How Cannabis Affects Reproductive Health from Fertility Through Menopause | Research

The takeaway

Cannabis exposure has been associated with adverse effects across the entire reproductive spectrum, from altered fertility and sperm quality to preterm birth, impaired fetal development, and presence in breast milk.

People trying to conceive, pregnant or breastfeeding individuals, reproductive health researchers

THC crosses the placenta and is detected in breast milk

What the researchers found

THC crosses the placenta and has been detected in breast milk. Prenatal cannabis use has been associated with small-for-gestational-age infants, preterm birth, and impaired offspring neurodevelopment. In males, cannabis has been linked to erectile dysfunction, abnormal spermatogenesis, and testicular atrophy. In females, it has been associated with infertility and abnormal embryo implantation.

Why it matters

Cannabis is the most commonly used federally illegal drug among people of reproductive age, and product potency has increased significantly. Understanding reproductive effects is critical as use continues to rise.

The numbers in context

Cannabinoid receptors found in male and female reproductive tracts, on sperm, and on the placenta; cannabis potency has increased significantly in the past decade

How the study worked

Narrative review synthesizing evidence on cannabinoid effects across the reproductive lifespan, including fertility, pregnancy, lactation, and menopause, with focus on endocannabinoid system biology.

What this study cannot tell us

Narrative review with limited available evidence, particularly for lactation and menopause. Most pregnancy studies cannot fully account for confounders like polysubstance use.

How to read the evidence

Comprehensive narrative review, but limited by quality of underlying studies and difficulty controlling for confounders in pregnancy research.

When this study was published

Published in 2022

The bigger picture

The endocannabinoid system plays a role in regulating reproduction at every stage. As cannabis use rises among reproductive-age adults and menopausal women, the gap between use and safety evidence continues to widen.

Questions still open

Does increased cannabis potency translate to greater reproductive risk? How long do cannabinoid effects on fertility persist after cessation?

Common questions

Does cannabis affect fertility?

The review found cannabis associated with altered reproductive hormones, menstrual cycle changes, and abnormal semen parameters in males, including erectile dysfunction and testicular atrophy.

Is cannabis safe during pregnancy?

The review found THC crosses the placenta and prenatal use has been associated with preterm birth, low birth weight, and impaired offspring neurodevelopment. THC has also been detected in breast milk.

Read the original research

Impact of cannabinoids on pregnancy, reproductive health, and offspring outcomes.

American journal of obstetrics and gynecology, 227(4), 571-581

View on PubMed ↗Publisher’s paper ↗

Citation

Lo, Jamie O; Hedges, Jason C; Girardi, Guillermina. (2022). Impact of cannabinoids on pregnancy, reproductive health, and offspring outcomes.. American journal of obstetrics and gynecology, 227(4), 571-581. https://doi.org/10.1016/j.ajog.2022.05.056