review · Reproductive Biology and Endocrinology
Psychoactive substances, while possessing therapeutic values, can significantly impair male reproductive health. They negatively influence sexual desire, erectile performance, androgen production, sperm creation, and overall sperm quality. At a cellular level, these substances trigger direct testicular toxicity by causing oxidative damage through reactive oxygen species, sparking inflammation, and prompting cell death. In parallel, they suppress the hypothalamic-pituitary-testicular axis, which leads to lower circulating testosterone levels, disrupted spermatogenesis, and compromised semen parameters. These combined actions alter the structural architecture of testicular tissues through multiple biological cascades. Understanding these interactions underlines the need for effective interventions to mitigate drug-induced male reproductive disorders.
Male reproductive disorders are a growing health concern. Understanding how therapeutic and abused psychoactive substances harm reproductive systems helps healthcare providers, public health advocates, and patients recognise potential side effects. Identifying the biological routes through which these substances alter hormones and cell structures is crucial for developing preventive strategies and treatments to preserve male fertility.
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Although psychoactive drugs have their therapeutic values, they have been implicated in the pathogenesis of male infertility. This study highlights psychoactive drugs reported to impair male fertility, their impacts, and associated mechanisms. Published data from scholarly peer-reviewed journals were used for the present study. Papers were assessed through AJOL, DOAJ, Google Scholar, PubMed/PubMed Central, and Scopus using Medical Subjects Heading (MeSH) indexes and relevant keywords. Psychoactive drugs negatively affect male reproductive functions, including sexual urge, androgen synthesis, spermatogenesis, and sperm quality. These drugs directly induce testicular toxicity by promoting ROS-dependent testicular and sperm oxidative damage, inflammation, and apoptosis, and they also suppress the hypothalamic-pituitary-testicular axis. This results in the suppression of circulating androgen, impaired spermatogenesis, and reduced sperm quality. In conclusion, psychoactive drug abuse not only harms male sexual and erectile function as well as testicular functions, viz., testosterone concentration, spermatogenesis, and sperm quality, but it also alters testicular histoarchitecture through a cascade of events via multiple pathways. Therefore, offering adequate and effective measures against psychoactive drug-induced male infertility remains pertinent.
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DOI: 10.1186/s12958-023-01098-2
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