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Effects of Drugs and Alcohol on the Reproductive System

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Misusing drugs or alcohol can have negative impacts on the reproductive health of both men and women. Although research in humans has been somewhat limited, existing evidence shows that alcohol and drug misuse can upset hormonal balance, impact fertility, and lead to sexual dysfunction.1,2

Additionally, it’s well documented that prenatal exposure to alcohol use and drug misuse can lead to a range of problems during pregnancy, including the increased risk of adverse outcomes like preterm birth, stillbirth, and maternal mortality, among others.2,3
What you will learn:
Understand the detrimental impact of substances on reproductive health
How different substances impact the reproductive health in males and females

Can Substance Misuse Impact Fertility?

There is no doubt that substance misuse and addiction impacts an individual’s health, including their reproductive health. Studies indicate that there are a variety of ways that drug and alcohol misuse can negatively impact fertility in both males and females.1,2

Impact of Substance Misuse on Male Fertility

Do drugs affect fertility in men? Studies indicate that yes, smoking tobacco, consuming alcohol, and misusing other substances can, in fact, have adverse effects on the male reproductive system and sexual function.1

How Does Alcohol Affect the Male Reproductive System?

There is research that suggests that chronic and excessive alcohol use can have a detrimental effect on reproductive hormones as well as semen quality—including semen volume, sperm count, and sperm motility.1 The findings, however, differ.

A meta-analysis that looked at 40 studies that examined how alcohol consumption affected male reproductive health in 23,258 males determined that alcohol intake decreased testosterone levels and reduced semen volume but found no association between alcohol use and factors such as sperm count or sperm mobility.4 However, another study found that men who consumed alcohol displayed low sperm count and low sperm motility.5

Additionally, research suggests that long-term alcohol use can suppress testosterone production and lead to erectile dysfunction.6

How Does Cocaine Affect the Reproductive System in Males?

Research on the impact of cocaine use on the reproductive system in men is limited.7

Although initial cocaine use may stimulate sexual arousal and even improve erectile function, prolonged use can ultimately decrease sexual arousal, impair erectile function, and delay both orgasm and ejaculation.6

How Does Marijuana Affect the Reproductive System in Males?

While the impact of marijuana use on the male reproductive system hasn’t been exhaustively studied, the existing literature shows conflicting results. Some evidence suggests that marijuana use may be associated with lower levels of testosterone in males that is acute and transient; other research found no difference in testosterone levels between those who use marijuana and those who do not.8

Additionally, research suggests that marijuana use may have a detrimental effect on semen quality, including decreased volume and reduced sperm count, concentration, and motility—all of which can impact fertility.9,10

How Do Opioids Affect the Reproductive System in Males?

Research indicates that chronic use of opioids—such as morphine and heroin—is linked to a reduced sexual desire, erectile dysfunction, and infertility.6

Additionally, men who use opioids can develop a condition known as opioid-induced androgen deficiency (OPIAD), a syndrome characterized by decreased levels of testosterone, reduced libido and muscle mass, fatigue, and osteopenia (loss of bone mineral density).11

How Does Meth Affect the Reproductive System in Males?

While the use of methamphetamine, or meth, in small doses has been reported to increase sexual desire and delay orgasm for men, prolonged and repeated use may lead to issues that include difficulty obtaining erections, decreased sexual desire, and anorgasmia, which is the inability to have an orgasm.6

Impact of Substance Misuse on Female Fertility

Generally, women may be more susceptible to the negative effects of drugs and alcohol than men and suffer from a greater physiological impact due to substance misuse, including potentially harmful reproductive system effects.12

How Does Alcohol Affect the Female Reproductive System?

Although research evidence may be somewhat mixed, findings in the available literature suggest that alcohol consumption may impact a female’s reproductive health in a variety of ways, including increasing estrogen and lowering progesterone levels; delaying menstruation; and leading to irregular cycles, ovulatory dysfunction, and difficulties conceiving.2

Alcohol use, especially heavy alcohol use, can affect female fertility and ovarian reserve and negatively impact the chances of conception.13 Additionally, for those trying to conceive, alcohol use can negatively affect fertility-related treatments. In fact, one study of couples undergoing in vitro fertilization (IVF) or gamete intrafallopian transfer showed a 3% decrease in the number of oocytes (developing eggs) retrieved, a 2.86 times higher chance of not achieving pregnancy, and a 2.21 times greater risk of miscarriage in women who had one additional drink per day compared to those who had one less in the weeks before undergoing fertility treatment.13

Another study found that women who consumed 4 or more drinks per week had a decreased live birth rate compared to women who drank less than 4 drinks per week.13

Furthermore, any alcohol use during pregnancy can increase the risk of miscarriage and stillbirth as well as fetal alcohol spectrum disorders, including partial fetal alcohol syndrome (PFAS), alcohol-related neurodevelopmental disorder (ARND), and alcohol-related birth defects.13

How Does Cocaine Affect the Reproductive System in Females?

While the research on this topic is scant, one population-based case-control study found that women who used cocaine had an increased risk of primary tubal infertility, which occurs when a blockage in the fallopian tubes don’t allow the egg and sperm to meet. On the other hand, another study found that for women who had ever used cocaine, there was a shorter time to conception and a higher risk of conceiving compared to women who had never used cocaine. However, both of these had some potential limitations in their retrospective study designs.2

How Does Marijuana Affect the Reproductive System in Females?

Though there is more research to be done, studies show that marijuana use may affect women’s reproductive health. One study found that marijuana may negatively impact assisted reproductive technology outcomes, with adverse effects on in-vitro fertilization and gamete intra-fallopian transfer. This study showed that women who smoked marijuana within 1 year of these procedures had 25% fewer retrieved oocytes, and these couples also had 28% fewer fertilized oocytes.8

Additional evidence shows that marijuana use during pregnancy may pose harm to the unborn baby. Since tetrahydrocannabinol (THC) can cross the placental barrier, there is concern that marijuana use during pregnancy may lead to an increased risk of preterm birth, stillbirth, and low birth weight.8,14

How Do Opioids Affect the Reproductive System in Females?

Misusing prescription and illicit opioids can have a variety of adverse effects on the female reproductive system, including harms to fertility and pregnancy outcomes.15 Opioids can impact endocrine regulation of fertility in women and also affect implantation, placentation (formation of the placenta), organogenesis (organ development in the baby), and later stages of fetal development.15

Additionally, women who are on long-term opioid therapy may experience amenorrhea (lack of menstrual cycle).15 Though research has been limited and inconclusive, the lack of a menstrual cycle may result in a lower probability of conception.15

Opioid use and misuse during pregnancy have also been associated with a variety of pregnancy complications, including a greater risk of maternal mortality, congenital heart defects, pregnancy loss, preterm birth, low birth weight, stillbirth, birth defects, and neonatal abstinence syndrome.3,15,16

How Does Meth Affect the Reproductive System in Females?

Most of the research in human females has focused on the impact of meth during pregnancy and its effects on the developing fetus.17-19

Studies have found that prenatal meth exposure can result in growth restriction, decreased weight, length, and head circumference in newborns.19 Meth use during pregnancy has also been associated with a variety of additional neurological problems that surface in children as they develop, including low quality of movement, poor coordination, poor behavioral and executive functioning, and decreased self-regulation.17

Additionally, prenatal meth exposure may affect the developing fetus’ other organs, including the heart and liver. Studies indicate that prenatal meth exposure can lead to cardiac abnormalities, hepatic insufficiency (liver impairment), coagulopathy (problems with blood clotting), and thrombocytopenia (low platelet count).17,19

Getting Help for Drug or Alcohol Misuse

Regardless of whether you are of reproductive age and want children or not, substance misuse can have a significant impact on your overall physical and mental health. If you or a loved one struggle with substance misuse or addiction, help is available. Research shows that treatment for drug or alcohol misuse can help people stop using substances, stay substance-free, and allow them to lead productive and healthier lives.20

If you’re worried about a loved one’s misuse, you can express concern, provide support, and help connect them with a treatment facility. For example, you can encourage them to speak to their doctor to get an evaluation and discuss treatment options or call helplines, such as the one operated by American Addiction Centers at . You can speak to one of our knowledgeable and compassionate admissions navigators, tell them your story, let them answer your questions, explain your treatment options, and help your loved one get on their path to lasting recovery.

No matter how things might seem now, there is always hope. Reaching out for help can be one of the most important things you do to regain control of your health and well-being.

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