What is the effect of cannabis (marijuana) on male fertility?

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Last updated: April 19, 2025View editorial policy

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From the Guidelines

Men trying to conceive should consider stopping or reducing cannabis consumption, as it can negatively impact male fertility by decreasing sperm count, reducing sperm motility, and causing abnormal sperm morphology, as supported by the most recent evidence 1.

Impact of Cannabis on Male Fertility

The active compound in cannabis, THC, interferes with the endocannabinoid system, which plays a role in reproductive function, and can disrupt hormone production, particularly by lowering testosterone levels and affecting the hypothalamic-pituitary-gonadal axis that regulates sperm production 1.

Key Considerations

  • The effects of cannabis on fertility appear to be dose-dependent, with heavier users experiencing more significant fertility issues 1.
  • While some effects may be reversible after stopping use, this can take 2-3 months for a complete sperm regeneration cycle 1.
  • Men experiencing fertility difficulties who use cannabis should discuss this with their healthcare provider, as stopping marijuana use may be an important first step in fertility treatment 1.

Additional Lifestyle Factors

Other lifestyle factors like maintaining a healthy weight, limiting alcohol, avoiding tobacco, and reducing stress can also help optimize fertility alongside cannabis cessation 1.

Clinical Guidance

Clinicians should counsel infertile men or men with abnormal semen parameters about the health risks associated with abnormal sperm production, and advise couples with advanced paternal age (≥ 40) that there is an increased risk of adverse health outcomes for their offspring 1.

From the Research

Effects of Weed on Male Fertility

  • The use of marijuana has been linked to compromised sperm quality, with studies suggesting that it can affect sperm morphology and motility 2, 3.
  • A study conducted in Jamaica found that recent and heavy marijuana use was associated with abnormal motility and morphology in men being investigated for infertility 2.
  • Another study found that cannabis use was associated with a mild decrease in sperm count and serum testosterone levels in infertile males, although the decrease was not significant 4.

Mechanisms of Action

  • The active component of marijuana, Δ9-tetrahydrocannabinol (THC), has been shown to interact with the hypothalamic-pituitary-gonadal axis, leading to decreased gonadotropin-releasing hormone (GnRH) secretion and affecting reproductive events such as folliculogenesis, ovulation, and sperm maturation and function 5.
  • THC has also been found to alter signaling pathways within spermatozoa, affecting spermatogenesis and fertility 3.

Contrasting Findings

  • A study conducted on rats found that cannabis extract improved sperm quality and increased the concentrations of follicle-stimulating hormone, luteinizing hormone, and other parameters, suggesting a potential beneficial effect of cannabis on male fertility 6.
  • However, this finding is in contrast to the majority of studies, which suggest that marijuana use has a detrimental effect on semen quality, particularly morphology and volume 2, 3.

Clinical Implications

  • The prevalence of marijuana use among men of reproductive age is high, and its potential impact on fertility is a concern 3.
  • Healthcare providers should routinely ask men undergoing fertility investigations about their recreational use of marijuana and counsel heavy users to stop 2.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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