The endocannabinoid system plays a critical role in male reproduction, and cannabis use may negatively affect sperm production, motility, and the hormonal axis controlling fertility.
Read this if you use cannabis and are trying to conceive or concerned about fertility.
Cannabinoid receptors found throughout the male reproductive tract
What the researchers found
This review compiled evidence on how cannabis affects male reproductive function through the endocannabinoid system (ECS). The ECS is deeply involved in regulating the hypothalamus-pituitary-gonadal axis, sperm production, and sperm function.
Cannabinoid receptors (CB1 and CB2) are present throughout the male reproductive tract, including in the testes, epididymis, prostate, and on sperm cells themselves. Cannabis-derived cannabinoids can disrupt these systems by mimicking endocannabinoids.
Studies reviewed showed that cannabis use was associated with reduced testosterone levels, impaired spermatogenesis, decreased sperm motility, premature acrosome reaction (which prevents fertilization), and disrupted capacitation (the process sperm undergo to become fertilization-capable). The review noted that marijuana has the highest consumption rate of illicit drugs in the US, with popularity increasing especially among men of reproductive age.
Why it matters
Male factor infertility is increasing, and cannabis use is rising among reproductive-age men. If cannabis contributes to fertility problems through documented endocannabinoid disruption, this is relevant information for couples trying to conceive.
The numbers in context
Cannabinoid receptors found in testes, epididymis, prostate, and on sperm. Multiple reproductive functions affected: testosterone, spermatogenesis, motility, capacitation, acrosome reaction.
How the study worked
Narrative review of in vivo and in vitro studies examining the effects of marijuana and cannabinoids on male reproductive hormones, spermatogenesis, and sperm function, with detailed coverage of the endocannabinoid system in male reproduction.
What this study cannot tell us
Much evidence comes from animal studies or in vitro experiments. Human studies have been small and often poorly controlled for confounders. The review is narrative rather than systematic. Dose-response relationships are not well established.
How to read the evidence
Narrative review synthesizing preclinical and limited clinical evidence on cannabis and male reproductive function.
When this study was published
Published in 2015. Cannabis use among reproductive-age men has continued to increase.
The bigger picture
As cannabis use becomes more normalized, understanding its effects on fertility becomes more urgent. The endocannabinoid system's deep involvement in reproduction suggests that cannabis effects on fertility are biological, not coincidental.
Questions still open
- At what frequency or dose does cannabis use meaningfully affect fertility? Are the effects reversible with cessation? Does CBD have the same effects as THC on male reproductive function?
Common questions
Can cannabis affect male fertility?
Are the fertility effects of cannabis reversible?
Read the original research
Marijuana, phytocannabinoids, the endocannabinoid system, and male fertility.
Journal of assisted reproduction and genetics, 32(11), 1575-88
Citation
du Plessis, Stefan S; Agarwal, Ashok; Syriac, Arun. (2015). Marijuana, phytocannabinoids, the endocannabinoid system, and male fertility.. Journal of assisted reproduction and genetics, 32(11), 1575-88. https://doi.org/10.1007/s10815-015-0553-8
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