Dr. David Pompei, PharmD, MS
Does marijuana affect testosterone levels? While this may seem like a surprising question, cannabis has a wide range of effects within the body such as lowering body temperature and affecting your metabolism. In this article, we will explore the latest research on how cannabis affects testosterone.
So, does marijuana affect testosterone levels? Keep reading to find out!
Testosterone is the primary hormone responsible for producing male sex characteristics. In men, testosterone plays a role in regulating libido, muscle mass, bone mass, body fat distribution, and the production of sperm and red blood cells.
Testosterone is primarily synthesized in “Leydig cells from cholesterol under direct control of luteinizing hormone which is secreted by the pituitary gland.” The pituitary gland is a pea-sized gland at the base of the brain that secretes hormones such as growth hormone, oxytocin, endorphins, and testosterone. Leydig cells are testicular cells responsible for the biosynthesis and secretion of androgens such as testosterone.
In men, low testosterone levels are associated with symptoms such as fatigue, decreased libido, loss of bone density and muscle mass, and an increase in body fat. Doctors often prescribe hormone replacement therapy to treat low testosterone levels. But how does cannabis use affect testosterone levels?
The question of whether cannabis raises or lowers testosterone levels has been researched fairly extensively - and there have been conflicting reports. Some studies have found that cannabis and THC lower testosterone, while others have found that cannabis users have higher testosterone. The answer may depend on dose and frequency of use.
In 2020, researchers revisited the question: does marijuana increase testosterone? Scientists from the Universities of Chicago, Miami, and Baltimore examined the association between testosterone levels and cannabis use in the last 12 months. The study found that men who report using cannabis 2-3 times per month have slightly higher levels compared to non-users or more frequent users.
This data is noteworthy as 82% of the cannabis users in the study reported using cannabis 4 or more times per month. If those who reported consuming cannabis at least 2-3 times per month demonstrated the most significant increases in testosterone, does dose and frequency of cannabis use affect testosterone? While we can’t draw any definitive conclusions, the researchers state that “this increase declined as individuals consumed greater amounts.”
To complicate the matter further, a 2017 study found that recent cannabis users had higher testosterone levels compared to subjects who had never used cannabis as well as subjects who had used cannabis but were not current users. The researchers found that “recency of use, and not duration or frequency, had the strongest relationship with testosterone levels.”
However, other studies have produced contradictory results.
In the mid-1970s, researchers designed a study to investigate the question, “does THC lower testosterone?” The researchers compared the testosterone levels of twenty male subjects between the ages of 18-28 who were chronic cannabis users (at least four days per week over six months) and non-users. In this limited study, there was almost a double increase in testosterone levels among men who did not use cannabis.
Furthermore, the study found that cannabis users had a dose-dependent decrease in testosterone levels - as in, the more a subject used, the lower his testosterone levels were. Additionally, the researchers found that cannabis users who abstained from cannabis during the study experienced a marked increase in testosterone.
However, a follow-up study assessed a population of cannabis users who were under observation in a hospital. This study found no decrease in testosterone levels over the course of one month, which prompts the question of whether the original data were due to cannabis or other factors for which the researchers did not control.
To complicate the matter, a 1983 study found that a single cannabis cigarette or an intravenous dose of THC decreased testosterone levels for approximately 24 hours.
How is it possible that THC could both increase and decrease testosterone at different frequencies or doses? The authors of the 2020 study state, “THC may affect [testosterone] through [luteinizing hormone] modulation, receptor activity within the testicles, central suppression, hypothalamic modulation, or effects on multiple levels.” The authors also suggest, “THC use may cause androgen receptor insensitivity where higher amounts of [testosterone] are required for normal receptor activation in THC users.”
Evidently, cannabis has complex interactions with testosterone and the androgen system. Our knowledge of the endocannabinoid system is evolving, so we cannot make a definitive statement about how cannabis affects testosterone.
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