Does cannabis make sex better?

In moderate doses yes - 67 percent of consumers report improved experience (Gebel 2018). Sensitivity increases, anxiety decreases, orgasm intensity can increase. High-dose or chronic use reverses this effect: testosterone decreases, erectile dysfunction increases. Dose is crucial.

Does cannabis cause erectile dysfunction?

With chronic high consumption yes. CB1 in the corpus cavernosum inhibits erection when over-activated. Chronic cannabis use lowers testosterone by 15-30 percent and increases prolactin. Moderate, occasional use does not show a consistent risk of ED. If ED is present, cannabis use should be discussed with your doctor.

Does cannabis help with sexual pain in women?

Yes, especially for endometriosis- or vaginismus-related pain. Lynn et al. (2019, n=373 women) showed 52 percent pain reduction after cannabis use before sex. CBD suppositories or lubricants can have a local analgesic effect. Endometriosis pain is one of the most recognized cannabis indications.

Does cannabis permanently lower testosterone levels?

With chronic high consumption (daily) yes - reduction by 15-30 percent is proven. After abstinence, testosterone levels recover within 4-8 weeks. Moderate occasional use shows no lasting testosterone effects in the available studies.

Cannabis and sexuality: libido, erection & ECS

Most important: CB1 is expressed in genital tissue, hypothalamus and limbic system. Cannabis has a biphasic effect: low doses increase libido and sensitivity, high doses inhibit them. Sun 2017 (n=28,000): Cannabis users had more sex in all groups.

At a glance:

CB1 in genital tissue, hypothalamus and limbic system – ECS directly integrated into sexual function
Biphasic: low THC doses increase libido and sensitivity, high doses inhibit them
Sun 2017 (n=28,000): Cannabis users had more sex across all demographic groups

Cannabis and sexuality: what the ECS has to do with it

Overview hide

Cannabis and sexuality: what the ECS has to do with it

The biphasic model: a little helps, a lot harms

Study situation: Cannabis and sexual function

Women: Cannabis and sexual dysfunction

Men: Erectile dysfunction and cannabis

FAQ: Cannabis and sexuality

Summary

Cannabis and sexuality is one of the most discussed but least systematically researched cannabis topics. The endocannabinoid system (ECS) has been shown to play a role in sexual function: CB1 receptors are expressed in genital tissue, hypothalamus (sexual motivation), limbic system (pleasure, reward) and peripheral neural pathways (erection, orgasm).

Anandamide (AEA) and 2-AG directly influence libido, arousal and orgasmic function. This explains why cannabis can both enhance and impair sexual experiences, depending on the dose.

The biphasic model: a little helps, a lot harms

Cannabis has a clear biphasic effect on sexual function:

Low dose THC:
– Sensory hypersensitivity (TRPV1 effect on sense of touch) → more intensive touch perception
– Anxiolysis → Reduction of performance anxiety, which is common in sexual dysfunction
– Dopamine increase → mood enhancement, sexual motivation ↑
– Time-perception distortion → subjectively longer arousal phases

High dose THC / chronic use:
– Testosterone suppression: Chronic cannabis use lowers serum testosterone by 15-30% (Gorzalka 2010)
– Erectile dysfunction: CB1 overactivation inhibits NO synthase in penile blood vessels → Erectile dysfunction
– Hyperprolactinemia: THC increases prolactin → inhibits libido
– Anorgasmia: CB1 overactivation can affect orgasm timing and intensity

Study situation: Cannabis and sexual function

Study	Design	Result
Sun & Eisenberg 2017 (J Sex Med)	NSFG data, n=28,176, cannabis use frequency vs. sex frequency	Cannabis users had sex 20% more often than non-users; correlation with frequency of use
Gebel et al. 2018 (J Sex Med)	Online survey, n=373, self-report after cannabis	67 % report increased sexual experience; 24 % no effect; 9 % impaired; dose responses: low better
Gorzalka et al. 2010 (Eur J Pharmacol)	Review, Cannabis + male sexual function	Chronic cannabis use lowers testosterone, increases prolactin, increases ED risk; acute use ambivalent
Lynn et al. 2019 (Sex Med)	Prospective, n=373 women, before/after cannabis use before sex	Consumed before sex: 68 % report better orgasm, 60 % increased desire, 52 % less pain

Women: Cannabis and sexual dysfunction

For women, the data consistently shows positive effects with moderate consumption:

Pain during sex (dyspareunia): Cannabis analgesia via CB1 in pelvic nerves – particularly relevant for endometriosis-related sexual pain. Lynn 2019: 52 % pain reduction.

Lubrication: Reduced lubrication (vaginal dryness) is often caused by anxiety. CBD anxiolysis improves the ability to relax → better arousal response.

Vaginal CBD products: CBD lubricants and suppositories are available in Germany. Local CB1 activation in vaginal tissue can reduce pain and improve lubrication. Clinical studies are still lacking.

Men: Erectile dysfunction and cannabis

Erectile dysfunction (ED) in cannabis users is well documented with chronic high use:
– CB1 in corpus cavernosum smooth muscle inhibits NO-mediated relaxation when overactivated → ED
– Chronic THC use: testosterone ↓ + prolactin ↑ → dopaminergic libido inhibition
– Consumption <2×/week in moderate quantities: usually no ED risk; acute sexual mood improvement frequently reported

Study highlight: Sun & Eisenberg 2017 (J Sex Med, n=28,000): Cannabis users had significantly more sex than non-users – in all demographic groups. Mechanism: Anandamide increases libido, low THC doses potentiate the effect. High doses reverse it.

More on the topic:

Cannabis microdosing
Cannabis during the menopause

FAQ: Cannabis and sexuality

Summary

Cannabis and sexuality show a clear biphasic effect: low doses improve sexual experience via anxiolysis, sensory enhancement and dopamine; high and chronic doses cause testosterone suppression, ED and loss of libido. Women particularly benefit from the analgesic effect on sexual pain. Chronic male users should monitor testosterone and sexual function. Related topics: Cannabis and stress (anxiolysis as a key mechanism) and Cannabis and hormones.

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