# Phytocannabinoids and Male Fertility: Implications of Cannabis sativa and the Endocannabinoid System in Reproductive Regulation

## TL;DR

This review explores how cannabis compounds like THC and CBD may negatively affect male fertility by interacting with the endocannabinoid system.

## Contribution

The paper provides a comprehensive synthesis of how Cannabis sativa and its phytocannabinoids influence male reproductive health and the endocannabinoid system.

## Key findings

- THC disrupts the HPG axis, reducing testosterone and impairing sperm function.
- CBD's long-term effects on male fertility remain unclear despite its antioxidant properties.
- Cannabinoids interact with CB1 and CB2 receptors in reproductive tissues, affecting sperm motility and morphology.

## Abstract

Cannabis sativa, a species within the Cannabaceae family, produces a diverse range of phytochemicals, notably cannabinoids and terpenoids, with significant physiological and pharmacological relevance. Among its phytochemicals, Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are the most studied for their psychoactive and medicinal properties. However, emerging evidence indicates that chronic or excessive exposure to these phytocannabinoids may adversely affect male fertility. This review synthesizes current knowledge on the influence of C. sativa and its constituents on the male reproductive system, with emphasis on spermatogenesis, sperm function, hormonal regulation, and the role of the endocannabinoid system (ECS). Experimental and clinical studies demonstrate that cannabinoids interact with CB1 and CB2 receptors expressed in the testes, epididymis, and spermatozoa, thereby modulating testosterone synthesis, sperm motility, morphology, and capacitation. THC, in particular, disrupts the hypothalamic–pituitary–gonadal (HPG) axis, leading to reduced luteinizing hormone and testosterone levels, impaired mitochondrial activity, and abnormal sperm morphology. Although CBD exhibits anti-inflammatory and antioxidant properties, its long-term impact on reproductive function remains uncertain. The review further highlights the complex interplay between exogenous cannabinoids and the endogenous ECS in maintaining reproductive homeostasis. Understanding these molecular mechanisms is critical for balancing the therapeutic potential of Cannabis-derived products with their reproductive risks. This knowledge could inform safe medicinal applications and contribute to the development of targeted cannabinoid-based therapies for male infertility.