Cannabis Use and Men’s Fertility

The Trump administration’s current efforts to ease federal drug restrictions are raising questions about cannabis and its broader health implications. This includes ongoing discussions about both medical and recreational marijuana. A particularly overlooked concern is its potential impact on men’s fertility.

During National Infertility Awareness Week, health professionals are emphasizing how both types of cannabis could negatively affect male reproductive health. “It’s disheartening, especially for men and women hoping to start a family,” notes Dr. Alta DeRoo from the Hazelden Betty Ford Foundation.

Cannabis has been linked to various changes in reproductive health across genders, but existing human studies present mixed findings.

For instance, a Harvard-connected study from 2025 found that women undergoing fertility treatments faced double the rate of miscarriages if they were cannabis users compared to those who abstained from it. Yet, it’s important to mention that many people mistakenly attribute fertility issues solely to women. According to Dr. Stephanie Seminar from Massachusetts General Hospital, male infertility is actually more common than many realize.

“People often assume infertility is a woman’s issue, but male factors account for about 45% of infertility cases globally,” she points out.

There’s a tendency to think that normal sexual performance equates to normal fertility, which isn’t always the case, Seminar says. Evaluating male infertility requires looking beyond semen analysis, considering aspects like sexual dysfunction, exposure to toxins, and substance use.

Effects of Cannabis on Male Fertility

Heavy and chronic cannabis use could harm male fertility, Seminar warns. This might involve shifts in reproductive hormones and declines in sperm count and mobility.

Research supports these concerns. A 2019 review indicated associations between smoking cannabis and reduced semen quality. Additionally, a study involving over 1,200 young Danish men found that smoking cannabis more than once a week correlated with significant drops in sperm concentration—28% and 29% lower total sperm count.

Interestingly, mixing cannabis with other recreational drugs exacerbated the issue, leading to even steeper declines in sperm metrics.

Hormonal Disruption

The body produces its own endocannabinoids that help regulate functions like fertility, a point confirmed in studies. Cannabis, particularly its compounds CBD and THC, can interfere with this natural system.

While THC may provide relief from pain and stimulate appetite, it can also trigger adverse side effects, including anxiety. The entry of cannabis into the body might impede sperm quality and reproductive function by binding to the same receptors as natural endocannabinoids.

Some evidence suggests that cannabis can alter levels of critical reproductive hormones, such as FSH and LH, which stimulate sperm production. This disruption could lead to fertility challenges, although there’s still ongoing debate about the full extent of these effects.

Potential Reversibility

Experts recommend that men hoping to father children should cease cannabis usage, as impaired sperm quality significantly diminishes the chances of conception. Stopping could lead to improvements in fertility, with suggestions that discontinuing cannabis use at least three months before attempting to conceive allows time for the body to produce healthier sperm.

The American Society for Reproductive Medicine likewise encourages couples to stay clear of recreational drugs to boost their odds of a successful pregnancy. “Quitting cannabis often leads to better overall health, and for many, the goal of starting a family can be a powerful motivator,” adds DeRoo.

Cannabis Use in America

In 2021, nearly 52.5 million Americans were reported to have used cannabis, illustrating its prevalence as the most commonly used federally illegal drug in the U.S. About 30% of users may develop a cannabis use disorder, affecting various day-to-day aspects of their lives.

While recreational cannabis is legal in nearly half of U.S. states, medical marijuana is permitted in over 30 states. Nevertheless, a small number of states still maintain strict bans on cannabis.