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Your sex life, your way
Weed is no longer just for hippies or hip-hop stars — around 22 million people in the U.S. are cannabis users. But there’s still a lot we don’t know about the long-term effects of marijuana on men’s health. For example, does weed affect testosterone?
Does it kill sperm? Can it cause erectile dysfunction (ED)?
Conflicting state and federal regulations keep research scarce, but we do know cannabis can impact hormones, including testosterone. And this can have residual effects on fertility and sexual function.
But it’s not so cut-and-dried. Frequency of use, consumption method (whether you smoke it or eat it), and lifestyle habits can all play a role in how weed impacts health.
Ahead, we’ll break down how marijuana interacts with the endocannabinoid system and what this means for your hormonal, sexual, and reproductive health. We’ll also look at CBD — is it safer choice?
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The endocannabinoid system (ECS) is a widespread cell-signaling network in the body that affects numerous biological functions, such as appetite, anxiety, learning, reproduction, and growth.
To activate the ECS, your body makes chemical compounds called endocannabinoids, which bind to cannabinoid receptors located throughout your body and brain.
Research shows the ECS is present in various parts of the body involved in male reproduction. Both endocannabinoids and cannabinoid receptors have been found in testicular tissue, including within Sertoli cells (which play a crucial role in sperm production) and Leydig cells (the primary source of testosterone).
The ECS also affects the male reproductive system by interacting with the hypothalamus-pituitary-gonadal (HPG) axis.
This mechanism, located in the brain and pituitary gland, controls the release of two other key hormones: follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These hormones communicate with the cells in your testes to aid sperm and testosterone production.
Though your body makes some endocannabinoids that activate the ECS, you can also activate them by using cannabis.
The cannabis plant has over 100 cannabinoids, but the two that get the most hype are:
Delta-9-tetrahydrocannabinol (THC)
Cannabidiol (CBD)
THC is the part of the plant that gets you high, and CBD has no psychoactive effects.
When you use cannabis, cannabinoids like THC and CBD bind to cannabinoid receptors, including those located along the male reproductive tract.
Research is still emerging on how these cannabinoids influence testosterone levels, but so far, there are some conflicting results.
Firstly, a study on nearly 1,600 U.S. males found no significant differences in serum testosterone concentrations between men who’d used marijuana in the past and those who had never used the drug.
However, researchers found that serum testosterone levels were higher in men who recently used marijuana.
What does this all mean? Marijuana may increase testosterone in the short term, but more research is needed to understand the long-term effects.
Contradicting the study above, a study on over 2,000 infertile men found that cannabis use actually lowered plasma testosterone levels.
Among the participants, roughly 11 percent reported cannabis use — and these cannabis users had lower total testosterone levels than non-users.
On top of having lower testosterone, cannabis users also had lower sperm morphology (meaning sperm shape and size were below what’s typically needed to conceive). But there were no effects on sperm concentration or motility (sperm movement).
Despite this link to lower testosterone levels, researchers concluded that cannabis use wasn’t linked to hypogonadism (clinical testosterone deficiency).
Testosterone is just one hormone that may be impacted by marijuana use.
In a study exploring how different lifestyle habits impact male fertility, researchers found a link between marijuana use and altered hormone levels.
Specifically, they saw that marijuana use lowered estradiol. This form of estrogen impacts male reproductive health by regulating libido, erectile function, and sperm production.
The study also found that cannabis use increased prolactin levels (prolactin is a hormone associated with lactation). This could have a negative effect on sperm production. However, they found no evidence that marijuana users have low testosterone levels.
In another review that looked at the effects of marijuana use on male fertility, researchers didn’t find a clear link between cannabis and hormonal imbalances. But there was some evidence that marijuana may negatively impact sperm, including sperm count, concentration, morphology, motility, and viability.
Before you start worrying that your vape pen will lead to infertility, you should know the studies included in the review had small sample sizes. Researchers said larger-scale human trials are needed before making any sweeping conclusions.
With all this talk about how smoking weed may or may not impact testosterone, you may wonder what this means for sexual function. After all, testosterone plays an important role in erectile function and libido.
Some research has found that cannabis has negative effects on erectile function because it stimulates specific receptors in the penile tissues. Other research has found cannabis to be a vasodilator (meaning it opens blood vessels) linked to increased desire and sexual satisfaction.
In a study of 4,800 men with sexual dysfunction, cannabis users showed better penile health (based on a test measuring penile blood flow) — despite the fact that they tended to drink more alcohol and smoke more tobacco. There was no difference in total testosterone levels between cannabis users and non-users.
However, it’s unclear if there’s a causal relationship between marijuana use and better penile health. Researchers pointed out that cannabis users tend to be younger and have fewer other health issues.
Interestingly, after controlling for other factors, the researchers did find a link between cannabis use and more relationship problems.
Read more about the connection between marijuana and ED in our blog.
There’s still a lot we don’t know about how cannabis affects overall health, including testosterone levels.
Some factors that may influence the outcomes are frequency of use and method of consumption.
For example, THC users in a 2019 study had small yet statistically significant increases in testosterone than non-users. This increase was biggest among regular users who smoked cannabis two to three times a month.
But the increase in testosterone seemed to decline with a higher frequency of use.
In another study of 1,215 Danish men, testosterone levels were seven percent higher in self-reported marijuana smokers than in non-users. However, researchers noted cigarette smokers also have higher testosterone levels than non-smokers. So it’s unclear if the act of using marijuana is what increased testosterone — or the act of smoking it. Chronic use was also associated with lower sperm quality.
An older study looked at how chronic marijuana use affected levels of testosterone, LH, FSH, prolactin, and cortisol in both men and women. The findings showed that chronic marijuana use had no significant impact on hormone concentrations in either men or women.
Most other research linking chronic marijuana use with lower testosterone is based on animal studies.
Edibles, tinctures, and topicals are safer than joints when it comes to lung health. Still, more research is needed to fully understand how the method of weed consumption affects your hormonal, reproductive, and sexual health.
Does weed affect testosterone? Maybe — but what about CBD? Though CBD won’t get you high, it could impact your hormones.
In a 2023 study, short-term exposure to CBD and THC didn’t directly affect testosterone production (or testicular cells, for that matter) when studied outside the body.
This might mean that neither of these compounds pose a threat to male reproductive health when used short-term. But the researchers did recommend more research to confirm their findings.
In another 2023 study on long-term use, CBD was linked to fewer cases of low testosterone in older men than what’s typical for this age group. This suggests CBD may actually have a positive effect on testosterone levels.
Though these findings are promising, it’s not always clear how safe or effective CBD products are.
Since federal restrictions on growing cannabis plants with low amounts of THC have been lifted, CBD has become widely available in a range of products and formulations, including topicals, foods, and beverages. And most of these commercial CBD products aren’t regulated by the FDA (U.S. Food and Drug Administration)
A recent poll found that as many as one in three American adults use CBD products. But being accessible doesn’t necessarily mean a product is safe.
If you’re thinking of using CBD to increase your testosterone, improve erectile function, last longer in bed, or relieve anxiety, there are many other science-backed, thoroughly studied methods to try first.
Does smoking weed affect testosterone levels? The jury’s still out.
Research into how marijuana affects the endocrine system (your body’s feedback loop of hormones) is still emerging, but here’s what we do know:
The endocannabinoid system is linked to the male reproductive system. Research on the ECS is still fairly new, but both endocannabinoids and cannabinoid receptors have been found in testicular tissue, including within the cells that regulate sperm and testosterone production.
Marijuana may increase testosterone in the short term. Some research shows serum testosterone levels are higher in men who’ve recently used marijuana.
Other research shows marijuana may lower testosterone and sperm quality. In a study of infertile men, cannabis users had lower total testosterone levels than non-users. They also had lower sperm morphology, essentially meaning they weren’t the right shape or size to fertilize eggs and lead to pregnancy.
We’re not sure if cannabis use leads to erectile dysfunction. There’s not enough evidence to say marijuana causes ED, but it probably won’t help much. Also, many other, more effective treatment methods for ED are available.
Think you might have low testosterone because you’ve been struggling with telltale symptoms like ED, hair loss, or low libido? Do an online consultation with a healthcare provider today to figure out what’s going on.
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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.
Dr. Kelly Brown is a board certified Urologist and fellowship trained in Andrology. She is an accomplished men’s health expert with a robust background in healthcare innovation, clinical medicine, and academic research. Dr. Brown was previously Medical Director of a male fertility startup where she lead strategy and design of their digital health platform, an innovative education and telehealth model for delivering expert male fertility care.
She completed her undergraduate studies at University of North Carolina at Chapel Hill (go Heels!) with a Bachelor of Science in Radiologic Science and a Minor in Chemistry. She took a position at University of California Los Angeles as a radiologic technologist in the department of Interventional Cardiology, further solidifying her passion for medicine. She also pursued the unique opportunity to lead departmental design and operational development at the Ronald Reagan UCLA Medical Center, sparking her passion for the business of healthcare.
Dr. Brown then went on to obtain her doctorate in medicine from the prestigious Northwestern University - Feinberg School of Medicine and Masters in Business Administration from Northwestern University - Kellogg School of Management, with a concentration in Healthcare Management. During her surgical residency in Urology at University of California San Francisco, she utilized her research year to focus on innovations in telemedicine and then served as chief resident with significant contributions to clinical quality improvement. Dr. Brown then completed her Andrology Fellowship at Medical College of Wisconsin, furthering her expertise in male fertility, microsurgery, and sexual function.
Her dedication to caring for patients with compassion, understanding, as well as a unique ability to make guys instantly comfortable discussing anything from sex to sperm makes her a renowned clinician. In addition, her passion for innovation in healthcare combined with her business acumen makes her a formidable leader in the field of men’s health.
Dr. Brown is an avid adventurer; summiting Mount Kilimanjaro in Tanzania (twice!) and hiking the incredible Torres del Paine Trek in Patagonia, Chile. She deeply appreciates new challenges and diverse cultures on her travels. She lives in Denver with her husband, two children, and beloved Bernese Mountain Dog. You can find Dr. Brown on LinkedIn for more information.
Education & Training
Andrology Fellowship, Medical College of Wisconsin
Urology Residency, University of California San Francisco
M.D. Northwestern University Feinberg School of MedicineB.S. in Radiologic Science, Chemistry Minor, University of North Carolina at Chapel Hill
Published as Kelly Walker
Cowan, B, Walker, K., Rodgers, K., Agyemang, J. (2023). Hormonal Management Improves Semen Analysis Parameters in Men with Abnormal Concentration, Motility, and/or Morphology. Fertility and Sterility, Volume 118, Issue 5, e4. https://www.sciencedirect.com/journal/fertility-and-sterility/vol/120/issue/1/suppl/S
Walker, K., Gogoj, A., Honig, S., Sandlow, J. (2021). What’s New in Male Contraception? AUA Update Series, Volume 40. https://auau.auanet.org/content/update-series-2021-lesson-27-what%E2%80%99s-new-male-contraception
Walker, K., Shindel, A. (2019). AUA Erectile Dysfunction Guideline. AUA Update Series, Volume 38. https://auau.auanet.org/content/course-307
Walker, K., Ramstein, J., & Smith, J. (2019). Regret Regarding Fertility Preservation Decisions Among Male Cancer Patients. The Journal of Urology, 201(Supplement 4), e680-e681. https://www.auajournals.org/doi/10.1097/01.JU.0000556300.18991.8e
Walker, K., & Smith, J. (2019). Feasibility Study of Video Telehealth Clinic Visits in Urology. The Journal of Urology, 201(Supplement 4), e545-e545. https://www.auajournals.org/doi/10.1097/01.JU.0000556071.60611.37