What is it about?

This article looks at whether e-cigarettes, or vaping, could affect testosterone production and male reproductive health. Testosterone is mainly made by Leydig cells in the testes, and it plays an important role in sperm production, sexual function, metabolism, and overall male health. We reviewed evidence from animal studies, cell experiments, and the small number of human studies currently available. In experimental models, e-cigarette aerosols and their ingredients, including nicotine, solvents, flavorings, and metals, appear to interfere with the normal pathways that help Leydig cells make testosterone. These effects may involve oxidative stress, inflammation, mitochondrial damage, changes in gene regulation, and reduced activity of key enzymes needed for testosterone production. However, the human evidence is still limited. Some studies do not show clear changes in blood testosterone levels among e-cigarette users, so we cannot yet say that vaping causes testosterone deficiency in humans. What the evidence does show is that there is a strong biological reason to study this more carefully.

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Why is it important?

Many people see e-cigarettes as a safer alternative to smoking, but we still do not fully understand their long-term effects on hormones and reproductive health. This matters because vaping is common among young people, including males who are still in important stages of reproductive and hormonal development. Our review shows that experimental studies repeatedly point to possible disruption of testosterone-producing cells. Importantly, some effects have been seen even without nicotine, which suggests that other parts of e-cigarette aerosol may also play a role. The main message is not that vaping has been proven to lower testosterone in humans. The message is that the warning signs from experimental studies are strong enough to justify better human research. Future studies need to track vaping habits more accurately, measure exposure biomarkers, follow people over time, and include detailed hormone and fertility-related outcomes.

Perspectives

I wrote this review because vaping is often discussed in terms of the lungs, heart, or addiction, but less attention is given to possible effects on male hormones and reproductive health. I wanted to bring together the current evidence and show where the science is strong, where it is still uncertain, and what needs to be studied next. For me, the most important point is balance. The experimental evidence is concerning, but the human evidence is not yet strong enough to make definite claims. I hope this article helps researchers and health professionals consider testosterone regulation as an important outcome in future vaping studies, especially in adolescents and young adults.

Ardie Barry Sailis
University of Malaya

Read the Original

This page is a summary of: E-cigarette aerosol constituents modulate Leydig cell steroidogenic pathways: Evidence from experimental models, Molecular and Cellular Endocrinology, July 2026, Elsevier,
DOI: 10.1016/j.mce.2026.112786.
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