Is Tylenol Safe During Pregnancy?
Acetaminophen, more commonly known as Tylenol or paracetamol, is one of the most widely used medications out there. But while national health agencies- and likely your doctor- will tell you that Tylenol* is safe to use during pregnancy, a group of experts is cautioning women and healthcare providers that using Tylenol during pregnancy may impact fetal development. Read on to find out why these experts are concerned, what the risks are, and what you can do to minimize your risk if you are pregnant.
Tylenol and Pregnancy
Tylenol is widely used by pregnant women. It is estimated that over 50% of pregnant women worldwide use it. There are two main reasons that may explain this high rate. First, Tylenol is generally considered safe to use during pregnancy for pain and fever management by federal health agencies, while NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen and aspirin are not. Second, it is often considered by doctors as the go-to drug of choice for pain and fever relief during pregnancy, and it is very easy and convenient for doctors to recommend it when they only have a brief few minutes with patients.
But while Tylenol is generally considered safe to use during pregnancy for pain and fever management (i.e., in situations when not using it may come with negative risks for mom and/or baby), up to two-thirds of pregnant women use Tylenol for other reasons, including headache, muscle pain, infection, and generally not feeling well. And because of the reasons stated above, Tylenol is generally recommended as a safe medication by healthcare professionals for pregnant women. But, this is not always the case: after a group of experts issued a warning statement, this blanket recommendation is now changing.
Concerned Scientists Warn Against Tylenol Use During Pregnancy
In 2021, a group of healthcare experts released a consensus statement on Tylenol use during pregnancy. The statement has been supported by over 100 scientists and healthcare professionals around the world, and warns that:
“Increasing experimental and epidemiological research suggests that prenatal exposure to [Tylenol] might alter fetal development, which could increase the risks of some neurodevelopmental reproductive and urogenital disorders”
And that:
“evidence is strong enough for pregnant women to be cautioned by health professionals against its indiscriminate use”
You can read the full consensus statement by clicking the link provided further down in this post, but the general argument this group of experts makes is that there are significant enough risks associated with Tylenol use during pregnancy that we should give pause and consider these potential risks before taking it.
A Detailed Look at the Risks
When weighing the risks vs benefits of taking Tylenol during pregnancy, here is what you need to know. While Tylenol may be effective in treating pain and fever, it is also known to readily cross the placenta and blood-brain barrier, which means that if you take Tylenol, it can reach your baby. It is also a known endocrine disruptor: a chemical that can interfere with hormone activity. As a result, studies have shown that Tylenol directly impacts hormone-dependent processes in the fetus, particularly those involved in neurodevelopmental and reproductive development.
What exactly does this mean for your baby? Let’s have a look at the studies and their results.
The consensus statement on Tylenol use during pregnancy outlines several key studies and their findings, including:
4 studies that found that prenatal Tylenol exposure is linked to reduced female reproductive health and fertility
5 studies that showed a link between prenatal Tylenol exposure and male urogenital and reproductive tract abnormalities
26 studies that identified a link between Tylenol exposure during pregnancy and neurodevelopmental outcomes including ADHD, ASD, hyperactivity, language delays, decreased IQ, etc.
While the consensus statement admits that the studies that have been conducted so far on whether or not Tylenol is safe during pregnancy have been limited and there is still much more to be investigated, there is nonetheless a clear and direct link between Tylenol use during pregnancy and an increased risk of fetal neurological and reproductive development issues.
Before You Panic, Here’s What the Experts Recommend
The consensus statement makes some clear recommendations on the safety of Tylenol use during pregnancy. The basic gist is this:
Use Tylenol cautiously: at the lowest effective dose for the shortest possible time.
Or, to put it another way:
Recognize that Tylenol is a drug. Take only what you need, when you actually need it.
And Here’s What I Would Add
If you are currently pregnancy and are considering taking Tylenol, here are my recommendations for you:
If you have a high fever or unbearable pain, follow your doctor’s advice as well as the principle of taking the lowest dose for the shortest possible time
If you have a headache, muscle pain, or are generally not feeling well, before you reach for Tylenol try these ideas that may help you to feel better without needing to resort to drugs:
drink a glass of water
eat something (ideally something nutritious)
go outside
gently move your body
do some deep breathing exercises
If you decide that you need to take Tylenol, consider taking a NAC (N-acetyl cysteine) supplement along with it. Taking NAC supports liver detoxification, which helps your liver to break down the Tylenol and avoid liver damage from any potential buildup.
Additional Resources
Looking for more information on the safety of Tylenol during pregnancy?
Read the full consensus statement: Paracetamol use during pregnancy - a call for precautionary action
Dr Shanna Swan is a renowned environmental and reproductive epidemiologist and was one of the experts involved in drafting the consensus statement. Here her speak more about Tylenol and pregnancy on this episode of the Joyous Health podcast.
Planning a pregnancy and looking for more information on how to safely and confidently optimize your fertility for a healthy and thriving pregnancy? Click on the button below to download your free copy of my Fertility Fundamentals Guide.
*To keep things simple, I use the term “Tylenol” to refer to acetaminophen and other drugs that contain acetaminophen
** Think this sounds like medical advice? Read my website disclaimer.