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We sit down with Yemi Famuyiwa, a renowned fertility specialist, to discuss the hidden dangers of e-cigarettes and their impact on reproductive health. As e-cigarettes continue to gain popularity, evidence reveals alarming risks, especially concerning fertility in both men and women. Yemi breaks down the toxic components of e-cigarettes, their effects on hormonal balance, sperm quality, and ovarian function, and their role in the ongoing fertility decline in the United States.

Oluyemisi (Yemi) Famuyiwa is a renowned fertility specialist and founder, Montgomery Fertility Center.

She discusses the KevinMD article, “Are e-cigarettes harming your reproductive health?”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome back Yemi Famuyiwa. She is a fertility specialist and founder of the Montgomery Fertility Center. Today’s KevinMD article is “Are e-cigarettes harming your reproductive health?” Yemi, welcome back to the show.

Yemi Famuyiwa: Thank you very much. Thank you for having me.

Kevin Pho: So today we’re going to talk about e-cigarettes. So tell us the events that led you to write this article, and then go into the article for those who didn’t get a chance to read it.

Yemi Famuyiwa: Right. So I think I had a patient that came to my office, and I asked her, “Do you smoke?” She goes, “No, I don’t smoke, I don’t touch those things, but I vape.” I’m like, “Oh. And how much do you vape?” “Every single day, sometimes twice or two, three times.” “I see. And how long have you been vaping?” “Oh, eight years, and it’s supposed to be harmless.” I’m like, oh, we have a problem.

So what I saw was a clear misunderstanding of what vaping is, and trying to enlighten my patient, that led me to bring this up.

Kevin Pho: All right, so tell us some of the misperceptions or misconceptions about vaping, and how people may not know that it can affect reproductive health.

Yemi Famuyiwa: Yeah, so one of the things that people don’t realize is they think, oh, it’s vaping, it’s not cigarettes, I’m fine. Come to find out, some of those e-cigarettes actually contain higher amounts of nicotine than a regular cigarette does, so they can be quite addictive on their own.

Another issue is that people have no idea that there are certain chemicals released in the vapor, in the fumes, especially what we call phthalates, sometimes PFAS, that can act as endocrine disruptors. They can affect your body’s ability for, you know, the brain to properly control your gonads, your ovaries or your testes. It can disrupt that fine balance, that orchestra going on, can put a little discord in there. So you can disrupt your hormone production, and that can affect your fertility.

And then the other misconception is, and I didn’t even know this until I started reading more about it, there are heavy metals being released in those formulations, and those metals can be toxic, and some of them have been shown to be carcinogenic even. Who knew? You know, lead, nickel, released in when you heat that chamber up and you spark it and ignite it. You also release additional stuff that is not even in cigarettes.

Kevin Pho: Right, I mean you don’t find heavy metals in cigarettes. Not that I think cigarettes are good for you. And as far as you know, are there any studies that have shown a clear connection between e-cigarettes specifically and reproductive health?

Yemi Famuyiwa: So I think that there are ongoing studies on the direct effect, because most of this is new. But there are indirect studies looking at animals, where you give high dose of certain components found in cigarettes that have been found to be either disruptive or carcinogenic or even toxic.

So I think as more studies are being done, we can extrapolate, because it all starts from animal studies and then you extrapolate into humans some of these effects.

Kevin Pho: And the effects on the reproductive system aren’t limited to females. It can also affect reproductive health in men as well.

Yemi Famuyiwa: Yes, absolutely. So it’s not just the ovaries that we should focus on. So if you disrupt what we call the HPG axis, right, the G for gonads, not just HP, meaning hypothalamic pituitary ovarian axis, where you have the hypothalamic pituitary testes axis. So just as you disrupt the axes going to the ovary, you can also disrupt the axes going on with the sperm.

So I’ll have gentlemen, and I see it every single day, Kevin, I just had another patient yesterday who told me they vape, oh, two to three times a day, and they’ve been doing it for over five, eight, 10 years in some cases. And I’m struggling with why can’t I get better sperm from this gentleman, what’s going on here. So I believe that there is some effect on the sperm, and also the heavy metals cannot be even salubrious for spermatogenesis, formation of the sperm. So I think it affects both women and men.

Kevin Pho: And in terms of your conversations with these patients, when you make that connection between reproductive health and e-cigarettes, what do you recommend in terms of stopping? Because as you know, nicotine is highly addictive, and if they could stop, many would. What kind of advice do you share with these patients?

Yemi Famuyiwa: So therein lies the difficulty. I think that they can turn to probably addiction experts to help them, they can turn to therapy to help them, or try to substitute. So I try to work with some holistic nutritionists or coaches in this regard that may help them substitute something healthier.

Now I tell you, Kevin, let me tell you, I have some patients who swore that they would never give up anything like that, they just can’t, it’s, “You just don’t understand me, you know, I just, you just don’t get it.” And then something catastrophic happens and boom, they stop cold turkey. So I don’t want something bad to happen before they have to stop cold turkey, but I think that if they make a concerted effort and maybe seek coaching help, they may be able to slowly dial it down and try to get over it.

Kevin Pho: When you talk about the risks of e-cigarettes, sometimes you don’t often hear its association with reproductive health. So how would you better inform the public about the reproductive health risk of e-cigarettes?

Yemi Famuyiwa: So I think that if we could maybe just show patients what’s in some of these formulations and having them understand what this could, maybe just teaching them better and understanding what these things are and what it can do for the body. Because I think that if they get an understanding what’s going on, they may make better choices than what they’re doing right now.

Kevin Pho: And in terms of brands of e-cigarettes, are they uniformly having impurities in them? Are there some brands that may be better than others? Is there any type of regulation that they should look out for?

Yemi Famuyiwa: Yeah, I think one of the most dangerous ones are the ones that have flavoring in them. You know, they have chewing gum flavor, they have strawberry flavor. I guess they do the flavoring to attract more of an audience, and also even attract children. But the more flavor that they have, the more toxic the flavors can be, because what gives off the flavor, like the phthalates, can actually be more dangerous than the plain ones. So the more flavoring it has, the more it has been shown to be more detrimental to patients.

Kevin Pho: Now tell us the type of ongoing studies that you say are going on in terms of better connecting the toxicity of e-cigarettes specifically with reproduction.

Yemi Famuyiwa: So I think not specifically with reproduction. I think that a lot of the studies that are coming on is mostly what is the detrimental effects of e-cigarettes per se. So I think that now they’re starting to look into the effect of it on fertility. There’s not a whole lot on fertility yet, but there is a lot coming out in terms of overall health.

But when you look at the individual, for instance, if you look at the individual mechanism of action, if something affects your gonadotropin axis, then it’s going to affect your fertility, whether or not specific studies have come out to answer specific questions per se.

Kevin Pho: And from a biochemical standpoint, are these effects reversible? If people stopped with e-cigarettes, is the damage irreversible?

Yemi Famuyiwa: I think that some of the damage can be reversible, as it wears off in patients. So I think that it’s never too late to stop. I think you can stop, and the body’s ability to heal itself is really dramatic. So if the body can heal itself, you can give it a go.

Kevin Pho: Now what do you tell patients who are smokers and they want to quit smoking, and they want to turn to e-cigarettes as a substitute, or as a stepwise intervention to help quit smoking? So obviously smoking affects reproductive health, e-cigarettes affect reproductive health. What do you advise those patients who want to quit smoking but may not be able to do so cold turkey, and may sometimes turn to e-cigarettes as a stepwise next intervention?

Yemi Famuyiwa: So I think that, you know, trying to get a coach to help will be very beneficial. I’m not so sure that e-cigarettes can help you get off cigarettes per se, because you find that the contents in e-cigarettes are even more addictive than regular cigarettes. So I don’t think e-cigarettes are a way to wean yourself off cigarettes. You can try everything else you want, but e-cigarettes deliver a lot of nicotine, way more nicotine than you have in cigarettes.

Kevin Pho: So what do you anticipate as the next steps? You want to get the awareness out, so tell us the next steps you would like to see when it comes to reproductive health and e-cigarettes.

Yemi Famuyiwa: I think that I would like to see more advocacy, to say how can we get the noise out in the general population, let people know how dangerous this can be for fertility. And we all complain about fertility declining. So I think just having that advocacy, having the message out there, and if the health department wants to start making legislation about it, that would be fine. But I don’t see government really taking a strong stride in it right now.

I think the more individuals, the more patients are aware and talking about it, eventually the government is going to catch on that they need to make some regulation about it.

Kevin Pho: We’re talking to Yemi Famuyiwa. She’s a fertility specialist and founder of the Montgomery Fertility Center. Today we’re talking about how e-cigarettes may be harming your reproductive health. Yemi, as always, we’ll end with your take-home messages that you want to leave with the KevinMD audience.

Yemi Famuyiwa: So take-home message: E-cigarettes can be very harmful to your fertility, and they actually contain more toxins than you are aware of. So buyer beware, make yourself alert so that you know what you’re dealing with.

Kevin Pho: I mean, the thought of that may start to deter some patients.

Yemi Famuyiwa: And if that deters you, that’s even better.

Kevin Pho: Thanks again for sharing your perspective and insight, and thanks again for coming back on the show.

Yemi Famuyiwa: Thank you.