Cannabis and Male Fertility: A Systematic Review | Hacker News Reader

Cannabis and Male Fertility: A Systematic Review

pubmed.ncbi.nlm.nih.gov

74 pointsdmitriy_ko118 comments

For comparison, alcohol is well known to have a dramatic impact on both sperm and testosterone production once you exceed a fairly modest threshold (5 drinks/week):

https://pathfertility.com/how-does-alcohol-affect-male-ferti...

People who have ED need to read this.

What does ED stand for?

Erectile Disfunction

Why? An erection is just a natural delivery mechanism, no measure of healthy, or rather fertile sperm. Besides that Weed tends to give me a real hard boner.

So I don't get your point?

Biking too

Hot tubs are the closest thing we have to male birth control.

I guess I should stop having a cold beer in the hot tub after riding my bike back from work…

Those phytoestrogens play some interesting games. As does a liver with damage caused by alcohol. Add to this the irony of all the advertising around beer being a predominantly "man's drink" and it gets even more interesting.

I'm not sure my kids would agree with that.

Anecdotes are irrelevant when discussing large-scale statistical trends.

Which is why more studies are needed

Haha my thought exactly

5 drinks/week is a lot.

It's not a huge figure though: a glass of wine with dinner most nights, or a couple of brewskis with boys on Fri & Sat night. For men, the bar for "heavy" drinking is 15+ drinks/week.

Research has “The bar” being lowered for many years. It is pretty clear at this point that all but the most sparing consumption of alcohol has measurable negative effects.

Not even remotely. That’s less than a drink a day.

Drinking ~everyday is a lot for a lot of people.

> fairly modest

> 5 drinks/week

This makes me wonder strongly what you would consider a significant amount of alcohol consumption, because 5 drinks/week seems like a huge amount to me already.

Where on earth do you live? Looking at some stats, that number was the average for the UAE in 2016. At this time it was illegal to drink without a license, and Muslims could not obtain these at all.

I live in the Netherlands and here alcohol consumption is highly skewed. Smoking too btw. Also one of the few - if not only - places where alcohol consumption correlates inversely with poverty.

If you drink here, you're probably an alcoholic. Even if most don't think they are.

Can't believe that, though I haven't been in .nl for a long time, so I have no 'feeling' for how it could be now. But why then there is Amstel, Grolsch, Heineken and some more?

I think they were saying everyone who drinks there is an alcoholic (by normative global standards?). The reason there would be so many beer brands is because there are a lot of consumers :)

One thing to remember that is that for alcohol consumption, average >>> median. The top drinkers drink an astronomical amount, but a typical person drinks much less than the average.

significant is more like 5 drinks/day, not /week

The important bit:

> Current research suggests that cannabis may negatively impact male fertility. Further studies are needed to validate that robust findings in animal models will carry over into human experience.

My takeaway: if you are having trouble reproducing, and/or your doctor finds some anomalies in a full fertility workup, you may want to talk about your marijuana use with them. That's about it.

> to our knowledge these results have not yet been replicated in human studies

Yup, this is just a literature review and there have been no human studies on this specific scenario.

If you read that in context, it's clear that the qualification only applies to some of the results they're reporting:

The strongest evidence of cannabis induced alterations in male fertility is in the category of semen parameters. Research supports a role for cannabis in reducing sperm count and concentration, inducing abnormalities in sperm morphology, reducing sperm motility and viability, and inhibiting capacitation and fertilizing capacity. Animal models demonstrate a role for cannabis in testicular atrophy, and reduced libido and sexual function but to our knowledge these results have not yet been replicated in human studies.

"These results" clearly refers to the animal model studies they mention later, so that caveat does not apply to the "strongest evidence" they lead with, about sperm motility and viability, etc. At least not to judge by the abstract.

Yeah I saw that I was just highlighting the bit about animal studies. GP had the entire quote in context.

> My takeaway: if you are having trouble reproducing, and/or your doctor finds some anomalies in a full fertility workup, you may want to talk about your marijuana use with them. That's about it.

You should discuss all use of non-prescribed drugs with your doctor on a routine basis.

Absolutely; in my experience, they always ask (you probably won't have to be the one that brings it up). Healthcare is expensive, at least get your money's worth!

Do you not worry about buying life insurance and then asking for your medical history and then denying coverage or increased premiums?

Just because you discuss something with your doctor, doesn't mean that data needs to go into the EHR.

On the contrary you should assume it does unless you explicitly ask otherwise and even then it still might. And the OP is right, when you ask for life insurance they get everything because you have to allow them to ask for all data as if the request were coming from you.

Yes, what I was insinuating is that you should talk to your doctor about keeping occasional drug use out of the EHR before revealing any data.

They might add that data to your EHR against your wishes, though.

Then fire them.

Unfortunately, that doesn't fix the problem.

YMMV but my prescribed cannabis usage did not impact my life insurance premium. I was worried it would, but knew that the blood + urine tests would show usage anyway. It worked out for me.

Maybe things have changed but in 2016 I was unable to get life insurance in CA due to admitting to recreational cannabis use with a vaporizer. A ridiculously expensive “smokers” policy was the only thing on offer.

Things might have changed. I got my policy Sept. 2021.

There was a whole section of my application regarding cannabis usage. I provided my medical rec. There was a question about seeing a psychiatrist regarding cannabis usage (no). No questions about consumption method. My premium was that of the quoted non-tobacco premium, so I don't think it was affected at all.

In Norway, admitting usage of recreational cannabis to your doctor is likely to result in your driver's license being suspended as they are known to forward the information on to police.

Advice to talk about it with your doctor is useless if you can just stop taking it. If you cannot (f.e. due to chronic pain), then you may as well stop worrying about it. Your doctor will not be able to magic anything away in either one of those scenarios.

You should still be able to be 100% honest and open with your doctor in regards to your health. The more they know about your health and habits, the better they can help you. Your doctor should not be ratting you out to the cops. That just keeps shit underground and untreated.

> should not

I agree, but the unfortunate fact is that it's not just Norway where you are one mistake away from being ratted out. General rules of thumb in this case should serve the individual. If you are very scared of drug interactions, you can just as easily find this information online.

The only caveat I would imagine with what you said is in the case of prescription drugs. Drugs of all kinds can have interactions when combined with together (both known and unknown), so disclosing the usage of non-prescribed supplements and alternative drugs can be vital information.

However, in the case of the GP comment about Norway -- if there are legal ramifications, then I suppose this becomes a more complex issue to navigate. Though, if "socially unacceptable" drugs and their usages were not so stigmatized, this wouldn't be an issue either.

One can see something like this in the US a bit. There is a somewhat rare condition called CHS (Cannabinoid Hyperemesis Syndrome) where chronic, long-term users of cannabinoid products develop a condition similar to Cyclical Vomiting Syndrome. For ER professionals, telling the difference between the two (and other GI issues) can be extremely difficult -- especially if the patient does not disclose their usage of cannabinoid products. Some ERs are starting to drug test patients exhibiting symptoms of CHS/CVS to help in the diagnostic process, so they do not have to rely on patient honesty.

I think this explains the sudden rush to legalize marijuana - if you can’t jail the pot heads then keep them from breeding! Solves multiple problems and so simple I’m surprised Nixon didn’t do this in the 70s.

In most recreationally legal states, the legalization laws came from direct democracy with the people who would not be involved with any convoluted goal aside from the stated goal on the ballot. There is nothing a governor or representative could do.

The people decided that jail was a counterproductive public policy measure and the people decided that the supply chain could be controlled to protect consumers.

This concept will likely to be extended to most of the schedule, a new framework is necessary as prohibition is being repealed, again.

Thanks for your comment. I used to think in conspiratorial ways - “Marijuana movement in US is a Chinese CCP weapon to kill US productivity, plummet the GDP and reduce population”.

Sometimes it’s just easy to imagine that a bunch of people voted for it.

China doesn't need to help, they just need to be patient while we do it to ourselves!

Are we really doping animals to find out that potheads can't reproduce as easily? To what benefit?

Medical and therapeutic marijuana has a wide range of benefits, from depression to Parkinson to glaucoma.

Since your understanding of marijuana usage seems limited to recreational usage and you pejoratively call the consumers "potheads", I'd suggest you turn to the scientific literature, conclusively applied as policy in a growing number of countries, and confront your views to what you'd read.

To be frank, you sound pretty ignorant with this comment. I'm sure you didn't intend such but any modern perspective puts weed as a safer alternative to alcohol and a social indulgence used by many extremely successful people. This also ignores all of the medical uses which alone make it worth studying.

Yeah, when we wanted to have a kid I quit cannabis and hot-tubbing for 6 months in anticipation of conceiving. It worked, and she's healthy! Sample size of 1, but it felt like kind of a nice way to commit to a family and get in the proper head space anyways.

> hot-tubbing

How does this affect fertility?

The hot water cooks your balls. There’s a reason they dangle outside the thermal mass of your body.

Regular exposure to hot water (baths or hot tubs) is a somewhat reliable male birth control.[1]

[1]: https://en.wikipedia.org/wiki/Heat-based_contraception

Tangential addendum: I used to smoke pot all the time. From my mid-teens to mid-twenties. At least once a day, increasing over time to 3-5-∞ times a day. In the last year, I have significantly reduced my marijuana usage to less than once a week. My mental health has benefitted tremendously (also thanks to a great therapist!). I sleep better, I eat less shitty food, I enjoy sex more, I feel overall more equipped to handle my daily life and be an adult. I only date people of the same sex, so standard reproduction isn't a big concern for me; but if you're a pothead like I was (am?)--there's a lot more to reflect on than your sperm count. :)

> I only date people of the same sex

I initially read that as a side effect of not smoking weed anymore.

hahahaha! In which case, can't recommend it enough!

I think a lot of pro cannabis people are out of balance with viewing the negative side effects. It's a drug and has side-effects. It's much safer than tobacco and alcohol but it certainly has side effects including a strong psychological addiction potential.

Maybe a blend of low psychoactive cannabinoids + some THC could become a better norm.

I agree. It's going to get complicated though. There are hundreds of cannabinoids we're aware of with barely any scientific understanding of the effects. CBD, CBN, and CBG all started popping up in dispensaries in different combinations with THC. We still don't really fully understand what they do. There are also more potent versions of THC like THC-O (1)

(1) https://en.wikipedia.org/wiki/THC-O-acetate

Cannabinoids have been studied a bit already, not claiming we know everything about them but we're not in the blur either. And I was not thinking about THC derivatives, mostly non psychoactive (cbn/d/g).

We don't have a mature culture around cannabis usage. Alcohol has this benefit, and we have some social norms on how to enjoy it. A big one is the "don't drink before 5" adage. Norms like this for weed will develop in time, I'm sure.

We live in different bubbles. I certainly live in a social circle that has a mature view on cannabis. Perhaps it's Amsterdam.

I smoke about 6 to 12 times per year, mostly THC/CBD (Dutch weed), sometimes CBD only (specifically, weed from Switzerland).

Dutch weed: 3 to 5 puffs and I'm fine. Smoking half a joint or more is definitely overdosing it, feeling cold and uncontrollable tremors can occur.

Swiss weed: I smoke half a joint.

Yeah, wake and bake is a bad cultural norm for weed. Then again, smoking at 4:20 would mirror the "no day drinking" norm.

I'm seeing the opposite quite often where I live, people who are quite a bit into weed usually end up needing to bake in order to sleep more comfortably.

Maybe they are having problems sleeping to begin with.

Likely, but also cannabinoids can interfere with sleep. A regular user can experience night sweats when they do not have cannabinoids, depending on frequency of use

Preferable to waking up to panic attacks from dream content.

Smoking cannabis 8 times a day in not being "pro" cannabis. Not wanting to get incarcerated for life for possession of few grams of a plant is "pro" cannabis.

i don't understand this cannabis-is-safer-than-alcohol myth. for example, i know people that have an extremely low mental tolerance for cannabis while functioning completely normal on a bottle of beer a day. also, i think that it is fairly well known that cannabis has a worrying correlation with schizophrenia [0]

[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7442038/

Eating cannabis won't give you cancer, drinking alcohol likely will. One of these things has metabolites that actively damages DNA and one does not

a glass of red a night is most likely not going to give you cancer or damage your DNA. a joint a night on the other have just might (depending on your predisposition) have an extremely negative effect

besides given how long we have been consuming alcohol throughout our history, i think its effects are largely understood. we do not know this about cannabis

How long do you think humans have been consuming cannabis? Arguably longer than alcohol, not that it matters anyhow. The restrictions are arbitrary, not to mention being habituated to a nightly GABA agonist (alcohol) has just as many negative implications as nightly cannabinoids. The cannabinoids just won't five you cancer on top of it

It's like you don't even know google exists. You just spout one false fact after another.

Cannabis is one of the oldest cultivated plants in human history (1). It was smoked for pleasure and religiously long before Christianity became a religion.

I wonder, do you dilute your glass of red wine before drinking it? The ancient Greeks diluted their wine with 25% wine and 75% water. They also viewed anyone who didn't as a barbarian and drunkard (2).

1) https://en.wikipedia.org/wiki/History_of_cannabis#:~:text=Ca....

2) https://www.worldhistory.org/article/944/wine-in-the-ancient...

So vaporize it.

Not "vape", with juice.

Heat, and inhale.

I'm specifically focusing on the pharmacology of the psychoactive substances rather than the method used to consume them. No matter the method of administration, there are still risks and side effects. Sidestepping the discussion of smoking vs gaping allows us to focus on the action of the compounds themselves. We already know smoking is bad, we should not combust things and inhale the byproducts

Yah, well. Then don't. Maybe plug the gaping hole with it. Rectal administration is a thing. (I've heard)

It's not a myth and a few simple google with give you plenty of evidence. Here's a few:

- Cancer

- Weight gain (alcohol is more calorie dense than sugar)

- Birth defects

- Drunk driving: 10K deaths a year

- Violence / sexual violence

- Overdosing

- Withdrawal can cause death

- Did you know date rape drugs wouldn't work without alcohol? (2) It's only the combination with alcohol that causes the victim to pass out.

If you actually look at how alcohol has an impact on the body, it's effectively a poison. It has no medical benefits and only consequences. The whole red wine thing has nothing to do with alcohol but some of the enzymes in red wine specifically. Just drink grape juice instead.

I really don't care if you give yourself cancer. That's a personal decision but consumption of alcohol leads to so much crime and impact on others. Weed not so much. As a society, we've made a decision to tolerate it but it's still there.

1. https://drugabuse.com/blog/marijuana-vs-alcohol/

2. https://www.drugs.com/illicit/ghb.html

All things have negatives when overdone.

When my cousin stopped cold turkey, his speech/thoughts pace was a solid 50% up. It was surreal.

Counter point - Bob Marley had 12 kids

Weed was a lot less potent back then.

Probably not the stuff Bob Marley was smoking.

I was reading somewhere Bob Marley had 12 acknowledged children so for him it wasn’t a problem. I wonder how his smoking affected his his offspring though

There is some debate there apparently. I once heard a wailer say that it was actually 22, but checking wikipedia it says 11.

There is an exception to every rule.

It just might be that BM was having a lot more sex than the average guy.

Probability alone would account for 12 (or 22) children.

Quality could also have been affected.

He only had 12 kids.

The rate he went through groupies I would expect 100+

interestingly enough it actually increases testosterone

Cool, do fast food or alcohol next!

Or plastic exposure. But I’m not sure how you would find a control group.

How to tell your brother to stop spending money on fertility treatment without telling your brother to stop smoking weed?

> Animal models demonstrate a role for cannabis in … reduced libido and sexual function but to our knowledge these results have not yet been replicated in human studies.

Um.

A systematic review that came out with 'may' do something and never addressed the elephant in the room?

That's very weak in my books. Cannabis is an aphrodisiac. If they found a small effect, it's something else.

What is that something else?:

https://www.niehs.nih.gov/health/topics/agents/endocrine/ind...

Every single one of those is in your drinking water, most of them are in your food. It's even worse if you live coastal on salt water where they recycle water often. No government attempts to remove these. This is the reason you need water filtration or pay for the giant water bottles. Also the reason why many countries don't even bother trying to make clean water. Dont drink the water in Mexico etcetc.

> We performed a literature search using PubMed®/MEDLINE® to identify relevant studies of the effects of cannabis on male fertility. Relevant studies were identified and reviewed.

Why is this presented as new research?

It's not, that's what a review is.

Good, fewer stoners in the next generation

I'm not saying that their data isn't accurate, but it is strange that there's a 1:1 relationship between what the government wants to clamp down on and what will make your sperm die, make your testicles shrink, or make your penis flaccid.

> government wants to clamp down on and what will make your sperm die, make your testicles shrink, or make your penis flaccid

Hey man, if those are things you want, there are much easier ways which the government isn't clamping down on! You have my full support!

No, my point is that essentially saying your man parts are going to stop working is an easy path to ground for propagandists. I'm just floating the idea that's why cigarettes, alcohol, weed, cocaine, steroids, COVID, (edit also vaccines against COVID) and god-knows-what all have a steady stream of clickbait articles about how they damage your manhood.

I worked in the legal cannabis industry & I'm pretty sure it's just old puritan values for the most part. There's also a large history related to alcohol prohibition. Long story short, the government agency that handled enforcing prohibition needed something to do after prohibition ended. Then came waves of propaganda associating weed with black people, mexicans, and gays to make white people scared of it. Isn't it kind of weird that we call it marijuana in federal laws? Before, it was all just called "hemp". Nixon ramped it up and created the beginnings of our modern prison state. The US is the most incarcerated country in the world both by per capita and total number (1). Mass imprisonment became a way steal votes away from these communities as well as create a more palatable version of slavery where we currently have people working for $0.25/hour.

The reason why so much research is just coming out now is because it was illegal to study the plant. So it's kind of backwards to say the fertility or any other non-obvious effects inspired criminalization as no science was done until it became legal enough to study.

(1) https://www.statista.com/statistics/262961/countries-with-th...

I'd suggest that if you're seeing a steady stream of clickbait articles like this you may be in the wrong neighborhoods of the internet.

What about the vaccine that’s making everyone flaccid.. cure covid and solve overpopulation all in one go

Reply on news.ycombinator.com