How Does Marijuana Affect Men's Sexual Health and Performance?

Man laying down and smoking marijuana.

How does marijuana affect men in the bedroom? Dozens of scientific studies have been published on the topic, and here’s what we’ve learned so far.

Marijuana affects the subjective experience of sex

When researchers survey men about how marijuana impacts their sex lives, many of them report that this drug has aphrodisiac-like properties. In fact, according to a review of 91 studies exploring the sexual effects of marijuana, researchers summarized the data as follows: “Some reports suggest that 70–85% of marijuana consumers experience increased sexual pleasure and satisfaction, 25–40% experience prolonged duration of intercourse, and 55–70% experience heightened sensation during orgasm” [1].

In other words, many guys say that marijuana improves or enhances their sexual experiences. Clearly, however, this drug doesn’t seem to affect everyone the same way, given that there was quite a bit of variability in responses reported.

Also, these data don’t tell us why marijuana has the effects that it does. For example, it may be that the people who are reporting positive effects are just demonstrating what’s called an expectancy effect. In other words, for people who expect marijuana to enhance their sex lives, it may have that effect simply because they have convinced themselves that it would. Expectancy effects are a big part of the reason why most aphrodisiacs have the reputation that they do—it’s not necessarily that they truly work, it’s just that people expect aphrodisiacs to work and, when an expectation is strong, it can create a self-fulfilling prophecy.

Marijuana is linked to both improved and impaired erections

Several survey studies have found that marijuana is linked to a boost in sexual performance for a majority of men, leading to reports of longer-lasting sex [2]. However, caution is warranted in interpreting this finding because it is based on unverified self-report data. While it could be the case that marijuana gives some men longer-lasting erections, it could also be the case that this drug just alters men’s perception of time, leading them to draw erroneous conclusions about how long sex lasted.

In an attempt to see how marijuana actually affects the penis, biomedical researchers have begun to look at this issue more closely. Animal studies have found that cannabis has inhibiting effects on some receptors in the penile tissue, suggesting that marijuana has the potential to decrease both quantity and quality of erections [2]. Consistent with this, one study found that the rate of erectile dysfunction was three times higher among daily marijuana smokers compared to non-smokers [3]. At the same time, however, another study found that habitual marijuana users reported improved erectile functioning compared to non-users [4].

What’s behind these conflicting results? It may be a matter of dosing. Perhaps those who use marijuana in smaller quantities are less likely to experience the inhibitory effects than those who use marijuana in larger quantities. In addition to dose, it is important to keep in mind that some people are just more sensitive to this drug than others, which may lead it to be experienced very differently across persons. Plus, there’s also the fact that there are different types/strains of marijuana, and it’s possible that different strains may produce different sexual effects as well.

Marijuana is linked to a decline in semen quality

Several studies have looked at the link between marijuana use and fertility in men. These studies suggest that habitual marijuana use may have negative effects on sperm quality and fertility. In a recent review paper on this topic, researchers summarized one of the more compelling studies to date on this subject as follows: “Routine usage of cannabis more than once per week was associated with a nearly 30% reduction in median sperm concentration and total sperm count after adjustment for confounding variables including hours of abstinence prior to providing the semen sample, tobacco and alcohol consumption, sexually transmitted diseases, and other recreational drug usage” [1].

What’s behind this association? It turns out that there are cannabinoid receptors in parts of the testes, which provides a plausible mechanism for marijuana consumption to disrupt sperm production.

Marijuana is linked to lower risk of some cancers, but higher risk of others

There is some compelling evidence that marijuana may have protective effects against prostate cancer, as well as certain cancers of the bladder; at the same time, however, marijuana use is linked to a higher risk of testicular tumors in younger men [1]. In other words, the results are kind of a mixed bag when it comes to cancer risk.

Overall, despite the large number of studies that exist on this subject, research on the link between marijuana and male sexual function is still very much in the early stages and we need more research before we can draw definitive conclusions, especially research that carefully controls for dosage effects.

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[1] Rajanahally, S., Raheem, O., Rogers, M., Brisbane, W., Ostrowski, K., Lendvay, T., & Walsh, T. (2019). The relationship between cannabis and male infertility, sexual health, and neoplasm: A systematic review. Andrology, 7(2), 139-147.

[2] Shamloul, R., & Bella, A. J. (2011). Impact of cannabis use on male sexual health. The Journal of Sexual Medicine, 8, 971-975.

[3] Cohen, S. (1982). Cannabis and sex: Multifaceted paradoxes. Journal of Psychoactive Drugs, 14, 55–70.

[4] Suarez-Sarmiento, A., & Walker, C. (2018). 206 Association between Habitual Cannabis use in Young Men and IIEF Sexual Domain Scores. The Journal of Sexual Medicine, 15(2), S67.

Image Source: 123RF/guruxox

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