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Let's talk about CBD and fertility

7 min read

This article was last updated May 17, 2021.

Have you been known to enjoy a CBD latte on occasion? How about a delicious brownie with a few milligrams of CBD in it? CBD has a number of medical and therapeutic properties, but people often ask: What's the deal with CBD oil and fertility? What about other forms of CBD?

For now, the American College of Obstetrics and Gynecology (ACOG), the leading body of OB-GYNs, does not have separate recommendations for CBD but does advise people to avoid marijuana if they're trying to get pregnant, currently pregnant, or breastfeeding/chestfeeding — and talking to their healthcare provider about individual cannabis use. However, the US Food & Drug Administration (FDA) specifically recommends avoidance of CBD during pregnancy and while breastfeeding/chestfeeding.

But because ACOG doesn't yet have dedicated recs for CBD, we're going to give you the lowdown and what we know so far about CBD and fertility, pregnancy, and breastfeeding/chestfeeding.

CBD 101

Before you set out down the Google wormhole, CBD stands for cannabidiol, a naturally occurring chemical in the marijuana plant and hemp plant. As a cannabinoid, it’s also produced by the human body itself and can be synthetically manufactured.

There is a key difference between CBD and weed, which is that there is no tetrahydrocannabinol (THC) in CBD — which is the component in marijuana that gets you high. You can't get addicted to CBD, although you should know it's not always clear how much CBD is in a product, or whether or not those products also contain traces of THC. CBD is available in many places in the US, usually in the form of an oil capsule, an extract, or a vapor, but its legality is constantly in question.

THC and CBD affect the body and mind differently, which leads us to believe that each chemical may or may not affect fertility differently too. A lot more research needs to be conducted before any definitive statements can be made, but let’s talk about what we do know so far.

Why do people use CBD?

  • Using CBD can help people manage anxiety and other related conditions, including post-traumatic stress disorder (PTSD).
  • CBD has been shown to be effective in treating Dravet syndrome and Lennox-Gastaut syndrome, two childhood epilepsy syndromes, which typically don't respond well to anti-epilepsy drugs. (Epidiolex, an FDA-approved medication for these conditions, contains CBD.)
  • CBD might also be good for relieving chronic pain and nausea, but more studies need to be done to verify this and to know which doses might work for certain syndromes.
  • Studies show CBD’s potential as a cancer drug.
  • It can help treat inflammatory disorders, such as rheumatoid arthritis and inflammatory bowel disease.
  • Studies are looking into CBD’s therapeutic potential for neurological disorders, including multiple sclerosis, Alzheimer’s disease, and Parkinson’s disease.

What are the different forms of CBD?

CBD is available in several different forms, which allows those taking the drug to use the most beneficial method and amount for their needs. Common forms of CBD include:

  • Creams and lotions: Topical ointments infused with CBD can relieve joint pain and muscle aches.
  • Oils and tinctures: This form of CBD helps your body absorb the chemical quickly and is especially useful for those who don’t want to take CBD in pill form.
  • Gummies: Edible CBD helps ensure you ingest an exact amount of CBD.
  • Vaping: Inhaling CBD is the fastest way to get the chemical in your system, but we don’t yet know how this method affects lung health.
  • Pills: CBD medications that treat conditions like seizure disorders are available in pill form.

What are potential risks and side effects of CBD use?

  • Nausea
  • Irritability
  • Fatigue and drowsiness
  • Dry mouth
  • Diarrhea
  • Reduced appetite
  • Interactions with various medications, including blood thinners (which is why you should always talk to your doctor if you’re planning on using CBD)

And because of what we don’t yet know, fertility issues may or may not be a potential risk. We’ll dive into the existing (and non-existing) research in the next section.

CBD and fertility

We can start to understand the questions out there right now around CBD and fertility by looking at marijuana use and fertility. When it comes to weed, there's a lack of research into the drug’s impact on reproductive health and fetal development because ethical concerns limit opportunities for research. Similarly, CBD, fertility, and the endocannabinoid system (ECS) in general have received very little attention from researchers. So, once again, there's a whole lot that we just don’t know.

However, if we look at our body’s ECS, we can start noticing potential differences between CBD and THC:

  • The ECS regulates various processes in our body, including sleep, appetite, mood, and — believe it or not — female and male reproductive systems.
  • Both the female reproductive tract and sperm cells have cannabinoid receptors. Because THC binds to these receptors, there are concerns about THC’s impact on fertility, and that’s one of the reasons we need more research.
  • An important difference between CBD and THC? Studies have not found evidence of CBD binding to these receptors — so we don’t actually know how CBD affects the body’s ECS, which means we don’t really know how it affects fertility either.
  • Another notable difference between THC and CBD chemicals was found in research from 1979, particularly that natural CBD had little impact on ovulation in rats, while a synthetic derivative of CBD did affect ovulation. (We certainly need more recent CBD findings to understand what this means for humans.)

Interestingly enough, because CBD doesn't appear to bind to cannabinoid receptors, we don’t really even understand why the drug is helpful. For example, one antiseizure CBD medication called Epidiolex "does not appear to exert its anticonvulsant effects through interaction with cannabinoid receptors," according to the FDA. As studies continue, some researchers are considering two possibilities:

  1. CBD might slow the breakdown process of natural cannabinoids, which would enhance their effects.
  2. CBD binds to a different receptor medical researchers have yet to identify.
    Since we don’t know enough (yet) about how CBD functions in the human body, our questions about fertility remain unanswered.

Why do some people think CBD can boost fertility?

  • Marketing from CBD wellness companies: Businesses that provide CBD suggest the chemical boosts fertility, and various online sources make similar claims — like CBD can improve ovarian function and follicle (the fluid-filled sacs that house and release eggs in the ovaries) maturation. However, research backing up this idea simply does not currently exist. If you come across advertisements boasting this information, you should know that those statements are, for now, not evidence-based.
  • Research into endocannabinoid-deficiency: As researchers consider the possibility that some people may be endocannabinoid-deficient (which would lead to conditions like fibromyalgia and irritable bowel syndrome), studies are looking into whether increasing the amount of CBD in your system can provide treatment. This is the same reasoning that often gets applied to explain CBD’s potential to improve fertility, but we don’t actually have that info.
  • Stress relief: Because stress may impact fertility and CBD can reduce stress levels, people might make a connection between CBD and boosted fertility. However, there are no current studies that directly link CBD to stress reduction with an impact on fertility.

CBD and male fertility

Until we have studies investigating the impact of CBD use on the reproductive systems of human males, let’s break down what we’ve learned from research on animal subjects:

  • In a review of 32 different animal studies including mice, monkeys, and rats, researchers found that male mammals exposed to CBD were more likely to develop smaller testicles, have less sperm-producing cells (meaning lower sperm count), and have lower reproductive hormone levels and fertilization rates overall.
  • Again, we need a lot more human-based studies to come to any sort of conclusion, but this review does show that chronic CBD use can impair the male reproductive system in vertebrates.
  • An important caveat: The review authors state that their knowledge is limited, and it is not known if any of this info would apply to humans using CBD.

CBD, pregnancy, and breastfeeding/chestfeeding

Is it safe to use CBD while pregnant? What about while breastfeeding/chestfeeding? We’re sorry to be repetitive, but once again, we just don’t know yet. Here's what we have evidence of so far:

1. Pregnancy

  • A 2018 study found that infants of birthing parents who’d inhaled non-medicinal cannabis during their pregnancies had detectable levels of CBD in their umbilical cord serum and meconium (their first poop). This tells us that CBD is in fact making its way into the systems of fetuses.
  • Findings from a 2019 review showed evidence of CBD causing harm to animal embryos and fetuses. Again, it's important to note that the results from animal studies may not apply to humans.

2. Breastfeeding/chestfeeding

  • Studies have not confirmed whether or not cannabidiol is present in breast milk/chest milk while using CBD.
  • Right now, CBD retailers state that deciding to use CBD while breastfeeding/chestfeeding requires you to consider potential risks to the infant, and/or whether the birthing parent needs to prioritize CBD’s health benefits and choose not to breastfeed/chestfeed.

OB-GYN and Modern Fertility medical advisor Dr. Eva Luo, MD says that "if fetal harm is more definitive, a future where additional ultrasounds or other forms of testing may be recommended" for patients with continued use of substances like CBD during pregnancy.

The bottom line on CBD and fertility

You probably know what we're going to say — it's complicated. We unfortunately don’t know anything about how CBD may positively or negatively affect human reproductive systems or developing fetuses. CBD has numerous benefits that may improve other areas of your health, but be wary of any fertility talk.

While the impact of CBD could be weaker than the impact of THC, because there are so many unanswered questions, you might want to steer clear of it if you're thinking about trying to get pregnant in the near future or if you’re currently pregnant. At present, the FDA is the only governing body with recommendations for CBD during pregnancy and while breastfeeding/chestfeeding, and they advise people to avoid it. As always, it's important to discuss any substance use with your healthcare provider. Because so much more research is needed, there's an organization you can contact if you’ve been exposed to cannabis or CBD while pregnant. Reach out to the North American Antiepileptic Drug (NAAED) Pregnancy Registry at 1-888-233-2334 or visit their website.

Navigating this type of ongoing research while you’re already on a complex fertility journey certainly isn’t easy. Modern Fertility is here to support you each step of the way and help you strategize, whether you’re learning about your reproductive hormone levels with our Fertility Hormone Test, getting tips on how to talk with your doctor and your partner, or speaking with other people in our community as together we learn about our bodies and plan our futures.

This article was medically reviewed by Dr. Eva Marie Luo, an OB-GYN at Beth Israel Deaconess Medical Center and a Health Policy and Management Fellow at Harvard Medical Faculty Physicians, the physicians organization affiliated with the Beth Israel-Lahey Health System.

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Chanel Dubofsky

Chanel's writing has appeared in Cosmo, Rewire, Lilith, HelloFlo, & Extra Crispy. She has an MFA in Fiction from Vermont College of Fine Arts & lives in New York. Follow her @chaneldubofsky.

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