Unlike females, who are born with all the eggs they’ll ever have, males regularly get a new supply of sperm. In a healthy male, the testicles produce millions of fresh sperm every single day.
But there are many reasons why your sperm count (and quality) may not be quite so robust. One of the more common causes of low sperm count or compromised sperm quality is substance use.
“Recreational and prescription drugs—including cigarettes and alcohol—can have a significant effect on sperm,” explains Amarnath Rambhatla, M.D., a urologist at Henry Ford Health. “The good news is that, in most cases, the effects are reversible after you stop using the drug.”
The Connection Between Drugs and Male Infertility
“Infertility is not just a woman’s problem,” says Dr. Rambhatla. “In up to 50% of cases, there is a male factor involved that’s contributing to the difficulty conceiving.”
Many drugs can impact the quantity and quality of sperm your body produces. They can also affect motility (how well the sperm move) and ejaculation. All of these can make it more difficult for sperm to fertilize an egg to create an embryo.
“And when there’s increased oxidative stress and DNA damage to the sperm, that can lead to poor embryo development and increased risk of miscarriage,” says Rambhatla.
Recreational Drugs That Impact Sperm
Substances you may use on a regular basis can have a big effect on your sperm. The most common recreational substances to impact sperm include:
- Alcohol: Moderate-to-heavy drinking can affect sperm quality.
- Marijuana: Whether you smoke, vape or use edibles, chronic marijuana use can impact your hormones, leading to a decrease in testosterone. Using marijuana on a regular basis can lower sperm count and also affect the shape and movement of sperm.
- Nicotine: Cigarettes, vapes, pouches and other nicotine delivery systems can negatively affect sperm. Nicotine can cause oxidative stress that damages sperm DNA and impairs fertilization capability.
“Cocaine and other recreational drugs can potentially also have an impact on sperm,” says Dr. Rambhatla. “Further studies are needed to determine the full effects that these substances can have on fertility.”
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Prescription Medications That Affect Sperm
It’s not just recreational drugs that affect sperm. There are many prescription medications that also negatively impact sperm production and movement. These include:
- Anabolic steroids: Steroid use can shut down testosterone production. That can lead to azoospermia (a complete lack of sperm).
- Calcium channel blockers: These blood pressure medications can affect sperm motility.
- Finasteride: This oral medication used for hair loss or benign prostatic hyperplasia (an enlarged prostate) can affect sexual function and libido.
- Tamsulosin: A treatment for enlarged prostate, this drug can cause retrograde ejaculation, which decreases the amount of sperm ejaculated.
- SSRIs and tricyclic antidepressants: Certain classes of antidepressant medications can affect sexual function and lead to trouble ejaculating.
Is Sperm Damage from Drugs Reversible?
The good news is that, yes, in most cases sperm do rebound once you stop using whatever drug was affecting them. Even when steroid use completely eliminates sperm production, it can recover.
“Generally, you’ll start to see improvements in three to six months,” says Dr. Rambhatla. “If there’s no improvement in a year, that may mean the damage is more permanent.”
Talk to Your Doctor About Drug Use and Sperm Quality
If you and your partner are having difficulty conceiving, talk to your doctor about testing your sperm. A simple lab analysis can help determine if sperm count, shape or motility is a factor affecting your fertility.
If your sperm count or quality is compromised, talk to your doctor about what can help improve it. They can provide resources if you need help to stop using recreational drugs. They can also look at prescription medications you’re taking that might affect your sperm. If necessary, they can switch you to a medication with less impact on sperm.
“A healthy lifestyle—including diet and exercise—can optimize sperm quality and improve fertility,” says Dr. Rambhatla. “In general, all the lifestyle factors that are good for your heart health are also good for your sperm health.”
Reviewed by Amarnath Rambhatla, M.D., a urologist who sees patients at Henry Ford Hospital, Henry Ford West Bloomfield Hospital and Henry Ford Medical Center – Royal Oak.
