From the Guidelines
Marijuana use can negatively impact female fertility, and women trying to conceive should be advised to stop using it at least 3-6 months before attempting pregnancy. The active compound in marijuana, THC, interferes with the endocannabinoid system, which plays an important role in regulating reproductive hormones like estrogen and progesterone 1. This disruption can affect the normal development and release of eggs and may impair the implantation of a fertilized egg in the uterus. Studies suggest that THC can also alter the function of the hypothalamus and pituitary gland, which control the release of reproductive hormones.
Key Points to Consider
- Women who regularly use marijuana may experience disruptions to their menstrual cycle, delayed ovulation, and reduced chances of conception 1.
- The effects of marijuana on female fertility appear to be temporary, and fertility typically returns to normal after discontinuing use.
- The impact of marijuana on female fertility may be more pronounced in women who already have underlying fertility issues or irregular menstrual cycles.
- Providers should advise clients who wish to become pregnant to maximize fertility by educating them about peak days and signs of fertility, and discouraging the use of recreational drugs, including marijuana 1.
Recommendations for Clinical Practice
- Women trying to conceive should be advised to stop using marijuana at least 3-6 months before attempting pregnancy to allow the body's hormonal systems to normalize.
- Providers should ask clients about their marijuana use and provide counseling on the potential effects on fertility.
- Women with regular menstrual cycles should be advised that vaginal intercourse every 1–2 days beginning soon after the menstrual period ends can increase the likelihood of becoming pregnant, but marijuana use may reduce fertility 1.
From the Research
Effects of Marijuana on Female Fertility
- Marijuana use has been shown to affect female fertility by disrupting the hypothalamic-pituitary-ovarian (HPO) axis regulation, leading to reduced estrogen and progesterone production and anovulatory menstrual cycles 2.
- The endocannabinoid system plays a crucial role in regulating female reproductive health, and exogenous cannabinoids in marijuana may disrupt this delicate balance 2.
- Studies have found that marijuana use can reduce female fertility by decreasing gonadotropin-releasing hormone (GnRH) secretion, which affects folliculogenesis, ovulation, and sperm maturation and function 3, 2.
- The current evidence suggests that marijuana use adversely affects female reproductive health, although more research is needed to fully understand the effects of marijuana on female fertility 4, 5.
Mechanisms of Marijuana's Effects on Female Fertility
- THC, the primary psychoactive compound in marijuana, interacts with the hypothalamic-pituitary-gonadal axis, leading to decreased GnRH secretion and subsequent effects on reproductive hormones 3.
- Marijuana use has been shown to affect ovarian hormone production, leading to reduced estrogen and progesterone levels, which can disrupt the menstrual cycle and fertility 2.
- The effects of chronic marijuana use on human female reproduction are largely unknown, although tolerance to these effects has been shown in animal studies 2.
Current Research and Recommendations
- The existing literature on the effects of marijuana on female fertility is limited, and more research is needed to fully understand the potential risks and consequences of marijuana use on female reproductive health 4, 5.
- The current evidence suggests that abstaining from marijuana use is the safest choice for couples interested in conception or who are expecting 5.
- Further studies are needed to investigate the effects of marijuana on female fertility and to provide evidence-driven recommendations and guidelines for women of reproductive age 4, 5, 6.