Cannabis and Testosterone: What Every Utah Man Needs to Know
Cannabis and Testosterone: What Every Utah Man Needs to Know
A Comprehensive, Evidence-Based Clinical Review by Arsenal Men's Health
Medical Disclaimer: This article is for educational purposes only and does not constitute medical advice. Treatment decisions should be made in consultation with a licensed healthcare provider. Arsenal Men's Health offers comprehensive hormone evaluations for Utah men.
Introduction: The Growing Conversation About Cannabis and Male Hormones
As cannabis legalization continues to expand across the United States—with Utah permitting medical marijuana use—men are increasingly asking an important question: How does cannabis affect testosterone levels and overall reproductive health? This is particularly relevant for the men we serve at Arsenal Men's Health, many of whom are actively optimizing their hormonal profile while navigating decisions about cannabis use.
The relationship between cannabis and testosterone is complex, nuanced, and—critically—still evolving in the scientific literature. Unlike simple cause-and-effect relationships, the interaction between cannabinoids and male hormones involves multiple biological pathways, varies based on usage patterns, and may affect individuals differently based on age, overall health status, and concurrent lifestyle factors.
In this comprehensive review, we'll examine the current peer-reviewed evidence, explain the biological mechanisms at play, and provide actionable guidance for men who want to make informed decisions about their health. Whether you're currently using cannabis, considering it for medical purposes, or simply curious about its effects, understanding this relationship is essential for anyone serious about hormone optimization.
Understanding the Endocannabinoid System and Male Reproduction
Before examining how cannabis affects testosterone, it's essential to understand the endocannabinoid system (ECS)—the body's natural regulatory network that interacts with cannabinoids. Discovered in the 1990s during research on THC, the ECS plays a critical role in maintaining homeostasis across numerous bodily functions, including reproduction.
The ECS in Male Reproductive Tissues
Research published in the peer-reviewed journal Molecular and Cellular Endocrinology demonstrates that both endocannabinoids and cannabinoid receptors (CB1 and CB2) are present throughout the male reproductive system. These receptors have been identified in:
Leydig cells: The primary testosterone-producing cells in the testes
Sertoli cells: Essential for sperm production and development
Spermatozoa: Mature sperm cells themselves contain cannabinoid receptors
Hypothalamus and pituitary gland: The command centers controlling hormone release
This widespread distribution suggests that the ECS serves as a critical regulatory mechanism for male reproductive function. When external cannabinoids (like THC from cannabis) enter the body, they interact with these same receptors, potentially influencing testosterone production and sperm health through multiple pathways.
The Hypothalamic-Pituitary-Gonadal (HPG) Axis
The HPG axis represents the hormonal communication network controlling testosterone production. According to research published in the British Journal of Pharmacology, this cascade works as follows:
Hypothalamus: Releases gonadotropin-releasing hormone (GnRH)
Pituitary Gland: Responds by secreting luteinizing hormone (LH) and follicle-stimulating hormone (FSH)
Testes: LH stimulates Leydig cells to produce testosterone; FSH supports sperm production
Preclinical studies indicate that THC can suppress GnRH release from the hypothalamus, creating a cascade effect that may reduce LH levels and subsequently decrease testosterone production. Research by Wenger and colleagues demonstrated that THC injected into the third cerebral ventricle of male rats caused indirect decreases in LH by inhibiting hypothalamic LHRH release.
What Does The Research Actually Show? Examining the Evidence
The scientific literature on cannabis and testosterone presents a complex, sometimes contradictory picture. Understanding these nuances is crucial for making informed decisions about your health.
Studies Suggesting Short-Term Testosterone Increases
Several large-scale studies have found surprising results that challenge conventional assumptions:
The NHANES Study (2017)
A landmark study published in the journal Drug and Alcohol Dependence analyzed data from 1,577 men in the U.S. National Health and Nutrition Examination Survey. Key findings included:
Men with more recent marijuana use exhibited higher serum testosterone concentrations compared to those who hadn't used recently
Recency of use was more strongly correlated with testosterone levels than frequency of use
This represents the largest study to date examining marijuana and serum testosterone in U.S. males
The Danish Study (2015)
Research published in the American Journal of Epidemiology examined 1,215 healthy young Danish men and found that testosterone levels were actually higher among marijuana users compared to non-users, with the effect most pronounced in those who had used more recently.
Harvard T.H. Chan School of Public Health Study (2019)
This prospective study of 662 men at a fertility clinic found that men who had ever smoked marijuana had significantly higher sperm concentrations (62.7 million/mL) compared to never-users (45.4 million/mL). Researchers also observed that among marijuana smokers, greater use was associated with higher serum testosterone levels.
Studies Suggesting Negative Effects on Testosterone
Conversely, other research suggests potential negative impacts, particularly with chronic or heavy use:
The OHSU Primate Study (2022)
A study published in Fertility & Sterility by Oregon Health & Science University researchers examined nonhuman primates given daily THC edibles over seven months. The findings were notable:
THC use was associated with decreased testosterone levels
Researchers observed greater than 50% decrease in testicular size
Effects occurred at doses equivalent to heavy medical marijuana use in humans
Infertility Cohort Studies
Research published in Frontiers in Reproductive Health examining 316 infertile men found that marijuana use was associated with significant hormonal changes, including lower estradiol levels and altered testosterone-to-estradiol ratios. The study also identified elevated prolactin levels in cannabis users, suggesting broader endocrine disruption.
Direct vs. Indirect Effects: A Critical Distinction
A 2023 study published in the World Journal of Men's Health provides important context. Researchers exposed human adult testis tissue directly to THC and CBD for up to 9 days and found:
No direct effect: Neither THC, CBD, nor the mixture significantly modified testosterone secretion
Leydig cells unaffected: The spatial distribution and function of testosterone-producing cells remained unchanged
Implications: Any negative effects may occur through central mechanisms (HPG axis) rather than direct testicular impact
This suggests that while cannabis may not directly damage testosterone-producing cells, it could still affect hormone levels through its actions on the brain and pituitary gland.
Beyond Testosterone: Cannabis and Sperm Quality
While testosterone levels show conflicting results, the evidence regarding sperm parameters is more consistent—and concerning for men considering fertility.
Systematic Review Findings
A comprehensive systematic review published in the Journal of Urology evaluated all available evidence on cannabis and male fertility. The conclusions were significant:
Reduced sperm count and concentration: Multiple studies demonstrate lower sperm numbers in cannabis users
Morphological abnormalities: Cannabis use associated with abnormal sperm shape and structure
Reduced motility: Sperm from cannabis users show decreased swimming ability
Decreased viability: Lower percentage of living sperm in samples
Inhibited fertilizing capacity: Reduced ability to successfully fertilize eggs
The Denmark Fertility Study Finding
The same Danish study that found higher testosterone in cannabis users also revealed concerning sperm findings: smoking marijuana more than once per week was associated with a 28% lower sperm concentration. When combined with other recreational drugs, the reduction was even more dramatic—52% lower sperm concentration and 55% lower total sperm count.
Sperm DNA Integrity
A 2025 study published in Scientific Reports examined sperm DNA integrity in cannabis smokers versus non-smokers. Using specialized testing (Chromomycin A3 and Acridine Orange staining), researchers found that cannabis smokers had significantly higher rates of sperm DNA damage and chromatin abnormalities—factors that can affect fertilization success and embryo development.
Cannabis and Sexual Function: The Erectile Dysfunction Question
For many men, sexual performance is as important as hormone levels. The relationship between cannabis and erectile function presents another complex picture.
Meta-Analysis Findings
A systematic review and meta-analysis published in the American Journal of Men's Health analyzed five case-control studies involving 3,395 men. The results showed that cannabis users had approximately double the risk of erectile dysfunction compared to non-users.
However, researchers noted significant limitations: small sample sizes, heterogeneous study designs, and the difficulty of isolating cannabis effects from other lifestyle factors.
The Paradox of Subjective Experience
Interestingly, subjective reports often contradict objective measures. A large literature review found that 51.3% of cannabis users reported increased sexual arousal, and 73.5% reported enhanced sexual pleasure. A study using data from over 50,000 participants found that frequent marijuana users reported having sex more often than non-users.
This paradox may be explained by cannabis's dual mechanisms: while it may enhance subjective experience through mood and anxiety reduction, it could simultaneously impair physiological erectile mechanisms through effects on blood vessel function and smooth muscle tissue.
Potential Mechanisms of Erectile Impact
Research suggests two primary pathways through which cannabis might affect erectile function:
Central pathway: THC affects the hypothalamus, which coordinates sexual arousal responses
Peripheral pathway: Cannabinoids may directly affect smooth muscle in the corpus cavernosum, the erectile tissue of the penis
Studies have shown that cannabis users with erectile dysfunction are more likely to have signs of endothelial dysfunction—impaired blood vessel function that underlies many cases of ED.
CBD vs. THC: Are There Different Effects?
With the explosion of CBD products on the market, many men wonder whether cannabidiol affects hormones differently than THC.
Current Evidence on CBD
The 2023 World Journal of Men's Health study examined both THC and CBD effects on human testicular tissue. Key findings:
Neither CBD alone nor CBD combined with THC directly affected testosterone production
Short-term exposure showed no impact on Leydig cell function or distribution
No significant changes in genes involved in steroid synthesis were observed
Some preliminary research has suggested CBD might actually help preserve or slightly increase testosterone levels, though more research is needed. CBD-dominant products may offer a way to potentially minimize hormonal disruption while still obtaining some benefits of cannabis use.
Important Caveats
It's crucial to understand that most CBD products are not FDA-regulated, and quality varies dramatically between manufacturers. Additionally, many "CBD" products contain significant amounts of THC, which could affect hormones differently than pure CBD.
Dose and Frequency: Does Amount Matter?
One consistent finding across studies is that the effects of cannabis on male hormones appear to be dose-dependent and frequency-dependent.
Occasional vs. Heavy Use
The research suggests different patterns for different usage levels:
Occasional Use (Less than 3 times per week)
May cause short-term 5-15% fluctuations in testosterone
Recovery typically occurs within 24-72 hours after last use
Some studies show no clinically significant changes compared to non-users
Heavy or Chronic Use (Daily or near-daily)
More likely to affect HPG axis function
Some studies suggest 15-30% testosterone reductions in heavy users
Cumulative effects on sperm parameters more pronounced
Greater risk of persistent hormonal changes
Method of Consumption
How cannabis is consumed may also matter. Smoking introduces additional factors:
Combustion produces carcinogens and chemicals that may independently affect sperm
Respiratory effects may reduce oxygenation, potentially impacting overall health
Edibles provide more consistent dosing but may have different pharmacokinetics
Vaping may reduce some respiratory concerns but long-term effects remain unclear
Practical Recommendations for Utah Men
Based on the current evidence, here are evidence-based recommendations for men concerned about cannabis effects on their hormones:
If You're Trying to Conceive
Consider abstaining: The evidence on sperm quality is more consistently negative than testosterone effects
Allow recovery time: Spermatogenesis takes approximately 74 days, so plan for at least 3 months of abstinence before attempting conception
Get tested: A semen analysis can provide objective data on your current fertility status
If You're Concerned About Testosterone Levels
Get baseline labs: Before making assumptions, know your actual testosterone levels
Consider usage patterns: Occasional use appears less likely to cause significant changes than daily use
Monitor over time: Repeat testing can help determine if cannabis is affecting your individual hormone profile
Address other factors: Sleep, exercise, body composition, and stress often have larger impacts on testosterone than occasional cannabis use
If You Choose to Use Cannabis
Limit frequency: Less frequent use appears to minimize potential hormonal impacts
Consider CBD-dominant products: These may have fewer hormonal effects than high-THC options
Avoid smoking when possible: Other delivery methods may reduce additional respiratory and cardiovascular concerns
Maintain healthy lifestyle habits: Regular resistance training, adequate sleep, and healthy body composition can help maintain optimal testosterone
Get regular hormone monitoring: Periodic testing allows you to track any changes and adjust accordingly
When to Seek Professional Evaluation
Consider scheduling a comprehensive hormone evaluation with a qualified provider if you experience:
Persistent fatigue or low energy despite adequate sleep
Decreased libido or sexual performance concerns
Difficulty building or maintaining muscle mass
Unexplained mood changes, irritability, or depression
Difficulty concentrating or "brain fog"
Concerns about fertility
Questions about how cannabis may be affecting your health
At Arsenal Men's Health, our comprehensive hormone panels include total testosterone, free testosterone, LH, FSH, estradiol, SHBG, and other key markers that provide a complete picture of your endocrine health.
Conclusion: Evidence-Based Decision Making
The relationship between cannabis and male hormones is more nuanced than simple "good" or "bad" categorizations allow. Current evidence suggests:
Testosterone effects are inconsistent: Some studies show increases, others decreases, and many show no significant effect—individual response may vary significantly
Sperm quality concerns are more consistent: The evidence more uniformly suggests negative impacts on sperm count, morphology, motility, and DNA integrity
Sexual function presents a paradox: Enhanced subjective experience may coexist with objective physiological impairment
Dose and frequency matter: Heavy, chronic use appears more likely to cause negative effects than occasional use
Direct testicular effects may be minimal: Any impacts may occur through central nervous system mechanisms
The bottom line? Men who use cannabis—whether for medical or recreational purposes—should be aware of potential hormonal implications and make informed decisions based on their individual health goals, fertility plans, and risk tolerance. Regular hormone monitoring can help identify any personal impacts and guide decisions about usage patterns.
As research continues to evolve with expanding legalization, we'll continue to update our understanding of these complex relationships. In the meantime, the best approach is individualized: know your baseline, monitor your levels, and make decisions that align with your specific health objectives.
Take Control of Your Hormone Health
Schedule your comprehensive hormone evaluation with Arsenal Men's Health today. Our clinician-led approach provides personalized insights and evidence-based treatment options for Utah men.
Call (385) 666-6292 or visit arsenalmenshealth.com to get started.
Peer-Reviewed References
Thistle JE, et al. Marijuana use and serum testosterone concentrations among U.S. males. Drug and Alcohol Dependence. 2017;178:372-377. doi:10.1016/j.drugalcdep.2017.05.032
Gundersen TD, et al. Association Between Use of Marijuana and Male Reproductive Hormones and Semen Quality. American Journal of Epidemiology. 2015;182(6):473-481.
da Silva J, et al. The Acute Exposure of Human Adult Testis Tissue to Cannabinoids THC and CBD Does Not Impact Testosterone Production Nor Germ Cell Lineage. World Journal of Men's Health. 2023;41(4):928-939.
Lo J, Hedges JC, et al. Chronic THC exposure decreases testicular function in male nonhuman primates. Fertility & Sterility. 2022;117(2):388-396.
Paiva LC, et al. Marijuana Is Associated With a Hormonal Imbalance Among Several Habits Related to Male Infertility. Frontiers in Reproductive Health. 2022;4:820451.
du Plessis SS, et al. Marijuana, phytocannabinoids, the endocannabinoid system, and male fertility. Journal of Assisted Reproduction and Genetics. 2015;32(11):1575-1588.
Nassan FL, et al. Marijuana smoking and markers of testicular function among men from a fertility centre. Human Reproduction. 2019;34(4):715-723.
Pizzol D, et al. Relationship between cannabis use and erectile dysfunction: a systematic review and meta-analysis. American Journal of Men's Health. 2019;13(6):1557988319892464.
Hehemann MC, et al. Evaluation of the impact of marijuana use on semen quality. Therapeutic Advances in Urology. 2021;13:17562872211032484.
Alagbonsi IA, et al. Cannabis and Male Fertility: A Systematic Review. Journal of Urology. 2019;202(4):674-681.
Bhambhvani HP, et al. A Survey Exploring the Relationship Between Cannabis Use Characteristics and Sexual Function in Men. Sexual Medicine. 2020;8(3):436-445.
Wenger T, et al. Effects of cannabinoids on the hypothalamic-pituitary-gonadal axis. Brain Research Bulletin. 2001;56(3-4):177-182.
Burstein S, et al. Effects of cannabinoids on testosterone and protein synthesis in rat testis Leydig cells in vitro. Molecular and Cellular Endocrinology. 1979;14(1):41-50.
Kolodny RC, et al. Depression of plasma testosterone levels after chronic intensive marihuana use. New England Journal of Medicine. 1974;290(16):872-874.
Fantus RJ, et al. The effect of tetrahydrocannabinol on testosterone among men in the United States. Fertility and Sterility. 2020;114(3):e269.
About Arsenal Men's Health
Arsenal Men's Health is a premium, clinician-led telehealth practice serving Utah men. Founded by Courtney LaSumner Bass, NP—a board-certified nurse practitioner and military veteran—Arsenal provides comprehensive men's health services including testosterone replacement therapy, erectile dysfunction treatment, medical weight optimization, mental health support, and preventive care.
Our evidence-based approach combines clinical expertise with the convenience of telemedicine, delivering personalized treatment plans designed for the unique needs of each patient. With a commitment to discretion, quality, and results, Arsenal Men's Health has earned the trust of over 1,200 Utah men.
Contact Information:
Phone: (385) 666-6292
Email: info@arsenalmenshealth.com
Address: 489 South Jordan Parkway, Suite #254, South Jordan, UT 84095
Hours: Mon-Fri 8:00-18:00, Sat 8:00-13:00
Website: arsenalmenshealth.com
Disclaimer: This article is provided for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Arsenal Men's Health provides telehealth services exclusively to Utah residents.
