{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:55:17Z","timestamp":1790794517346,"version":"4.1.0"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T00:00:00Z","timestamp":1645056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Reprod. Health"],"abstract":"<jats:p>Marijuana is one of the most consumed drugs worldwide. There is increasing evidence of an association between marijuana and male infertility. This study intends to assess the repercussion of marijuana smoking and other habits (sedentary lifestyle, alcohol, and tobacco use) in the testicular function of infertile men seeking andrological evaluation. A retrospective study was performed using medical records data of men aged 18\u201359 years from 2009 to 2017. Complete semen analyses, sperm functional tests, SHBG, and hormonal levels, testosterone-to-estradiol ratio (T\/E<jats:sub>2<\/jats:sub>), and testis volume were evaluated. Exclusion criteria included cryptorchidism, infertility caused by genetic or infectious diseases, and cancer. A multiple linear regression analysis was performed to investigate which habit could predict certain parameters using the software SPSS 23.0 (<jats:italic>P<\/jats:italic> &amp;lt; 0.05). In a sample of 153 men, semen parameters, testosterone levels, and testis volume were not significantly influenced. Marijuana use had the broader hormonal changes since it influences estradiol (<jats:italic>P<\/jats:italic> = 0.000; <jats:italic>B<\/jats:italic> = \u221211.616), prolactin (<jats:italic>P<\/jats:italic> = 0.000; <jats:italic>B<\/jats:italic> = 3.211), SHBG levels (<jats:italic>P<\/jats:italic> = 0.017; <jats:italic>B<\/jats:italic> = 7.489), and T\/E<jats:sub>2<\/jats:sub> (<jats:italic>P<\/jats:italic> = 0.004; <jats:italic>B<\/jats:italic> = 14.030). Sedentary lifestyle (<jats:italic>P<\/jats:italic> = 0.028; <jats:italic>B<\/jats:italic> = 1.279) and tobacco smoking (<jats:italic>P<\/jats:italic> = 0.031; <jats:italic>B<\/jats:italic> = \u22122.401) influenced the prolactin levels. Marijuana is associated with hormonal imbalance in this infertile cohort by lowering estradiol levels and inhibiting aromatase function.<\/jats:p>","DOI":"10.3389\/frph.2022.820451","type":"journal-article","created":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T06:23:13Z","timestamp":1645078993000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Marijuana Is Associated With a Hormonal Imbalance Among Several Habits Related to Male Infertility: A Retrospective Study"],"prefix":"10.3389","volume":"4","author":[{"given":"Thiago A.","family":"Teixeira","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Iori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo","family":"Andrade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo H. N.","family":"Saldiva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00ebl R.","family":"Drevet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine M. F.","family":"Costa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Hallak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,2,17]]},"reference":[{"key":"B1","volume-title":"World Drug Report: United Nations","year":"2019"},{"key":"B2","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1038\/npp.2017.198","article-title":"US epidemiology of cannabis use and associated problems","volume":"43","author":"Hasin","year":"2018","journal-title":"Neuropsychopharmacol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1016\/j.fertnstert.2017.06.005","article-title":"The international glossary on infertility and fertility care, 2017 Fertil Steril","volume":"108","author":"Zegers-Hochschild","year":"2017"},{"key":"B4","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1016\/S0889-8529(05)70042-6","article-title":"Declining male fertility and environmental factors","volume":"27","author":"Giwercman","year":"1998","journal-title":"Endocrinol Metab Clin North Am."},{"key":"B5","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.fertnstert.2014.11.008","article-title":"Do some addictions interfere with fertility?","volume":"103","author":"Alvarez","year":"2015","journal-title":"Fertil Steril."},{"key":"B6","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1016\/j.euf.2018.08.006","article-title":"Adverse effects of cannabis on male reproduction","volume":"4","author":"Hsiao","year":"2018","journal-title":"Eur Urol Focus."},{"key":"B7","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1056\/NEJM197404182901602","article-title":"Depression of plasma testosterone levels after chronic intensive marihuana use","volume":"290","author":"Kolodny","year":"1974","journal-title":"N Engl J Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1093\/aje\/kwv135","article-title":"Association between use of marijuana and male reproductive hormones and semen quality: a study among 1,215 healthy young men","volume":"182","author":"Gundersen","year":"2015","journal-title":"Am J Epidemiol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1097\/JU.0000000000000248","article-title":"Cannabis and male fertility: a systematic review","volume":"202","author":"Payne","year":"2019","journal-title":"J Urol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1749","DOI":"10.1016\/0091-3057(86)90515-0","article-title":"Acute effects of smoking marijuana on hormones, subjective effects and performance in male human-subjects","volume":"24","author":"Cone","year":"1986","journal-title":"Pharmacol Biochem Behav."},{"key":"B11","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/0376-8716(91)90068-A","article-title":"Effects of chronic marijuana use on testosterone, luteinizing-hormone, follicle-stimulating-hormone, prolactin and cortisol in men and women","volume":"28","author":"Block","year":"1991","journal-title":"Drug Alcohol Depend."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1056\/NEJM197411142912003","article-title":"Plasma testosterone levels before, during and after chronic marihuana smoking","volume":"291","author":"Mendelson","year":"1974","journal-title":"N Engl J Med."},{"key":"B13","volume-title":"WHO Laboratory Manual for the Examination and Processing of Human Semen","year":"2010"},{"key":"B14","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1016\/S0015-0282(16)37684-1","article-title":"Varicocele size and results of varicocelectomy in selected subfertile men with varicocele","volume":"21","author":"Dubin","year":"1970","journal-title":"Fertil Steril."},{"key":"B15","unstructured":"12538942000"},{"key":"B16","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1016\/j.toxlet.2013.01.017","article-title":"OGG1 Ser326Cys polymorphism interacts with cigarette smoking to increase oxidative DNA damage in human sperm and the risk of male infertility","volume":"218","author":"Ji","year":"2013","journal-title":"Toxicol Lett."},{"key":"B17","volume-title":"Global Status Report on Alcohol and Health 2018.","year":"2019"},{"key":"B18","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1186\/s12885-015-1905-6","article-title":"Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis","volume":"15","author":"Gurney","year":"2015","journal-title":"BMC Cancer."},{"key":"B19","doi-asserted-by":"publisher","first-page":"2191","DOI":"10.1001\/jama.2013.281053","article-title":"World medical association declaration of Helsinki: ethical principles for medical research involving human subjects","volume":"310","year":"2013","journal-title":"JAMA"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.1016\/S0015-0282(16)49891-2","article-title":"Sperm morphological features as a prognostic factor in invitro fertilization","volume":"46","author":"Kruger","year":"1986","journal-title":"Fertil Steril."},{"key":"B21","volume-title":"Creatine Kinase in Sperm: The Presence of Mitochondrial and Brain-Type Creatine Kinase Isozymes","author":"Huszar","year":"1985"},{"key":"B22","doi-asserted-by":"publisher","first-page":"613","DOI":"10.2164\/jandrol.106.001966","article-title":"Development of normal reference values for seminal reactive oxygen species and their correlation with leukocytes and semen parameters in a fertile population","volume":"28","author":"Athayde","year":"2007","journal-title":"J Androl."},{"key":"B23","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.anireprosci.2016.01.017","article-title":"The Sperm Chromatin Structure Assay. (SCSA\u00ae) and other sperm DNA fragmentation tests for evaluation of sperm nuclear DNA integrity as related to fertility","volume":"169","author":"Evenson","year":"2016","journal-title":"Anim Reprod Sci"},{"key":"B24","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1152\/physrev.00017.2015","article-title":"Male reproductive disorders and fertility trends: influences of environment and genetic susceptibility","volume":"96","author":"Skakkebaek","year":"2016","journal-title":"Physiol Rev."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1575","DOI":"10.1007\/s10815-015-0553-8","article-title":"Marijuana, phytocannabinoids, the endocannabinoid system, and male fertility","volume":"32","author":"Du Plessis","year":"2015","journal-title":"J Assist Reprod Genet."},{"key":"B26","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1210\/er.2005-0009","article-title":"The emerging role of the endocannabinoid system in endocrine regulation and energy balance","volume":"27","author":"Pagotto","year":"2006","journal-title":"Endocr Rev."},{"key":"B27","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1016\/j.taap.2005.12.019","article-title":"Estrogenic effects of marijuana smoke condensate and cannabinoid compounds","volume":"214","author":"Lee","year":"2006","journal-title":"Toxicol Appl Pharmacol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1007\/BF02977903","article-title":"Antiestrogenic effects of marijuana smoke condensate and cannabinoid compounds","volume":"28","author":"Lee","year":"2005","journal-title":"Arch Pharm Res."},{"key":"B29","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1021\/tx970217f","article-title":"Roles of cytochromes P450 1A2 and 3A4 in the oxidation of estradiol and estrone in human liver microsomes","volume":"11","author":"Yamazaki","year":"1998","journal-title":"Chem Res Toxicol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.canlet.2004.10.007","article-title":"Cytochrome P450-mediated metabolism of estrogens and its regulation in human","volume":"227","author":"Tsuchiya","year":"2005","journal-title":"Cancer Lett."},{"key":"B31","doi-asserted-by":"publisher","first-page":"2233","DOI":"10.1093\/carcin\/13.12.2233","article-title":"Polynuclear aromatic hydrocarbon carcinogens as antiestrogens in mcf-7 human breast-cancer cells - role of the ah receptor","volume":"13","author":"Chaloupka","year":"1992","journal-title":"Carcinogenesis."},{"key":"B32","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/S0300-483X(99)00018-9","article-title":"Antiestrogenicity of environmental polycyclic aromatic hydrocarbons in human breast cancer cells","volume":"133","author":"Arcaro","year":"1999","journal-title":"Toxicology."},{"key":"B33","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1006\/bbrc.1996.1764","article-title":"The anti-estrogenic activity of selected polynuclear aromatic hydrocarbons in yeast expressing human estrogen receptor","volume":"229","author":"Tran","year":"1996","journal-title":"Biochem Biophys Res Commun."},{"key":"B34","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1021\/tx034036r","article-title":"Inhibitory aryl hydrocarbon receptor-estrogen receptor alpha cross-talk and mechanisms of action","volume":"16","author":"Safe","year":"2003","journal-title":"Chem Res Toxicol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"47","DOI":"10.3329\/dujps.v19i1.47818","article-title":"Cannabinoid as potential aromatase inhibitor through molecular modeling and screening for anti-cancer activity","volume":"19","author":"Baroi","year":"2020","journal-title":"DUJPS."},{"key":"B36","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1007\/s40618-014-0055-z","article-title":"Gynecomastia in subjects with sexual dysfunction","volume":"37","author":"Maseroli","year":"2014","journal-title":"J Endocrinol Invest."},{"key":"B37","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1007\/BF03033228","article-title":"Role of the endogenous cannabinoid system as a modulator of dopamine transmission: implications for Parkinson's disease and schizophrenia","volume":"3","author":"Rodriguez De Fonseca","year":"2001","journal-title":"Neurotox Res."},{"key":"B38","volume-title":"Effects of Continuous Use of Marijuana and Cigarette Smoking in Testicular Function and Its Relationship With Hypogonadism and Male Infertility [thesis]","author":"Hallak","year":"2018"},{"key":"B39","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1007\/s00213-008-1422-2","article-title":"The effects of cannabinoids on serum cortisol and prolactin in humans","volume":"203","author":"Ranganathan","year":"2009","journal-title":"Psychopharmacology."},{"key":"B40","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.aju.2017.10.002","article-title":"Hyperprolactinaemia in male infertility: clinical case scenarios","volume":"16","author":"Dabbous","year":"2018","journal-title":"Arab J Urol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"168","DOI":"10.4103\/0974-1208.121400","article-title":"Hyperprolactinemia","volume":"6","author":"Majumdar","year":"2013","journal-title":"J Hum Reprod Sci."},{"key":"B42","doi-asserted-by":"publisher","first-page":"1554","DOI":"10.1093\/humrep\/17.6.1554","article-title":"The impact of cigarette smoking on human semen parameters and hormones","volume":"17","author":"Trummer","year":"2002","journal-title":"Hum Reprod."},{"key":"B43","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1111\/j.1439-0272.1984.tb00381.x","article-title":"Prolactin and pituitary-gonadal function in cigarette-smoking infertile patients","volume":"16","author":"Andersen","year":"1984","journal-title":"Andrologia."},{"key":"B44","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1016\/j.pbb.2010.01.007","article-title":"Venous plasma nicotine correlates of hormonal effects of tobacco smoking","volume":"95","author":"Xue","year":"2010","journal-title":"Pharmacol Biochem Behav."},{"key":"B45","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1016\/j.scitotenv.2012.03.071","article-title":"Effect of current tobacco consumption on the male reproductive hormone profile","volume":"426","author":"Blanco-Munoz","year":"2012","journal-title":"Sci Total Environm."},{"key":"B46","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1111\/j.1365-2826.1995.tb00715.x","article-title":"Nicotine acts directly on pituitary gh(3) cells to inhibit prolactin promoter activity","volume":"7","author":"Coleman","year":"1995","journal-title":"J Neuroendocrinol."},{"key":"B47","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.1210\/jcem-45-6-1211","article-title":"Low serum testosterone and sex-hormone-binding-globulin in massively obese men","volume":"45","author":"Glass","year":"1977","journal-title":"J Clin Endocrinol Metab."},{"key":"B48","doi-asserted-by":"publisher","first-page":"3167","DOI":"10.2337\/db10-0179","article-title":"Relationships of circulating sex hormone-binding globulin with metabolic traits in humans","volume":"59","author":"Peter","year":"2010","journal-title":"Diabetes."},{"key":"B49","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1016\/j.tem.2015.05.001","article-title":"Novel insights in SHBG regulation and clinical implications","volume":"26","author":"Simo","year":"2015","journal-title":"Trends Endocrinol Metabol."},{"key":"B50","doi-asserted-by":"publisher","first-page":"1326","DOI":"10.1016\/j.juro.2017.01.018","article-title":"The utility of sex hormone-binding globulin in hypogonadism and infertile males","volume":"197","author":"Ring","year":"2017","journal-title":"J Urol."},{"key":"B51","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.mce.2009.09.020","article-title":"Sex hormone-binding globulin gene expression in the liver: drugs and the metabolic syndrome","volume":"316","author":"Pugeat","year":"2010","journal-title":"Mol Cell Endocrinol."},{"key":"B52","doi-asserted-by":"publisher","first-page":"2713","DOI":"10.1093\/humrep\/dev244","article-title":"Testicular function in a birth cohort of young men","volume":"30","author":"Hart","year":"2015","journal-title":"Hum Reprod."},{"key":"B53","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1016\/j.fertnstert.2018.01.015","article-title":"Association between use of marijuana and time to pregnancy in men and women; findings from the National Survey of Family Growth","volume":"109","author":"Kasman","year":"2018","journal-title":"Fertil Steril."}],"container-title":["Frontiers in Reproductive Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2022.820451\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T06:23:21Z","timestamp":1645079001000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2022.820451\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,17]]},"references-count":53,"alternative-id":["10.3389\/frph.2022.820451"],"URL":"https:\/\/doi.org\/10.3389\/frph.2022.820451","relation":{},"ISSN":["2673-3153"],"issn-type":[{"value":"2673-3153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,17]]},"article-number":"820451"}}