Abstract
Cannabis is a widely used recreational drug that elicits a large proportion of its effects through activation of an endogenous mechanism, the endocannabinoid system. The aim of this review is to examine the current state of the literature regarding the effects of cannabis and the potential role of the endocannabinoid system on sexual behavior and reproductive physiology. Largely consistent results reveal that in both men and women, cannabis use is adverse for reproductive processes, whereas its effects on sexual behavior and arousability are both dose-dependent and sex-specific. Accumulating evidence indicates an increasingly important role for the endocannabinoid system in regulating reproductive processes. Receptors responsive to cannabinoid agents are distributed throughout the entire body, including the hypothalamus, testes, and ovaries. Recent evidence now demonstrates the presence of cannabinoid receptors in sperm and within the uterus, attesting to the potential role of the endocannabinoid system at every level of the reproductive process from maintenance of sexual activity to embryonic implantation. The endocannabinoid system may possess the very realistic possibility of being a relevant system for the development of drugs that may help to treat erectile dysfunction, sexual arousal and desire disorders, and fertility in both men and women.