How Do Drugs Affect the Reproductive System?

Substance misuse can negatively impact the reproductive health of both sexes in several ways. It may contribute to serious health problems, such as sexually transmitted diseases (STDs), infertility, and cancer.

Women who use drugs and alcohol while pregnant put their unborn children at risk of pregnancy-related complications and future problems that can impact their health and ability to function in the world.¹

It is crucial for both men and women to understand the effects of drugs on their reproductive systems in order to make more informed decisions about their health.

Effects of Drugs on the Female Reproductive System

Substance abuse can lead to organ damage, infections, and diseases. Research on humans and animals has found that women are generally more vulnerable to the long-term physical effects of drugs and alcohol compared to men.²

Differences in physiology, weight, and hormone levels can affect the breakdown of drugs and alcohol in the body. In particular, drug use can harm the reproductive system and impact women in one or more of the following ways:

Changes to the menstrual cycle—Drug and alcohol use may alter a woman’s menstrual cycle and may result in lighter or heavier menstrual periods and increased cramping.² Heroin and methadone use may also lead to amenorrhea (absence of a period) in some women.
Sexually transmitted diseases (STDs) and other infections—Intravenous drug use puts women at risk of contracting infections and diseases transmitted through the blood, including HIV/AIDS, which may harm a woman’s fertility.² Heavy alcohol use is also linked to higher rates of STDs that may damage the reproductive system and/or hinder a woman’s ability to get pregnant.³ Women under the influence of drugs and alcohol may be more likely to put themselves in harmful situations that increase their risk of contracting STDs.
Cancer—Women who abuse alcohol and other drugs may put themselves in risky situations where they are more likely to contract STDs, which, depending on the infection, may contribute to cancer. For example, the human papilloma virus (HPV) is linked to increased cervical cancer risk.
Fertility—Drugs and alcohol are linked to infertility in women. One study found that females who are heavy alcohol users are more likely to experience fertility problems compared to low and moderate alcohol users.^4,⁵ Women who use tobacco products may also be at risk for fertility issues and delayed conception.²
Sexual dysfunction—Substance use may impact sexual arousal, pleasure, and desire in women.⁶ Specifically, heavy alcohol use can decrease vaginal lubrication and the ability to achieve an orgasm.⁷ STDs resulting from risky behaviors associated with substance use may also impact sexual desire.

Effects of Drugs on the Male Reproductive System

Men may experience 1 or more of the following reproductive problems as a result of drug and alcohol use:

STDs and other infections—Drug and alcohol abuse may put men at greater risk of contracting STDs. This may be due to lowered inhibitions associated with substance use. Alcohol can also suppress the immune system, making it easier to contract an STD.³ Men who use intravenous drugs and share needles put themselves at greater risk of contracting HIV/AIDS, hepatitis, and other bloodborne diseases. HIV and antiretroviral treatment drugs may negatively affect a male’s fertility.
Fertility—Substance use can lead to fertility problems in men.⁸ Men who use marijuana and cocaine may experience changes in hormone levels that can affect sperm movement and lead to infertility. Anabolic steroids also pose a danger to male fertility. Performance-enhancing drugs increase testosterone levels in the bloodstream, which leads the reproductive organs to produce lower amounts of the hormone. This can cause the testicles to shrink and produce less sperm. In some cases, infertility may be irreversible after a period of heavy steroid use. However, in most cases, the body will return to normal within months of stopping the drugs. Medications may also be prescribed to increase sperm production after quitting steroids.
Sexual dysfunction—Men who use drugs and alcohol may experience problems with sexual arousal.⁶ In small-to-moderate amounts, alcohol lowers inhibitions, which may increase desire for sexual activity and reduce inhibitions. However, alcohol is a central nervous system depressant, meaning that it slows the body and brain, and it may lead to erectile dysfunction, or inability to attain or maintain an erection, as well as problems with ejaculation.⁷ Similarly, men who use methamphetamine may initially experience sexual benefits, such as heightened arousal. However, over time, the use of methamphetamine and cocaine can lead to erectile dysfunction and delayed orgasm.

Effects of Drugs on Pregnancy

Women who use alcohol and other drugs while pregnant, including heroin, cocaine, methamphetamine, and marijuana, risk harming their unborn children.¹ Drugs and alcohol can easily pass through the placenta to the fetus, increasing the risk of:

Low birth weight.
Birth defects.
Changes in physical features.
Premature birth.
Sudden infant death syndrome (SIDS).

Women who use illicit drugs during pregnancy are up to 2 times more likely to have stillbirths. Some infants become dependent on the drugs their mothers take and go through withdrawal shortly after birth. This is common in infants exposed to heroin and other opiates, alcohol, benzodiazepines, barbiturates, and caffeine.

Drugs that may have negative effects on infants during pregnancy include:

Heroin—Women who use heroin and other opioid drugs while pregnant put infants at risk of neonatal abstinence syndrome (NAS), a condition where infants become opioid dependent after exposure to drugs through the placenta.¹ Infants with NAS may demonstrate increased irritability, seizures, and stomach problems. Infants with NAS may be treated with small amounts of methadone or morphine in order to gradually wean them off the drugs. The Agency for Healthcare Research and Quality National reports that a baby is born with NAS every 19 minutes.⁹
Cocaine—Pregnant women who use cocaine may experience migraines, seizures, premature membrane rupture, separation of the placenta from the uterus, high blood pressure, spontaneous miscarriage, preterm labor, and delivery problems.¹ An infant born to a mother who used cocaine during pregnancy is at risk for low birth weight, smaller head circumference, and shorter length. As an infant, they are at risk for showing signs of increased irritability, hyperactivity, and tremors.
Methamphetamine—Women who use methamphetamine while pregnant have a greater risk of premature delivery, separation of the placenta from the uterus, and preeclampsia—a condition in which pregnancy-related hypertension (high blood pressure) can lead to organ damage.¹ Infants born to mothers who use methamphetamine may have low birth weights and as children may experience high emotional reactivity, anxiety, depression, and attention and cognitive problems.
Marijuana—Despite marijuana’s increasing legalization, it is not considered safe to use during pregnancy.¹ Marijuana use during pregnancy has been linked to future cognitive problems in children, including hyperactivity, learning deficits, problem-solving deficits, memory issues, and attention problems. Using marijuana while breastfeeding can also cause similar cognitive problems. Consuming medical marijuana during pregnancy for nausea is not recommended due to marijuana’s effects on the brain.
Alcohol—The negative effects of alcohol on a developing fetus are so wide-ranging that we’ve devoted a full section to this drug below.

Alcohol and Pregnancy

According to the National Survey on Drug Use and Health (NSDUH), in 2019, approximately 9.5% of women (197,000) reported drinking alcohol while pregnant.¹⁰ The National Institute on Alcohol Abuse and Alcoholism (NIAAA) states that there is no safe level of drinking during pregnancy.¹¹

Drinking alcohol while pregnant can lead to serious long-term effects on infants. Alcohol use during the early stages of pregnancy—even before a woman is aware that she is pregnant—can begin affecting the unborn child.¹ Alcohol use during pregnancy can lead to birth defects and long-term health problems for children.¹²

Drinking alcohol while pregnant can increase the risk of:

Miscarriage and stillbirth—Moderate-to-heavy alcohol use during pregnancy is one risk factor associated with miscarriages and stillbirth—which occurs when a fetus dies in utero.¹³ In general, research studies have found that women who drink more alcohol have a greater risk of fetal death.
Premature delivery—Women who drink during pregnancy risk premature delivery or giving birth prior to 37 weeks’ gestation.¹³ Moderate-to-heavy alcohol use and binge drinking are especially risky.
Fetal alcohol spectrum disorders (FASD)—Symptoms of FASD can range on a continuum from mild to severe. Infants born with FASD may have problems with learning and memory, comprehension, shifting attention, emotional control, impulsivity, communication, socialization, and performing daily activities.¹¹ Drinking alcohol while breastfeeding also poses dangers to infants.¹ Breastfeeding women are urged to limit their daily alcohol use to 2 ounces of liquor (8 ounces of wine or 2 standard beers) and should allow 2 hours between the last drink and breastfeeding.
Sudden infant death syndrome (SIDS)—SIDS is the leading cause of infant death in the United States and is linked to alcohol use during pregnancy.¹³ Infants who die from SIDS are 2 times more likely to have been exposed to alcohol in utero and 3 times as likely to have been exposed to binge drinking by their mothers.

What Are My Treatment Options?

If you or a loved one is struggling with the misuse of drugs or alcohol, help is available. Addiction is a chronic, relapsing medical condition, and substance use disorders are treated as such. The first step is to meet with your healthcare provider in order to determine your unique needs for addiction treatment.

The abuse of alcohol and other drugs can cause serious harm to your reproductive system, as well as to a developing fetus. If you need help to stop using drugs and/or alcohol, don’t wait another day. American Addiction Centers (AAC) is a leading treatment provider and has trusted rehab programs across the country. A caring AAC representative at our 24-hour helpline can answer any questions you have, verify your health insurance coverage, and direct you towards treatment options. You can contact us free at at any time, day or night.

Effects of Alcohol and Drugs on the Male and Female Reproductive Systems