Cannabis and Female Reproductive Health

I’ve been helping people build families for 15 years, and I often answer questions about lifestyle changes for fertility, which includes marijuana use.

Cannabis is one of the most commonly recreationally used drugs in the United States. One in five Americans have tried marijuana at least once, and many people use it regularly. It is legal recreationally in over 18 states, and even more states have legalized it for medical use. 

There's an assumption that marijuana is safe for your health. After all, if doctors can prescribe cannabis to treat medical issues like nausea for chemotherapy patients, sleep disorders, and anxiety, then it must be safe, right? 

We'll find that this is just not the case regarding your fertility. 

Let’s dive in.

The Truth About Cannabis

This blog post might be disappointing for some people, mainly if you are struggling to build your family (whether it’s through fertility challenges or miscarriages) while regularly using cannabis.

However, getting the facts straight about cannabis is crucial when trying to build a family. When my patients report irregular menstrual cycles or unpredictable ovulation, I often ask about marijuana use because studies show that it can affect our hormones, impacting ovulation and time to conception.

Cannabis and Luteinizing Hormone (LH) Levels

Regular marijuana use can impact the pituitary gland's production of luteinizing hormone (LH). 

THC, the ingredient in cannabis associated with relaxation and feeling ‘high,’ has been shown to decrease the production of LH by at least 30% among individuals who smoke or consume it regularly. Lowered LH production is problematic because LH signals ovulation (the release of the egg) in the middle of your menstrual cycle. 

Low levels of LH can throw off ovulation. If you’re ovulating irregularly, it can take longer to get pregnant because it’s harder to time intercourse. Even if you are ovulating, lower levels of LH impact the function of the luteal (implantation) phase, which is when an embryo implants into the uterine lining during the second half of the menstrual cycle. 

To summarize: Cannabis affects LH levels, which impacts both ovulation and implantation, which means it can take longer to conceive. 

Cannabis and Conceiving

Studies have shown us that regular marijuana use increases the time it takes to get pregnant. 

An interesting study published in 2021 looked at 1,228 couples planning to conceive. The study found that the partner with eggs who regularly used cannabis had a 50% lower chance of getting pregnant over six months than non-users. 

Cannabis and IVF

Some patients will think it’s okay to use marijuana if they plan to undergo fertility treatment. After all, wouldn’t fertility assistance overcome any impact of cannabis? 

While I understand this logic, studies suggest that cannabis use can decrease in vitro fertilization (IVF) success rates. 

One study observed 221 IVF cycles, and patients shared their marijuana use habits. If the partner with eggs used cannabis regularly within months of their egg retrieval, fewer eggs were retrieved, which resulted in fewer embryos created and lowered overall success rate with their IVF cycle. 

Another study examined cannabis use among 421 women for 730 total IVF cycles. Of the 421 women, 317 women had a positive pregnancy test after their embryo transfer. If they regularly used cannabis within a few months of that positive pregnancy test, there was a two-fold higher risk of miscarriage. 

Cannabis and Pregnancy

There can be an assumption that cannabis is safe in pregnancy. However, cannabis use in early pregnancy, even to treat nausea, can be associated with an increased risk of miscarriage. Cannabis use in pregnancy is also associated with lower birth weight, and babies can even show withdrawal symptoms after birth. 

One review article observed cannabis use during pregnancy and the postpartum period. Conclusions showed that cannabinoids (like THC) disrupt DNA replication on a cellular level, such as cellular motility (like we’ve seen in sperm), cellular migration, and even cellular replication. There are concerns about cannabis’ impact on the function and development of embryos and even interference with vascular growth as the embryo is trying to implant into the uterine lining. 

Does Cannabis Impact Fertility in People with Eggs?

For someone who feels like cannabis is natural and safe, I know this can seem like a lot of negative information. But, if you are trying or planning to start your family, abstaining from regular marijuana use could improve your reproductive health. 

Many of my patients are disappointed when they hear the evidence regarding cannabis and reproductive health. Cannabis use impacts not only female partners but male partners as well. It can decrease success with fertility treatment and increase the chances of miscarriage. Instead of feeling disappointed, I encourage you to feel empowered to make positive lifestyle changes based on the latest research about cannabis and fertility. 

I hope this blog post was helpful. You might also like my post about cannabis and male fertility. If you have any questions, please comment on my YouTube video.