functions of the testes which can lead to a decrease in production of sperm, or by creating hormone imbalances. For an example, anti-androgenic drugs like spironolactone, cimetidine, and ketoconazole can disrupt androgens in the glands and seminal tract to cause a decrease in production of semen volume. Furthermore, common drugs used to treat hypertension and benign prostatic hyperplasia (increased size of prostate) like tamsulosin are attracted to dopamine and serotonin receptors in the brain to cause a decrease in sperm volume through a mechanism that remains unknown. Certain medications in the following classes of drugs may affect spermatogenesis or sperm parameters*: Immunosuppressants Non-steroidal anti-inflammatory drugs (NSAIDs) and salicylates Inhibitors of thyrosine kinases Opiates Treatment for benign prostatic hyperplasia Hormonal treatments and antiadrenergic drugs Antibiotics, antifungals, antiparasites, antivirals, and antimalarials Antidepressants Anti-gastroesophageal reflux drugs Anti-epileptic drugs Antihypertensive drugs Certain medications in the following classes of drugs may affect male sexual libido or sexual function**: Immunomodulators Inhibitors of protein kinases Opioids Analgesics Treatment of benign prostatic hyperplasia Antiadrenergic drugs Hormonal treatments Diuretics Antiretroviral therapy Antihistamines Antidepressants *"For most of the drugs that are likely to affect spermatogenesis and/or sperm parameters, the levels of scientific evidence are still insufficient (with the exception of Sirolimus, Sulfasalazine, exogenous testosterone, Finasteride and Cyproterone acetate, for which the levels of evidence are higher). In some cases, data in men do not even exist, and the toxicity of a drug for the male reproductive organs is determined solely on the basis of animal models." **"For a certain number of pharmaceutical molecules that are likely to affect the sexual function of men being treated, the actual imputability of the drug is often difficult to pinpoint owing to the effect of the illness itself on sexuality (cardiovascular disease and erectile dysfunction; depressive illness and loss of desire, etc.)" Furthermore, hyperthyroidism, an excess of thyroid hormones, has been associated with reduced semen volume, reduced sperm density, motility, and morphology. Studies in humans show that an excess of circulating thyroid hormones during thyrotoxicosis results in asthenozoospermia, oligozoospermia, and teratozoospermia. These abnormalities frequently associate with semen alterations like reduced semen volume. Lifestyle factors Alcohol use Lifestyle factors, such as substance use or adiposity, can play a detrimental role in the quality of the semen. One study examining the consequences of alcohol consumption and its effect on semen quality concluded that alcohol intake can lead to a negative effect on semen volume in daily