From the Guidelines
THC can significantly impact sex hormone levels, potentially leading to fertility issues in both men and women, and its effects should be considered when evaluating reproductive health. In men, regular cannabis use containing THC typically decreases testosterone production, potentially leading to reduced sperm count, quality, and fertility issues 1. For women, THC may disrupt normal menstrual cycles, ovulation, and estrogen levels, which can affect fertility. These effects occur because THC interacts with the endocannabinoid system, which plays a role in regulating reproductive hormones. The hypothalamic-pituitary-gonadal axis, responsible for hormone production and regulation, can be disrupted by THC. Key factors influencing the severity of these effects include:
- Frequency of use
- Dosage
- Individual factors Most hormone changes are temporary and reversible after discontinuing THC use, typically returning to normal within weeks to months. However, heavy, long-term users may experience more persistent effects. Anyone concerned about THC's impact on their hormonal health or fertility should consider reducing consumption or discussing these concerns with a healthcare provider. It is essential to weigh the potential benefits of THC use against the potential risks to reproductive health, particularly for individuals planning to conceive or experiencing fertility issues 1.
From the Research
THC Effects on Sex Hormones
- THC has been found to indirectly decrease gonadotropin-releasing hormone (GnRH) secretion by the hypothalamus, which can affect several key hormones and disturb important reproductive events like folliculogenesis, ovulation, and sperm maturation and function 2.
- The use of cannabis, particularly high-THC products, has been associated with reduced sperm count and concentration, abnormalities in sperm morphology, reduced sperm motility and viability, and inhibited capacitation and fertilizing capacity in males 3.
- Studies on hormonal changes suggest that cannabis use may have inconclusive effects on testosterone levels, lowered luteinizing hormone levels, and unchanged follicle-stimulating hormone levels 3.
- Chronic patterns of cannabis use have been linked to multiple adverse outcomes, including disrupted learning, impaired cognitive performance, reduced educational attainment, and an increased risk of cannabis use disorder, psychosis/schizophrenia, mood and anxiety disorders, and suicidal behaviors, particularly among adolescents and young adults 4.
- The evidence on the effects of THC on sex hormones is largely based on pre-clinical studies, and more research is needed to fully understand the impact of cannabis use on reproductive potential and teratogenicity 2, 5.
Key Findings
- Cannabis use has been found to negatively impact male fertility, with effects on semen parameters, testicular atrophy, and reduced libido and sexual function 3.
- The use of high-THC products has been associated with a range of adverse health effects, including mental, gastrointestinal, and cardiovascular problems, and motor vehicle accidents 5, 4.
- There is debate about the extent to which cannabis use is a cause of adverse outcomes, and more research is needed to fully understand the relationship between cannabis use and health effects 4.
Implications
- Clinicians should be aware of the potential effects of cannabis use on male fertility and consider the degree of cannabis use as a possible component of a complete male infertility workup 3.
- The legalization of cannabis for medical and recreational purposes should be approached with caution, and the public conversation should include scientific evidence for its adverse effects 6.