Cannabis use is more mainstream in 2025 than ever before, legalized in over 30 countries, widely available in diverse formulations, and openly marketed not only for pain, sleep, and anxiety but also for enhancing intimacy. Anecdotally, many users describe increased pleasure, deeper connection, and more satisfying orgasms. But behind the buzz lies a more complex and sometimes contradictory scientific picture. Recent studies have begun to draw clearer lines between cannabis’s short-term effects on sexual function and the risks associated with long-term use, particularly among heavy users. While women often report increased arousal and orgasm intensity, male users face a potential tradeoff: enhanced enjoyment in the moment, but a higher risk of erectile dysfunction (ED) and reduced reproductive parameters with chronic use. Importantly, these effects are not uniform, as they vary by sex, dosage, formulation, and frequency of use.
This article synthesizes current findings from the 2024–2025 literature, including observational and controlled studies, to help clinicians and patients alike make sense of the available evidence. We’ll explore the gendered differences in sexual response, examine the dose–response curve, and highlight the physiological concerns associated with habitual cannabis consumption, especially as it intersects with male erectile health.
Cannabis and Female Sexual Function
Women’s sexual responses to cannabis are gaining more scientific attention, especially as legalization expands and self-reported use increases. Across studies, many women describe enhanced sensitivity, lubrication, orgasmic ease, and emotional connection after cannabis consumption, yet researchers urge caution in interpreting these effects as universally beneficial.
A 2024 observational study published in Sexual Medicine offered one of the most detailed snapshots to date. Among women with self-reported orgasm difficulty, 73% reported increased orgasm frequency, 71% reported greater ease reaching orgasm, and 67% experienced heightened sexual satisfaction when using cannabis before partnered sex (Mulvehill et al., 2024). These findings echoed earlier survey-based research that identified cannabis as a potential enhancer of arousal and sexual pleasure, particularly when used occasionally and at moderate doses. However, these data come with limitations. Most are cross-sectional, reliant on self-report, and lack dose standardization or strain analysis. In other words, we know women report feeling better during sex after cannabis use, but we don’t know whether this stems from neurological, hormonal, psychological, or even placebo-based mechanisms. The Springer 2024 review (Lissitsa et al., 2024) emphasized the need for randomized, controlled data and noted that high doses or frequent use may have contrary effects, including reduced desire or dissociative detachment.
Interestingly, women may respond to cannabis more positively than men in sexual contexts, possibly due to estrogen’s modulation of cannabinoid receptors, or simply differing psychosocial associations with cannabis and intimacy. Additionally, cannabis has been linked to stress reduction and lowered sexual anxiety, which may disproportionately benefit women with performance or relational concerns.
In short, for many women, cannabis may amplify arousal and orgasm, especially when used thoughtfully and in low to moderate amounts.
Cannabis and Male Sexual Function
In contrast to women’s largely positive subjective reports, male sexual responses to cannabis are far more ambivalent, and increasingly scrutinized. While some studies suggest potential enhancements in arousal and satisfaction, others point to measurable detriments in erectile function and reproductive health, especially with chronic or heavy use.
A widely cited study in Sexual Medicine found that frequent cannabis-using men reported higher total IIEF scores, including domains such as orgasm and intercourse satisfaction, compared to non-users (Bhambhvani et al., 2020). These findings suggest that some men may experience subjective improvements in sexual pleasure, possibly linked to cannabis’s effects on anxiety, body awareness, and temporal perception. However, a major 2019 meta-analysis published in Journal of Public Health (Pizzol et al., 2019) painted a different picture: cannabis users were more than twice as likely to experience erectile dysfunction than non-users. This association remained significant even after adjusting for confounders like age, smoking, and alcohol use.
So what accounts for the disparity? One explanation may be dose-dependence and duration. Occasional cannabis use may help with relaxation and reduce performance anxiety, thereby enhancing function temporarily. In contrast, long-term or high-frequency use appears to impair vascular response, lower testosterone levels, and interfere with dopamine regulation—factors critical to erection physiology.
Moreover, reproductive health risks are a growing concern. Studies have found that chronic cannabis use can lower sperm count, motility, and morphology, and even alter testicular function (Payne et al., 2019). These changes may not directly impact libido or satisfaction but are crucial for men considering fertility.
In sum, while some men report better sex on cannabis, the objective data are mixed at best. Occasional use may pose little harm, but chronic, heavy consumption is increasingly associated with erectile and reproductive dysfunction.
Dose-Dependence and Usage Patterns
When it comes to cannabis and sexual function, dose and frequency appear to be critical variables, possibly more so than the specific strain or method of administration. The most consistent pattern emerging from recent literature is a non-linear, dose-dependent effect: low to moderate doses may enhance sexual response, while high doses can impair function.
The 2024 psychopharmacology review by Lissitsa et al. described this as an inverted-U curve, i.e., a model supported by both animal studies and self-reported human data. Small doses of THC can facilitate arousal, reduce anxiety, and heighten sensory perception. But as dosage increases, the risk of dissociation, sedation, and anorgasmia grows. High doses may also disrupt attention and emotional presence, the factors essential to fulfilling sexual experiences (Lissitsa et al., 2024).
Usage frequency matters, too. In a study examining cannabis and sexual activity patterns, frequent users (≥3 times per week) reported more sexual encounters, but their satisfaction levels were inconsistent. Some described enhanced connection and reduced inhibition, while others reported decreased libido over time, particularly if use became habitual or emotionally detached (Bhambhvani et al., 2020; Stilo et al., 2023). Complicating matters further is the potency of modern cannabis products. Today’s THC concentrations, often exceeding 20%, may amplify dose-related side effects, especially among new or infrequent users. Moreover, the rise of high-potency edibles, dabs, and concentrates increases the likelihood of crossing the beneficial threshold into sexual suppression or performance issues.
Ultimately, the key message from current research is this: moderation matters, and effects are rarely linear.
Risks of Chronic Use and Erectile Dysfunction
While occasional cannabis use may offer short-term benefits for sexual experience, the long-term risks, particularly for men, are increasingly hard to ignore. Chief among these is the link between chronic cannabis use and erectile dysfunction (ED).
A 2019 meta-analysis by Pizzol et al. found that cannabis users were more than twice as likely to experience ED compared to non-users. The proposed mechanisms include endothelial dysfunction, decreased testosterone production, altered dopaminergic signaling, and impaired parasympathetic nerve response, all of which play vital roles in erection initiation and maintenance. Moreover, regular cannabis use has been associated with reduced sperm count and motility, as well as changes in reproductive hormones. While these effects are more pronounced in high-frequency users, even moderate chronic use may carry risks for men concerned with fertility or long-term function (Payne et al., 2019).
In light of these findings, clinicians should approach cannabis-related sexual complaints with nuanced, individualized guidance, considering dose, frequency, and underlying health conditions rather than offering blanket reassurance or blanket warnings.
References
- Bhambhvani, H. P., Kasman, A. M., Wilson-King, G., & Eisenberg, M. L. (2020). A survey exploring the relationship between cannabis use characteristics and sexual function in men. The Journal of Sexual Medicine, 17(11), 2156–2163. https://doi.org/10.1016/j.jsxm.2020.08.001
- Lissitsa, D., Hovers, M., Shamuilova, M., Ezrapour, T., & Peled-Avron, L. (2024). Update on cannabis in human sexuality: Insights into gendered responses and neuroendocrine mechanisms. Psychopharmacology, 241(8), 1721–1730. https://doi.org/10.1007/s00213-024-06643-4
- Mulvehill, S., Erickson, A., & Velarde, A. (2024). Cannabis use before partnered sex in women with and without orgasm difficulty: A cross-sectional analysis. Sexual Medicine, 12(2), qfae023. https://doi.org/10.1093/sexmed/qfae023
- Payne, K. S., Mazur, D. J., Hotaling, J. M., & Pastuszak, A. W. (2019). Cannabis and male fertility: A systematic review. Fertility and Sterility, 112(3), 454–461. https://doi.org/10.1016/j.fertnstert.2019.05.017
- Pizzol, D., Demurtas, J., Stubbs, B., Soysal, P., Mason, C., Isik, A. T., & Veronese, N. (2019). Relationship between cannabis use and erectile dysfunction: A systematic review and meta-analysis. The Journal of Sexual Medicine, 16(8), 1304–1310. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6893937/
