Marijuana use and serum testosterone concentrations among U.S. males

Abstract

Background Marijuana has been reported to have several effects on the male reproductive system. Marijuana has previously been linked to reduced adult testosterone, however, a study in Denmark reported increased testosterone concentrations among marijuana users. This study was performed to estimate the effect of marijuana use on testosterone in U.S. males. Methods Data on serum testosterone, marijuana use and covariates for 1577 men from the 2011–2012 U.S. National Health and Nutrition Examination Survey (NHANES) were analyzed. Information on marijuana use was collected by a self-administered computer-assisted questionnaire. Serum testosterone was determined using isotope dilution liquid chromatography tandem mass spectrometry. The effects of marijuana use on serum testosterone concentrations were examined by frequency, duration, and recency of use. Adjusted means and 95% confidence intervals (CI) of serum testosterone across levels of marijuana use were estimated using multiple linear regression weighted by the survey weights. Results The majority (66.2%) of the weighted study population reported ever using marijuana with 26.6% reporting current marijuana use. There was no difference in serum testosterone between ever users (adjusted mean = 3.69 ng/mL, 95% CI: 3.46, 3.93) and never users (adjusted mean = 3.70 ng/mL, 95% CI: 3.45, 3.98) upon multivariable analysis. However, serum testosterone was inversely associated with time since last regular use of marijuana (p-value for trend = 0.02). When restricted to men aged 18 – 29 years, this relationship strengthened (p-value for trend < 0.01) and serum testosterone was also inversely associated with time since last use (p-value for trend < 0.01), indicating that recency of use, and not duration or frequency, had the strongest relationship with testosterone levels. Discussion Serum testosterone concentrations were higher in men with more recent marijuana use. Studies are needed to determine the extent to which circulating testosterone concentrations mediate the relationship of marijuana use to male reproductive outcomes.

Exploring the Association between Cannabis Use and Testosterone Levels in Men Receiving Methadone Maintenance Treatment

“…However, when controlling for other variables, neither cannabis-use nor the percentage of cannabis-positive urine drug screens within the 15-month study period were significantly associated with serum testosterone. These results suggest that cannabis use is not associated with serum testosterone levels in this population of men, despite findings from previous studies to suggest that frequency and/or recency of cannabis use may be associated with higher serum testosterone levels [4][5][6]. However, due to the limited literature in the field, it is unclear whether our results are generalizable outside of the male MMT population.…”

“…The variability in study design, sampling methods, and lack of consistent results render these studies inconclusive [7]. However, there are three larger and more recent questionnaire-based studies that reported correlations between cannabis use and serum testosterone levels [4][5][6]. In a study of 1215 Danish men aged 18-28, Gundersen et al found that testosterone was 7% (95% CI: 0, 14) higher in those that used cannabis more than once weekly, compared to never users [4].…”

“…Unfortunately, previous studies show that methadone dose is inversely correlated with testosterone levels in the MMT population [3]. Converse to the effect of opioids, there are some studies that report that cannabis use may elevate serum testosterone levels in men, [4,5] albeit inconsistently [6,7]. Further, it has been observed that the prevalence of cannabis use is higher in patients on opioids [8][9][10].…”

“…Overall, both cannabis and opioids have potentially detrimental effects on the endocrine system in men [2,6]. Interestingly, other studies showed that frequency and/or recency of cannabis use may be associated with elevated testosterone levels [4,5]. However, the clinical implications of concurrent opioid and cannabis use requires further study.…”

Substance Abuse and Male Hypogonadism

“…A recent population study on over 1,500 U.S. men found no differences in serum testosterone levels among ever users of marijuana compared to never users. However, testosterone concentrations were higher in men with more recent marijuana use, especially in men aged 18-29 [78]. A study on over 1,200 young healthy men reported, similarly to tobacco smokers, an increase in testosterone levels in marijuana smokers [79].…”