Marijuana is becoming all the rage among the government types and politicos, as a chance to win votes. There are countless (non scientific and unfounded) articles portraying the great benefit to society of increased marijuana availability, as well as its purported harmlessness. I am personally very concerned over the panacea that has taken hold, ignorant of the medical realities. As a urologist, the harm is multi-factorial. Smoking tobacco and marijuana expose the body to countless toxins. The smoking debate is mostly over. Marijuana however has a growing political popularity, which may have lasting impact on our national reproductive and overall health, as well as fiscal well being.
Medically there may be significant harm, however, that is mostly being ignored.
This article will discuss the mens health and urological/sexual health implications of marijuana use, rather than the debate about its overall benefit/harmlessness, which is more of a public health discussion.
The most pressing matter is reproductive health. Marijuana use, along with cigarette smoking and androgen abuse, represent the most preventable forms of (iatrogenic) damage to reproductive health. Marijuana seems to be the most insidious, due to the intense push to have it legalized and the political pressure to bury the harm of which most physicians are well aware.
On a basic science level, marijuana manages to cause low sperm count and abnormal sperm shape (morphology) and function (ability to swim and penetrate), resulting in sub-fertility/infertility.
Infertility accounts for over 7.3 million women having impaired fertility and over 1 million doctor visits in a study at the CDC reported in 2002 (and the numbers have steadily risen). These numbers are thought to grossly underestimate the problem. Equal numbers of men affected are expected. Average IVF costs are upwards of $12,000 USD. IVF is often needed for male factor infertility (sperm unable to swim well enough and reach and penetrate the ova). Surgery also treats male factor sub-fertility secondary to vasal obstruction or varicocoels. Male factor accounts for 20% of all infertility and combined male/female accounts for approximately 30% of couple fertility cases. Overall, men account for half of all infertility. These numbers are staggering. More staggering, though, is the unfortunate situation, when a young man comes into the office with his beautiful young wife, and they have been unable to conceive for over a year. It is heartbreaking to see the expression on a man’s face when he realizes his life style choices have been contributing to his fertility problem.
Reversibility vs permanence is unclear, however lifetime exposure is considered a risk. Recent (3 month) exposure is deemed a more clear risk factor (as sperm replenishment is approximately every 2-3 months).
Clearly, marijuana is a detriment to male (and female) fertility.
Clearly, it is preventable.
Possibly, the effects are able to ameliorate with time.
There may be some medical usefulness to cannabinoids (that can be obtained without smoking marijuana). It Is unclear what type of impact the individual cannabinoids, taken medically, would have.
More obviously, smoking marijuana exposes men and those nearby to various toxins, as does cigarette smoke. There is clear data implicating smoking with vascular inflammation and erectile dysfunction. Yes, I am suggesting marijuana use may lead to impotence as well.
If you are a parent, showing this article to your teenagers and college age children may have a beneficial impact, before it is too late. If you are of child bearing age, you are now empowered to make the right decisions for your reproductive health.
