Cannabis, Sex, and Mental Health with Dr. Jan Roberts

February 9, 2023
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Dr. Jan Roberts discusses how to use cannabis to improve your sex life.

As a practicing clinician focusing on integrative mental health and wellness, I have spent years researching how tools like diet, nutrition, plant medicine (cannabis and psychedelics), and neuroscience can benefit my patients and reduce their distress. I’ve discovered that most consumers, let alone clinicians, have very little understanding about the nuances of cannabis and its impact on the mind and body. Because of my work in cannabis and mental health, I often work with patients who use cannabis as part of their wellness regime. I’ve worked with patients who benefited from cannabis use and patients who experienced negative effects from cannabis use. The differentiator is often education, particularly an awareness of the factors that affect one’s cannabis experience. A 2019 study of cannabis consumers found that half of its participants reported using cannabis to influence their sexual experience. Around Valentine’s Day, you see many articles about cannabis and sex, but few of these discuss the factors that impact sexual health or the positive and negative ways cannabis can influence sex. In this article, I will draw upon my clinical and professional expertise as a mental health clinician to help you learn how purposeful cannabis consumption may positively impact your sexual experience, whether you are experiencing a sexual issue or just want to enhance your pleasure. I will also focus on how to reduce potential negative outcomes when using cannabis for sex.

Why Sex is Vital to Optimal Health

Over the years, my clinical practice has treated thousands of people with sexual-related issues and relationship issues. I’ve seen patients who experience difficulties with intimacy, loss of desire, lack of connection to themselves or their partner, or even have issues with physiological arousal. I can attest that sexual-related problems are more common than most would think. These issues impact people of all ages. I’ve found that people often won’t discuss their concerns and suffer in silence without the support they need. When people feel that they are not having fulfilling sexual experiences, they experience a great sense of shame and embarrassment. Unfortunately, sexual problems are more common than you’d imagine with hypoactive sexual desire disorder (HSDD), erectile dysfunction, orgasmic and ejaculatory disorders, and sexual pain disorders impacting about 43% of females and 31% of males (Kingsberg, Clayton, and Pfaus, 2015; Rosen, 2000). We know that sexual related issues lead to reduced satisfaction in people’s lives, and that a healthy sex life is a vital component of one’s wellbeing. But what is a healthy sex life?

Healthy Sex and Mental Health

We live in a society that glorifies sex. But that doesn’t mean people know what healthy and enjoyable sex really is, much less have the tools to create that for themselves.

Great sex involves attunement, reciprocity, creating safety, desire, and arousal. Often people equate great sex with orgasming, but that is not a true indicator of what people report as great sex. While orgasms are great, focusing on the outcome takes away from the prolonged arousal that can lead to toe curling bliss.

Sex is impacted by both the mind and body. If the brain is in a negative state, it can have disastrous consequences for sex. In my clinical practice, I’ve found that sexual issues such as erectile dysfunction and anorgasmia (i.e. the inability to climax) often stem from issues such as anxiety, depression, or even past trauma. However, sexual issues can also be related to one’s biology or the substances one takes.

We know that cannabis affects the body and the brain, so it’s logical to assume that cannabis can influence one’s sexual experience. In the next section, I will present some of the latest research on cannabis and sex and discuss how it compares to my clinical experience.

Cannabis and Sex: Positives and Negatives

Over the last several years, researchers have focused on the impact cannabis has on sexual satisfaction and functioning. Overwhelmingly, sex researchers have found that cannabis can positively impact the sexual experiences of both males and females.

Some studies have shown that males who use cannabis report higher levels of sexual functioning (less erectile dysfunction and premature ejaculation, greater ability to have orgasms). Women also report greater ability to orgasm following cannabis use.

Additionally, cannabis has been shown to enhance emotional experiences during sex. People report increased sensation from touch, increased feelings of closeness and intimacy, prolonged sexual duration, and increased pleasure all around (Weibe & Just, 2019). Through education, I’ve seen patients enhance their lives, including their sexual experiences, when they use cannabis more intentionally.

As a clinician, I know that not all news is positive when it comes to cannabis and sex.

Some researchers have found that, in males, cannabis may contribute to erectile dysfunction, delayed or inability to achieve orgasm, and premature ejaculation (Scimeca et al., 2017; Smith et al., 2010). I have seen patients who have been impacted by this, and it can be very scary and upsetting.

Given the range of research findings, what factors determine if cannabis positively or negatively impacts sex?

Factors to Consider About Cannabis and Sex

As a clinician, I’ve noticed four factors that have the greatest impact on how cannabis affects one’s sexual experience.

Biological Sex: While several studies have found that both men and women report heightened sexual experiences while consuming cannabis, women tend to report higher levels of desire and more positive experiences overall after consuming cannabis.

Men tend to demonstrate more negative physiological problems from cannabis. Research has not demonstrated the same effect in women (Smith et al., 2010).

My experience is that women tend to report more enhanced feelings of pleasure, connectedness, and physical arousal when using cannabis. It is believed that these differences may be attributed to sex-based differences in the endocannabinoid system (Gorzalka, Hill, & Chang, 2010).

It’s been my experience that men are more at risk of experiencing negative sexual side effects from cannabis than women. Men tend to have trouble getting and maintaining erections, and/or issues with premature or delayed orgasms (Gorzalka & Hill, 2006; Scimeca et al., 2017).

Dosing and Frequency of Cannabis Use: One of the most important factors influencing whether cannabis enhances or impairs sex is dose.

In my clinical practice, I’ve found that many patients using cannabis don’t pay attention to the dose of cannabinoids they are consuming. Cannabis has a biphasic effect which means that too little cannabis doesn’t provide the desired positive outcome and too much cannabis will provide a negative outcome.

I have seen firsthand how not paying attention to dose can negatively impact patients. To get the most out of cannabis, it’s important to find your right dose. Studies have shown that lower doses of cannabis are associated with more positive sexual experiences in both males and females (Scimeca et al., 2017).

In addition, other studies have shown that higher doses are related to erectile orgasmic dysfunction (Aldemir et al., 2017; Gorzalka & Hill, 2006; Gorzalka et al., 2010; Scimeca et al., 2017). This dose-response effect for cannabis users is important to consider, especially for males, as lower doses of cannabis may enhance sex while higher doses reduce sexual functioning, enjoyment, and motivation (Gorzalka & Hill, 2006).

Once you have found your ideal dose, you should learn how to self-regulate your cannabis consumption so you can maintain balance in your endocannabinoid system. Using cannabis too frequently can lead to a dysregulated endocannabinoid system and poorer outcomes.

There have been studies that indicate that high frequency of cannabis use may negatively impact males’ sexual functioning, specifically erectile function, and the ability to orgasm (Scimeca et al., 2017; Smith et al., 2010).

In a study of men with cannabis use disorder (CUD), those with CUD reported less sexual desire and sexual satisfaction (Aldemir et al., 2017) than men without CUD.

However, I’d argue that dose is more impactful than frequency of use. Based on my clinical experience, I believe that whether or not you get positive outcomes from cannabis is mostly determined by the dosing.

Other Substances: Alcohol and other substances have demonstrated negative consequences on sex. But we rarely discuss the side effects of commonly prescribed medications like antidepressants and benzodiazepines. Sexual side effects like the inability to orgasm or reduced sexual desire and arousal are the most common side effects of these drugs. Many patients I have worked with have expressed frustration and concern over these issues while taking medications for their depression or anxiety. Unfortunately, many people get off these medications as a result. I have seen people successfully use cannabis to compensate for the negative sexual side effects of antidepressants, but again dosing plays an important role.

Underlying Conditions: As a clinician who works with both females and males, I’ve found that most issues involving sex are relate to increased anxiety, depression, trauma, or other biological changes like menopause or testosterone deficiencies. We know that reduced sexual function or desire is commonly a symptom of an underlying mood, anxiety, or trauma-related disorder. While it is vital to seek appropriate treatment for these conditions, many of my patients have used cannabinoids to reduce symptoms of anxiety and depression. Education and the appropriate treatment can help you address the underlying conditions that may negatively influence your sexual experience.

Cannabis Can Improve Your Sex Life

Sex is about connection, safety, desire, and arousal. No matter your age, your biological sex, or whether you’re more vanilla, into kink, monogamous, or poly, sex and sexuality are vital components of a healthy and joy-filled life.

Cannabis can be a tool to augment the pleasurable experiences of sex and is therefore an important tool in integrative health and wellness. Understanding the science of cannabis and what research says about its impact on sexuality can help you learn how to experience sexual relationships in the most satisfying way possible.

Research indicates that cannabis may be able to help people deal with sexual related problems such as difficulties with orgasming and low sex drive (Lynn et al., 2019). Because of its ability to disinhibit behavior, reduce anxiety, and provide a richer sensory experience, cannabis appears to provide more meaningful and pleasurable sex.

To use cannabis to enhance your sex life, you have to find the right dose for you. Since cannabis is a biphasic drug, if you consume too much cannabis, your sexual experience may be less positive. When using cannabis to enhance your sex life, keep in mind that dosing, the cannabinoids in your cannabis, and your biological sex may impact how cannabis affects your sexual experience.

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