Duca · Journal of clinical medicine 2019 · narrative review · n=?

Substance Abuse and Male Hypogonadism.

Cited 73 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review summarizing mechanisms and clinical/experimental literature without systematic methodology

PubMed 31121993 · doi:10.3390/jcm8050732 · record verified 2026-08-29

What was done

This narrative review synthesized clinical and experimental literature regarding the effects of substance abuse—specifically alcohol, opioids, anabolic-androgenic steroids, nicotine, cannabis, and amphetamines—on male testosterone production (steroidogenesis) and sperm production (spermatogenesis).

What was found

The abstract reports no quantitative values, effect sizes, or study counts. It qualitatively reports that alcohol, opioids, and anabolic-androgenic steroids suppress testosterone by disrupting testicular and hypothalamic-pituitary signaling, whereas nicotine, cannabis, and amphetamines impair spermatogenesis through induction of oxidative stress and testicular apoptosis. The review notes that substance-induced hypogonadism is potentially reversible following cessation.

Why it matters

It highlights substance use as a modifiable and potentially reversible contributor to declining male reproductive health and testosterone levels, underscoring the clinical value of screening for substance intake in hypogonadal men.

Limits

The abstract describes a non-systematic narrative review with no defined search protocol, quality appraisal, or pooled quantitative effect estimates. It provides no data on dose thresholds, exposure durations, comparative drug potencies, or the expected timeframe for hormonal recovery following substance withdrawal.

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