Impact of Human Lifestyle and Androgen Antagonists on Reproductive Health: A Systematic Literature Review

Abstract

Reproductive health disorders have become an increasing global public health concern, with growing evidence linking infertility and hormonal dysfunction to adverse lifestyle behaviours and exposure to endocrine-disrupting substances. Human lifestyle factors, such as poor nutrition, obesity, smoking, alcohol consumption, psychological stress, physical inactivity, and sleep disturbances have been associated with impaired reproductive outcomes. Similarly, androgen antagonists and environmental anti-androgenic compounds have been implicated in endocrine disruption and reproductive toxicity. This systematic literature review aimed to evaluate the impact of human lifestyle factors and androgen antagonists on reproductive health outcomes in both males and females, with emphasis on mechanisms of reproductive dysfunction and associated fertility challenges. A systematic literature search was conducted using electronic databases including PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar. Relevant peer-reviewed articles published between 2000 and 2025 were identified using predefined keywords and Boolean search strategies related to lifestyle factors, androgen antagonists, endocrine disruptors, fertility, and reproductive health. Eligible studies included observational studies, experimental studies, and review articles published in English. Data extraction, quality assessment, and narrative synthesis were performed in accordance with PRISMA guidelines.The reviewed studies demonstrated a strong association between unhealthy lifestyle behaviours and impaired reproductive health outcomes. Obesity, smoking, excessive alcohol consumption, poor dietary habits, chronic stress, physical inactivity, and sleep disturbances were consistently associated with hormonal imbalance, oxidative stress, reduced sperm quality, menstrual irregularities, ovulatory dysfunction, and infertility. In addition, androgen antagonists including pharmaceutical anti-androgens and environmental endocrine-disrupting chemicals such as phthalates and bisphenol A were found to adversely affect reproductive development, gonadal function, and fertility through endocrine disruption, androgen receptor blockade, oxidative stress induction, and DNA damage. Evidence further suggested that combined exposure to unhealthy lifestyle factors and androgen antagonists may exert synergistic adverse effects on reproductive health. The findings of this systematic review indicate that both modifiable lifestyle factors and exposure to androgen antagonists play critical roles in reproductive dysfunction and fertility impairment. The interaction between behavioural and environmental risk factors contributes significantly to declining reproductive health outcomes globally. Preventive strategies focusing on healthy lifestyle promotion, reduction of endocrine-disrupting chemical exposure, and improved public health awareness are essential for preserving reproductive wellbeing. Further longitudinal and mechanistic studies are required to strengthen understanding of the complex relationship between lifestyle, androgen antagonism, and reproductive health.