A closer look at which hormones shift — and which don’t
STUDY: Galmiche M et al, Communications Medicine 2026;6:224
STUDY TYPE: Cross-sectional study
FUNDING: Swiss Centre for Applied Human Toxicology (SCAHT); Swiss National Science Foundation; FABER Foundation
Background
Whether cannabis raises or lowers testosterone has been debated for decades. The early data suggested suppression, but larger, better-designed studies in the U.S. and Denmark have consistently found higher testosterone in cannabis users. This study took a more granular approach — measuring 70 steroids at once — to figure out what’s actually happening hormonally.
The Study
Researchers compared 47 confirmed cannabis users and 47 matched controls, all healthy Swiss men aged 18–23, using blood biomarkers rather than self-report to verify exposure. Extended hormonal profiling identified 70 steroids, with 7 quantified precisely.
Cannabis users had significantly higher levels of androstenedione (A4), testosterone, and dihydrotestosterone (DHT) — the three major testicular androgens. Those hormones are produced by the testes, but levels of hormones produced in the adrenal gland were not altered.
Two progesterone metabolites, 5β-DHP4 and 11β-OHP4, were also markedly elevated (p < 0.0001 for both). Among heavier users, 5β-DHP4 showed a dose-dependent relationship with cannabis exposure. LH and FSH didn’t differ between groups.
Potential mechanism: Cannabis CB1 receptors in Leydig cells within the testes, changes in hepatic (liver) metabolism, or disruption of the hypothalamic-pituitary-gonadal (HPG) axis.
Limitations: small, cross-sectional study, cannot rule out confounders, such as the possibility that men with higher testosterone are more likely to use cannabis. However, the finding is supported by multiple large-scale crosssectional studies from both Europe and North America, pointing to higher levels of androgens in cannabis users.
Practice Implications
- This study points to testosterone increases on cannabis, not suppression.
- Some men may see that as a plus, but endocrine disruption is not a desirable goal, and some studies find lower sperm count with cannabis that may be related to this.
- Other risks of high testosterone in men include heart attacks, stroke, prostate enlargement, and acne.
— Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report
