Abstract
Marijuana is the most consumed illicit drug in the world, with approximately 200 million users. Male infertility is also increasing fast and both events may be linked. The aim of this study is to evaluate the effects of Marijuana and other habit and lifestyle issues (obesity, sedentary lifestyle, tobacco smoking, alcohol consumption) in hormonal and sperm function of men seeking general andrological evaluation, mostly for loss of libido and infertility. Retrospective study was conducted using data collected from men aged 18-59-years-old between 2009 and 2017. Exclusion criteria included cryptorchidism and infertility caused by genetic defects, infectious disease or cancer. A complete semen analysis1, testis volume (orchidometer and/or ultrasonography), biochemical markers of sperm function and functional tests (creatine-kinase activity, anti-sperm antibodies, reactive oxygen species, DNA fragmentation) hormonal levels (LH, FSH, total testosterone, prolactin, estradiol), SHBG and testosterone-to-estradiol ratio (T/E2) were evaluated as variables for prediction. Statistical analysis was performed with SPSS 23.0 (P<0.05) and a multiple linear regression analysis was performed to investigate which habit and/or lifestyle factor could predict certain hormonal or sperm item. A total of 153 men were included in the analysis. Conventional/functional semen parameters and testis volume were not significantly influenced by any habits or lifestyle factor evaluated. Marijuana use had the broader hormonal changes in infertile men since it influences estradiol (P=0.000; B=-11.616), prolactin (P=0.000; B=3.211), SHBG levels (P=0.017; B=7.489) and T/E2 (P=0.004; B=14.030). Prolactin level was also influenced by sedentary lifestyle (P=0.028; B=1.279) and tobacco smoking (P=0.031; B=-2.401). None of these variables could predict testosterone levels in this scenario. Marijuana use causes hormonal imbalance in infertile men, particularly in lowering estradiol levels, which probably contributes to impairment in their reproductive condition. Reference: (1) World Health Organization. WHO laboratory manual for the examination and processing of human semen. 5th ed. Geneva: World Health Organization; 2010.
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