Understanding and dealing with erectile dysfunction (ED) can be awkward, and the added stigma that can still surround cannabis use can make it difficult for cannabis consumers to determine whether smoking weed affects your erectile function.
Dr. Tom F. Lue, writing for The New England Journal of Medicine, describes ED as “the inability to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse,” — a condition affecting “20 million to 30 million men in the United States.”
In this post, we’ll dive into a brief overview of the intersection of cannabis and sex before exploring cannabis and erectile function specifically. If you're wondering, can smoking weed everyday cause erectile dysfunction, you've come to the right place.
Cannabis’ long history of enhancing intimacy dates back thousands of years. In traditional Indian culture, for example, scholars have found evidence of cannabis use in Tantric sexual practices, and describe cannabis as “the aphrodisiac par excellence” in Ayurvedic medical traditions.
Additional research from today’s research shows that marijuana and sexual performance are related — though not always in the way the Ayurvedic tradition might lead us to believe.
For example, one survey published in 2019 found that certain side effects of cannabis such as drowsiness negatively impacted individuals sex lives. Beyond those mentioned in the study, side effects like dry mouth or dizziness might also have a negative impact on sexual experiences.
Still, the ancient scholars of Ayurveda were onto something, and at least some of today’s cannabis users agree. The study linked above reports that a significant portion of respondents “found that cannabis helped them relax, heightened their sensitivity to touch, and increased intensity of feelings, thus enhancing their sexual experience.”
A more recent study, published in January 2023 and, unlike many studies, specifically including LGBTQ+ survey respondents, also found that “both men and women perceived that cannabis use increased their sexual functioning and satisfaction, particularly increased desire and orgasm intensity.”
In order to understand how cannabis use relates to ED, it's necessary to have a basic understanding of how the disorder works.
ED is most commonly the result of a range of both psychological and physical factors, though in some cases it may be tied exclusively to symptoms of a specific disorder.
According Lue, some physical factors that might lead to ED include:
Lue adds that psychological conditions such as schizophrenia, depression, anxiety (especially when related to sexual performance), stress, and even a strained relationship with one’s sexual partner can cause individuals to experience ED.
The wide variety of potential causal factors for ED muddies the relationship between the disorder and cannabis use. That relationship could be further complicated if you’re using cannabis as part of a wellness routine intended, for example, to reduce everyday stress or as a substitute for alcohol.
While a conversation with a medical professional about your ED might not sound especially inviting, a well-informed and individualized approach to tracing the roots of your own disorder is essential in determining whether your cannabis use might be a factor.
So, does weed cause erectile dysfunction? The current available literature regarding cannabis use and ED is mixed, and the authors of the works referenced below consistently state the need for additional research on the effects of cannabis on male sexual health in general.
One meta-analysis published in 2019 examined five studies and data from over 3,000 “healthy” men and found that ED might be more prevalent in men who consume cannabis.
The researchers found that the combined data from the five studies — all of which specifically examined consumers who smoke their cannabis — indicated “a higher prevalence of ED in cannabis users (more than two-thirds) and leading to four times increased odds ratio of ED in cannabis users compared to controls.”
The researchers suggest a few potential explanations for this correlation, the first of which is the presence of endocannabinoid receptors “in the paraventricular nucleus of the hypothalamus which regulates erectile function and sexual behavior of males.” They add that this connection might also explain “why cannabis can improve sexual function in some patients affected by conditions or symptoms such as depression, anxiety disorder, and pain.”
A survey published in 2020 (with a much smaller sample size of 325) found a somewhat contradictory result, stating that there may be a positive association between marijuana and sexual performance in men and noting no change to erectile function as a result of increased frequency of cannabis use.
The survey focused on adult males who purchased cannabis products from a dispensary between October 20, 2019 and March 12, 2020 (in contrast, the 2019 meta-analysis pulled studies from the Middle East and Europe), finding that frequent cannabis users scored higher on the widely accepted International Index of Erectile Function (IIEF) scale compared to those who said they used cannabis less frequently.
“The current report also found no change in erectile function,” the researchers write. “However, we did identify improvements in other domains of sexual function and a lower prevalence of ED with more cannabis use.”
While the researchers do outline some limitations for the survey, including the small and specialized sample size of male dispensary visitors and the potential biases inherent to the self-report approach to data gathering, their report makes it clear that further investigation may confirm “the existence of a relationship between the increasing frequency of cannabis use and increasing male sexual function, including improved sexual satisfaction and lower prevalence of ED based on the IIEF scores.”
There are four common types of ED medication: sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis) and avanafil (Stendra). All four are administered orally, and all function by “enhancing the effects of nitric oxide, a natural chemical your body produces that relaxes muscles in the penis,” according to the Mayo Clinic.
Studies of interactions between ED medications and cannabis are limited in general. Currently, studies of ED medication and cannabis have focused primarily on sildenafil, the generic version for Viagra, due to its position as one of the more popular medication options for individuals with ED.
One case report from 2000 tells the story of a 41-year-old man who experienced “central test tightness, radiating down both arms.”
According to the report’s author, a doctor in the cardiology department at the U.K.’s Perth Royal Infirmary, the man had smoked cannabis the previous evening and recreationally consumed a single tablet of Viagra “approximately 12 h before the onset of pain.” An electrocardiogram revealed developing symptoms of a heart attack that abated after hospital treatment.
“This is the first reported case indicating the potential interaction between Viagra and cannabis,” the report’s author states. He goes on to call for greater public education efforts concerning the recreational use of Viagra rather than cannabis.
A more recent study published in June 2021 notes that cannabis is a known “inhibitor” of the main protein that metabolizes sildenafil, but found that cannabis consumption blood concentrations of sildenafil were similar for cannabis smokers and non-smokers when both groups were administered the same dose. With that being said, the study’s authors do clarify that their findings could be the result of a lack of oversight over the participants’ cannabis consumption.
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