Marijuana Use Was Not Associated With Reduced Ovarian Reserve, Unlike Tobacco

What the researchers found

Researchers examined whether exposure to combustion products from tobacco, marijuana, and indoor heating sources affected antimullerian hormone (AMH) levels, a biomarker of ovarian reserve (the number of remaining eggs).

Heavy tobacco smoking (20+ cigarettes/day) was associated with a 56.2% reduction in AMH levels compared to nonsmokers. Long-term environmental tobacco smoke exposure (10+ years) was associated with a 31.3% reduction. Indoor burning of wood or artificial fire logs was also associated with lower AMH.

However, marijuana use was not associated with any change in AMH levels. Despite producing combustion by-products similar to tobacco, marijuana did not show the same toxic effect on ovarian reserve.

Why it matters

The finding that marijuana does not appear to affect ovarian reserve (unlike tobacco) is reassuring for women of reproductive age who use cannabis. It suggests that while both substances produce combustion by-products, their effects on reproductive biology differ, possibly due to different active compounds or exposure patterns.

The numbers in context

913 premenopausal women. Heavy smoking (20+ cigs/day): -56.2% AMH. 10+ years ETS: -31.3% AMH. Wood burning 10+ times/year: -36.0% AMH. Fire logs 10+ times/year: -45.8% AMH. Marijuana: no significant association.

How the study worked

Cross-sectional analysis of 913 premenopausal women (ages 35-54) from the Sister Study cohort (n=50,884). Serum AMH was measured by ultrasensitive ELISA. Exposure to tobacco, marijuana, and indoor heating/cooking sources was assessed by questionnaire.

What this study cannot tell us

Cross-sectional design. Self-reported marijuana use may be underreported. The study could not assess frequency or amount of marijuana use in detail. AMH is one marker of ovarian reserve but does not represent all aspects of reproductive health. The study population (Sister Study) consists of women with sisters who had breast cancer, which may introduce selection bias.

How to read the evidence

Moderate evidence from a well-powered cross-sectional study within a large established cohort, using validated biomarker measurement.

When this study was published

Published in 2016. The effects of cannabis on female reproductive health continue to be studied.

The bigger picture

This study adds nuance to the combustion by-product discussion: not all smoke is equally harmful to all organ systems. While marijuana smoke contains many of the same toxic chemicals as tobacco smoke, the ovarian effects appear different, possibly because nicotine has specific vasoconstrictive effects on ovarian blood supply that THC does not share.

Questions still open

• Does marijuana affect other markers of female reproductive health? Would heavy daily marijuana use show an effect not detected in this mixed-frequency sample? Does the lack of ovarian effect extend to fertility outcomes?

Common questions

Read the original research

Antimüllerian hormone in relation to tobacco and marijuana use and sources of indoor heating/cooking.

Fertility and sterility, 106(3), 723-30

Citation

White, Alexandra J; Sandler, Dale P; D'Aloisio, Aimee A; Stanczyk, Frank; Whitworth, Kristina W; Baird, Donna D; Nichols, Hazel B. (2016). Antimüllerian hormone in relation to tobacco and marijuana use and sources of indoor heating/cooking.. Fertility and sterility, 106(3), 723-30. https://doi.org/10.1016/j.fertnstert.2016.05.015

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