Leydig cell testosterone production decreases with age, but changes in testosterone production also occur as a result of alteration of the intracellular redox environment (Beattie et al., 2015), which can lead to oxidative stress and damage to cellular components. Our results were similar to those of Gundersen et al., however, recency of marijuana use was better correlated with testosterone level than was frequency of use. While a subsequent clinical study found a similar association (Cohen, 1976), most subsequent studies reported no association (Barnett et al., 1983; Block et al., 1991; Coggins et al., 1976; Cushman, 1975; Mendelson et al., 1978; Mendelson et al., 1974; Schaefer et al., 1975). The analysis resulted in no meaningful change in the relationship of marijuana and serum testosterone in any of the models (results not shown). Ever users of marijuana were more likely to be aged 50 years or older, NH white, and current/former cigarette smokers. In addition, we performed a sensitivity analysis to examine the effect of cigarette use on the association between marijuana use and testosterone concentration. This is important because TRT is all about managing and improving testosterone levels. When a man's testosterone levels are low, it can cause problems like fatigue, depression, and reduced sex drive. When people use TRT (Testosterone Replacement Therapy) to treat low testosterone, they often want to know if cannabis can affect their treatment. The effects of cannabis on testosterone may depend on various factors, including the amount used, the frequency of use, and individual differences in metabolism. In men, testosterone levels naturally decline with age, but certain conditions can cause abnormally low levels, a condition known as hypogonadism. Cannabis can have both positive and negative effects on health, so it's important to approach its use with caution, especially when managing conditions like low testosterone. Factors such as the amount of sleep the previous night (Auyeung et al., 2015) and physical activity immediately before blood draw (Hakkinen & Pakarinen, 1995; Kraemer et al., 1998) may affect testosterone levels. An influential early study by Kolodny et al. reported a significant decrease in testosterone level for marijuana users in a small, highly-selected population (Kolodny et al., 1974). Relationship between marijuana use and testosterone levels by age-group, males, NHANES 2011–2012 Testosterone replacement therapy (TRT) is a common treatment for men with Low T, helping restore hormone levels and alleviate symptoms like fatigue, decreased libido, and mood changes. While current research is very mixed, some studies conclude that heavy consumption of marijuana can exacerbate hormonal imbalances. Additionally, CBD’s interaction with the ECS may help balance the body’s hormonal environment, though more research is needed to confirm these effects. A 2022 study found that macaque monkeys regularly exposed to THC experienced testicular atrophy, resulting in a significant decrease in testosterone production. For example, CB1 receptors in the brain may influence the release of luteinizing hormone (LH), which stimulates testosterone production. The endocannabinoid system (ECS) regulates numerous physiological processes, including mood, appetite, sleep, and hormone production. In this article we’ll explore how cannabis interacts with testosterone, what the research says, and what these insights mean for your health. While some people might think that cannabis is harmless, combining it with TRT can have potential side effects and complications. This means that a man using both TRT and cannabis might experience more mood-related side effects, like irritability or depression. While TRT might improve mood by boosting testosterone, cannabis can sometimes cause anxiety or mood swings, especially in high doses. Table 4 shows the weighted associations between marijuana use and testosterone levels, stratified by age group. Table 3 shows the weighted associations between marijuana use and testosterone levels. As marijuana laws undergo reform, with the prevalence of marijuana use expected to rise further (Cerda et al., 2012), the potential effects of marijuana on male reproductive health requires further elucidation. Several studies have demonstrated negative effects of marijuana use on male reproductive health, particularly decreased semen quality (Battista et al., 2008; du Plessis et al., 2015; Fronczak et al., 2012; Rossato et al., 2008). Beyond stress, cannabis may also interact with your reproductive hormones — including testosterone and estrogen. To understand how cannabis might affect your hormones, we first need to look at your endocannabinoid system (ECS) — your body’s own network of cannabis-like messengers. From cortisol (your main stress hormone) to sex hormones like estrogen and testosterone, the endocannabinoid system interacts with key parts of your hormonal network. She is passionate about addressing health disparities by building scalable healthcare solutions. Studies have shown that testosterone levels typically return to normal within a few weeks to months after cessation of use. One encouraging finding from research is that marijuana's effects on testosterone appear to be largely reversible. Some preliminary research suggests CBD might actually help preserve testosterone levels or even slightly increase them, though more research is needed. While research suggests that cannabis — especially THC — can affect hormones, there are important caveats every patient should understand. That said, CBD can still indirectly influence hormonal health through its effects on stress, inflammation, and overall homeostasis. Unlike THC, CBD (cannabidiol) appears to have little to no direct effect on key sex hormones like testosterone or estrogen. Research suggests that THC can reduce testosterone levels, but mostly in cases of heavy or chronic use. And when you introduce cannabis into that system — especially regularly — you might influence hormone production, signaling, or metabolism. Are occasional users at risk of disrupting their body’s natural rhythm, or are the effects minimal for most people? Cannabis affects mood, appetite, sleep… but could it also be messing with your hormones?
