NSAIDs’ suppression of prostaglandin. Prostaglandins are essential for the embryo to implant itself in the uterine lining. This study does not establish a cause-and effect relationship. Nonetheless, it does suggest that women might wish to avoid these drugs while they are trying to conceive.

What About Acetaminophen?

Women taking acetaminophen did not miscarry more often in this study than those not on any pain reliever. However, some previous research has raised a red flag about this medication. In particular, a Danish study we referred to above suggested a link between acetaminophen use during pregnancy and ADHD in the baby.

We discussed the diagnosis and (over)treatment of ADHD in a one-hour interview with Enrico Gnaulati, PhD, author of Back to Normal: Why Ordinary Childhood Behavior Is Mistaken for ADHD, Bipolar Disorder and Autism Spectrum Disorder, and Alan Greene, MD, FAAP, founder of www.drgreene.com and author of Raising Baby Green and Feeding Baby Green.

Update on the Acetaminophen/ADHD Connection:

Epidemiologists have recently taken a new look at this link, using long-term data from the Boston Birth Cohort (Brain Sciences, July 3, 2018). The mothers in the study had given blood samples soon after delivery. Children of women whose blood indicated recent acetaminophen use were slightly more likely to be diagnosed with ADHD. That timing is quite different from the research indicating that NSAIDs taken around the time of conception could possibly interfere with embryo implantation.

We think that people trying to conceive should avoid unnecessary medications. However, the most recent research should be comforting for women who need pain relief during pregnancy and use acetaminophen for that purpose.