The physiology of male reproduction: Impact of drugs and their abuse on male fertility

Male factor accounts for about 30–50% of infertility. A common cause of male infertility is drug abuse; either illicit or prolonged use of prescribed drugs. This study provides a review of the physiology of the hypothalamic–pituitary–gonadal axis and recent literature on drugs that have been linked to male infertility and the associated mechanisms. Relevant peer‐reviewed papers were assessed online using PubMed/PubMed Central, Scopus, AJOL, Google Scholar and DOAJ databases using Medical Subjects Headings (MeSH) indexes and relevant key word searches. Although drugs are beneficial when used at therapeutic levels, the abuse leads to impairment of hypothalamic–pituitary–gonadal functions, increased sperm DNA fragmentation and apoptosis, and reduced sperm quality. A good knowledge of the physiology of the hypothalamic–pituitary–gonadal axis and the influence of drugs on male fertility will guide healthcare providers in managing cases of infertility.