Skip to main content

Individual prolactin reactivity modulates response of nucleus accumbens to erotic stimuli during acute cannabis intoxication: an fMRI pilot study



Self-report studies indicate that cannabis could increase sexual desire in some users. We hypothesized that intoxication increases activation of brain areas responsive to visual erotica, which could be useful in the treatment of hypoactive sexual desire disorder, a condition marked by a lack of sexual desire.


The aim of this study is to assess the aphrodisiacal properties of cannabis.


We conducted an open-randomized study with 21 heterosexual casual cannabis users. A 3T MRI was used to measure brain activation in response to erotic pictures. Blood samples were collected to determine the serum levels of cannabinoids, cortisol and prolactin. Participants were grouped according to whether they had ever experienced any aphrodisiacal effects during intoxication (Group A) or not (Group non-A).


Intoxication was found to significantly increase activation in the right nucleus accumbens in the Group A while significantly decreasing activation in the Group non-A. There was also a significant interaction between the group and intoxication, with elevated prolactin in the Group non-A during intoxication. No intoxication-related differences in subjective picture evaluations were found.


Cannabis intoxication increases activation of the right nucleus accumbens to erotic stimuli. This effect is limited to users whose prolactin is not elevated in response to intoxication. This effect may be useful in the treatment of low sexual desire.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2


Group A:

Group of participants who experience aphrodisiacal effects of cannabis

Group non-A:

Group of participants who do not experience aphrodisiacal effects of cannabis


Anterior cingulated cortex left


Anterior cingulated cortex right


Anterior insula left


Anterior insula right


Amygdala left


Amygdala right




Inferior parietal lobe left


Inferior parietal lobe right


Nucleus accumbens left


Nucleus accumbens right


Orbitofrontal cortex left


Orbitofrontal cortex right


Posterior insula left


Posterior insula right


Superior parietal lobe left


Superior parietal lobe right


Ventro-lateral occipito-temporal junction left


Ventro-lateral occipito-temporal junction right


  • Aharon I, Etcoff N, Ariely D, Chabris CF, O’Connor E, Breiter HC (2001) Beautiful faces have variable reward value: fMRI and behavioral evidence. Neuron 32:537–551

    CAS  Article  PubMed  Google Scholar 

  • American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn text rev. American Psychiatric Association, Washington, DC

    Google Scholar 

  • Androvicova R, Horacek J, Stark T, Drago F, Micale V (2017) Endocannabinoid system in sexual motivational processes: is it a novel therapeutic horizon? Pharmacol Res 115:200–208

    CAS  Article  PubMed  Google Scholar 

  • Arnow BA, Millheiser L, Garrett A, Polan ML, Glover GH, Hill KR, Lightbody A, Watson C, Banner L, Smart T, Buchanan T (2009) Women with hypoactive sexual desire disorder compared to normal females: a functional magnetic resonance imaging study. Neuroscience 158:484–502

    CAS  Article  PubMed  Google Scholar 

  • Baird AD, Wilson SJ, Bladin PF, Saling MM, Reutens DC (2004) The amygdala and sexual drive: insights from temporal lobe epilepsy surgery. Ann Neurol 55:87–96

    Article  PubMed  Google Scholar 

  • Balikova M, Hlozek T, Palenicek T, Tyls F, Viktorinova M, Androvicova R, Tomicek P, Roman M, Horacek J (2013) Time profile of serum THC levels in occasional and chronic marihuana smokers after acute drug use-implication for driving motor vehicles. Soudni lekarstvi (Forensic medicine). The journal of Forensic medicine section of the Czech medical society of J E Purkyne 59:2–6

    Google Scholar 

  • Beutel ME, Stöbel-Richter Y, Brähler E (2008) Sexual desire and sexual activity of men and women across their lifespans: results from a representative German community survey. BJU Int 101:76–82

    PubMed  Google Scholar 

  • Bhattacharyya S, Atakan Z, Martin-Santos R, Crippa JA, Kambeitz J, Prata D, Williams S, Brammer M, Collier DA, McGuire PK (2012a) Preliminary report of biological basis of sensitivity to the effects of cannabis on psychosis: AKT1 and DAT1 genotype modulates the effects of δ-9-tetrahydrocannabinol on midbrain and striatal function. Mol Psychiatry 17:1152–1155

    CAS  Article  PubMed  Google Scholar 

  • Bhattacharyya S, Crippa JA, Allen P, Martin-Santos R, Borgwardt S, Fusar-Poli P, Rubia K, Kambeitz J, O’Carroll C, Seal ML, Giampietro V (2012b) Induction of psychosis byδ9-tetrahydrocannabinol reflects modulation of prefrontal and striatal function during attentional salience processing. Arch Gen Psychiatry 69:27–36

    CAS  Article  PubMed  Google Scholar 

  • Bianchi-Demicheli F, Cojan Y, Waber L, Recordon N, Vuilleumier P, Ortigue S (2011) Neural bases of hypoactive sexual desire disorder in women: an event-related fMRI study. J Sex Med 8:2546–2559

    Article  PubMed  Google Scholar 

  • Block RI, Farinpour R, Schlechte JA (1991) Effects of chronic marijuana use on testosterone, luteinizing-hormone, follicle-stimulating-hormone, prolactin and cortisol in men and women. Drug Alcohol Depend 28:121–128

    CAS  Article  PubMed  Google Scholar 

  • Bolour SY, Braunstein GD (2005) Pharmacologic treatment options for hypoactive sexual desire disorder. Womens Health (Lond) 1:263–277

    CAS  Article  Google Scholar 

  • Bossong MG, van Berckel BNM, Boellaard R, Zuurman L, Schuit RC, Windhorst AD, van Gerven JMA, Ramsey NF, Lammertsma AA, Kahn RS (2009) Delta 9-tetrahydrocannabinol induces dopamine release in the human striatum. Neuropsychopharmacology 34:759–766

    CAS  Article  PubMed  Google Scholar 

  • Brett M, Anton J, Valabregue R, Poline J (2002) Region of interest analysis using an SPM toolbox. Presented at the 8th International Conference on Functional Mapping of the Human Brain, June 2–6, 2002, Sendai, Japan. Available on CD-ROM in Neuroimage 16(2)

  • Canseco-Alba A, Rodriguez-Manzo G (2013) Anandamide transforms noncopulating rats into sexually active animals. J Sex Med 10:686–693

    CAS  Article  PubMed  Google Scholar 

  • Cera N, Di Pierro ED, Sepede G, Gambi F, Perrucci MG, Merla A, Tartaro A, Del Gratta C, Galatioto Paradiso G, Vicentini C, Romani GL (2012) The role of left superior parietal lobe in male sexual behavior: dynamics of distinct components revealed by FMRI. J Sex Med 9:1602–1612

    Article  PubMed  Google Scholar 

  • Chivers ML, Seto MC, Lalumiere ML, Laan E, Grimbos T (2010) Agreement of self-reported and genital measures of sexual arousal in men and women: a meta-analysis. Arch Sex Behav 39:5–56

    Article  PubMed  PubMed Central  Google Scholar 

  • Christensen RHB (2013) Ordinal - regression models for ordinal data. R package version 2015:6–28

    Google Scholar 

  • Dax EM, Pilotte NS, Adler WH, Nagel JE, Lange WR (1989) The effects of 9-ene-tetrahydrocannabinol on hormone-release and immune function. J Steroid Biochem Mol Biol 34:263–270

    CAS  Article  Google Scholar 

  • Demos KE, Heatherton TF, Kelley WM (2012) Individual differences in nucleus accumbens activity to food and sexual images predict weight gain and sexual behavior. J Neurosci 32:5549–5552

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Fadda P, Scherma M, Spano MS, Salis P, Melis V, Fattore L, Fratta W (2006) Cannabinoid self-administration increases dopamine release in the nucleus accumbens. Neuroreport 17:1629–1632

    CAS  Article  PubMed  Google Scholar 

  • Fattore L, Fadda P, Spano MS, Pistis M, Fratta W (2008) Neurobiological mechanisms of cannabinoid addiction. Mol Cell Endocrinol 286:S97–S107

    CAS  Article  PubMed  Google Scholar 

  • Fattore L, Melis M, Fadda P, Pistis M, Fratta W (2010) The endocannabinoid system and nondrug rewarding behaviours. Exp Neurology 224:23–36

    CAS  Article  Google Scholar 

  • Ferretti A, Caulo M, Del Gratta C, Di Matteo R, Merla A, Montorsi F, Pizzella V, Pompa P, Rigatti P, Rossini PM, Salonia A (2005) Dynamics of male sexual arousal: distinct components of brain activation revealed by fMRI. NeuroImage 26:1086–1096

    Article  PubMed  Google Scholar 

  • Fitzgerald P, Dinan TG (2008) Prolactin and dopamine: what is the connection? A review article. J Psychopharmacol (Oxf) 22:12–19

    Article  Google Scholar 

  • Georgiadis JR, Kringelbach ML (2012) The human sexual response cycle: brain imaging evidence linking sex to other pleasures. Prog Neurobiol 98:49–81

    CAS  Article  PubMed  Google Scholar 

  • Gonzalezmora JL, Guadalupe T, Mas M (1990) Invivo voltammetry study of the modulatory action of prolactin on the mesolimbic dopaminergic system. Brain Res Bull 25:729–733

    CAS  Article  Google Scholar 

  • Goode E (1970) The marijuana smokers. Basic Books, New York

    Google Scholar 

  • Green B, Kavanagh D, Young R (2003) Being stoned: a review of self-reported cannabis effects. Drug Alcohol Rev 22:453–460

    Article  PubMed  Google Scholar 

  • Guadarrama-Bazante IL, Canseco-Alba A, Rodriguez-Manzo G (2014) Dopamine receptors play distinct roles in sexual behavior expression of rats with a different sexual motivational tone. Behav Pharmacol 25:684–694

    CAS  Article  PubMed  Google Scholar 

  • Halikas J, Weller R, Morse C (1982) Effects of regular marihuana use on sexual performance. J Psychoactive Drugs 14:59–70

    CAS  Article  PubMed  Google Scholar 

  • Hamilton LD, Rellini AH, Meston CM (2008) Cortisol, sexual arousal, and affect in response to sexual stimuli. J Sex Med 5:2111–2118

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Hathaway SR, McKinley JC (1989) MMPI-2. MN: University of Minnesota Press, Minneapolis

  • van Hell HH, Vink M, Ossewaarde L, Jager G, Kahn RS, Ramsey NF (2010) Chronic effects of cannabis use on the human reward system: an fMRI study. Eur Neuropsychopharmacol 20:153–163

    Article  PubMed  Google Scholar 

  • Howlett AC, Breivogel CS, Childers SR, Deadwyler SA, Hampson RE, Porrino LJ (2004) Cannabinoid physiology and pharmacology: 30 years of progress. Neuropharmacology 47:345–358

    CAS  Article  PubMed  Google Scholar 

  • Hunter SA, Burstein SH (1997) Receptor mediation in cannabinoid stimulated arachidonic acid mobilization and anandamide synthesis. Life Sci 60:1563–1573

    CAS  Article  PubMed  Google Scholar 

  • Hurlbert DF, Apt C, Rabehl SM (1993) Key variables to understanding female sexual satisfaction: an examination of women in nondistressed marriages. J Sex Marital Ther 19:154–165

    CAS  Article  PubMed  Google Scholar 

  • IBM Corp. (2011) IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY

  • Jezova D, Vigas M, Hlavacova N, Kukumberg P (2010) Attenuated neuroendocrine response to hypoglycemic stress in patients with panic disorder. Neuroendocrinology 92:112–119

    CAS  Article  PubMed  Google Scholar 

  • Karama S, Lecours AR, Leroux JM, Bourgouin P, Beaudoin G, Joubert S, Beauregard M (2002) Areas of brain activation in males and females during viewing of erotic film excerpts. Hum Brain Mapp 16:1–13

    Article  PubMed  Google Scholar 

  • Kobori Y, Koh E, Sugimoto K, Izumi K, Narimoto K, Maeda Y, Konaka H, Mizokami A, Matsushita T, Iwamoto T, Namiki M (2009) The relationship of serum and salivary cortisol levels to male sexual dysfunction as measured by the International index of erectile function. Int J Impot Res 21:207–212

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Kruger THC, Haake P, Hartmann U, Schedlowski M, Exton MS (2002) Orgasm-induced prolactin secretion: feedback control of sexual drive? Neurosci Biobehav Rev 26:31–44

    CAS  Article  PubMed  Google Scholar 

  • Kruger THC, Haake P, Haverkamp J, Kramer M, Exton MS, Saller B, Leygraf N, Hartmann U, Schedlowski M (2003) Effects of acute prolactin manipulation on sexual drive and function in males. J Endocrinol 179:357–365

    CAS  Article  PubMed  Google Scholar 

  • Laan E, Everaerd W, Velde J, Geer JH (1995) Determinants of subjective experience of sexual arousal in women: feedback from genital arousal and erotic stimulus content. Psychophysiology 32:444–451

    CAS  Article  PubMed  Google Scholar 

  • Lang PJ, Bradley MM, Cuthbert BN (2008) International affective picture system (IAPS): affective ratings of pictures and instruction manual. University of Florida, Gainesville, FL

    Google Scholar 

  • Leiblum SR, Koochaki PE, Rodenberg CA, Barton IP, Rosen RC (2006) Hypoactive sexual desire disorder in postmenopausal women: US results from the Women’s International study of health and sexuality (WISHeS). Menopause 13:46–56

    Article  PubMed  Google Scholar 

  • Lyons MJ, Toomey R, Meyer JM, Green AI, Eisen SA, Goldberg J, True WR, Tsuang MT (1997) How do genes influence marijuana use? The role of subjective effects. Addiction 92:409–417

    CAS  Article  PubMed  Google Scholar 

  • Maldjian JA, Laurienti PJ, Kraft RA, Burdette JH (2003) An automated method for neuroanatomic and cytoarchitectonic atlas-based interrogation of fMRI data sets. NeuroImage 19:1233–1239

    Article  PubMed  Google Scholar 

  • Mitchell JB, Gratton A (1994) Involvement of mesolimbic dopamine neurons in sexual behaviors: implications for the neurobiology of motivation. Rev Neurosci 5:317–330

    CAS  Article  PubMed  Google Scholar 

  • Mykletun A, Dahl AA, O’Leary MP, Fosså SD (2005) Assessment of male sexual function by the Brief sexual function Inventory. BJU Int 97:316–323

    Article  Google Scholar 

  • Nestor L, Hester R, Garavan H (2010) Increased ventral striatal BOLD activity during non-drug reward anticipation in cannabis users. NeuroImage 49:1133–1143

    Article  PubMed  Google Scholar 

  • Pfaus JG (2009) Pathways of sexual desire. J Sex Med 6:1506–1533

    CAS  Article  PubMed  Google Scholar 

  • R Core Team (2014) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria

    Google Scholar 

  • Ranganathan M, Braley G, Pittman B, Cooper T, Perry E, Krystal J, D’Souza DC (2009) The effects of cannabinoids on serum cortisol and prolactin in humans. Psychopharmacology 203:737–744

    CAS  Article  PubMed  Google Scholar 

  • Redoute J, Stoleru S, Gregoire MC, Costes N, Cinotti L, Lavenne F, Le Bars D, Forest MG, Pujol JF (2000) Brain processing of visual sexual stimuli in human males. Hum Brain Mapp 11:162–177

    CAS  Article  PubMed  Google Scholar 

  • Sami MB, Rabiner EA, Bhattacharyya S (2015) Does cannabis affect dopaminergic signaling in the human brain? A systematic review of evidence to date. Eur Neuropsychopharmacol 25:1201–1224

    CAS  Article  PubMed  Google Scholar 

  • Simons JS, Carey MP (2001) Prevalence of sexual dysfunctions: results from a decade of research. Arch Sex Behav 30:177–219

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Stoléru S, Mouras H (2007) Brain functional imaging studies of sexual desire and arousal in human males. In: Janssen E (ed) The psychophysiology of sex. Indiana University Press

  • The MathWorks I (2006) MATLAB v.7.3 (R2006b)

  • Ückert S, Fuhlenriede MH, Becker AJ, Stief CG, Scheller F, Knapp WH, Jonas U (2003) Is there an inhibitory role of cortisol in the mechanism of male sexual arousal and penile erection? Urol Res 31:402–406

    Article  PubMed  Google Scholar 

  • Versace F, Engelmann JM, Jackson EF, Slapin A, Cortese KM, Bevers TB, Schover LR (2013) Brain responses to erotic and other emotional stimuli in breast cancer survivors with and without distress about low sexual desire: a preliminary fMRI study. Brain Imaging Behav 7:533–542

    Article  PubMed  Google Scholar 

  • Vescovi PP, Pedrazzoni M, Michelini M, Maninetti L, Bernardelli F, Passeri M (1992) Chronic effects of marijuana smoking on luteinizing-hormone, follicle-stimulating-hormone and prolactin levels in human males. Drug Alcohol Depend 30:59–63

    CAS  Article  PubMed  Google Scholar 

  • Wellcome Trust Centre for Neuroimaging (2009) SPM8.

  • Weller RA, Halikas JA (1984) Marijuana use and sexual-behavior. J Sex Res 20:186–193

    Article  Google Scholar 

  • West SL, D’Aloisio AA, Agans RP, Kalsbeek WD, Borisov NN, Thorp JM (2008) Prevalence of low sexual desire and hypoactive sexual desire disorder in a nationally representative sample of US women. Arch Intern Med 168:1441–1449

    Article  PubMed  Google Scholar 

  • Zoner Photo Studio 7 [Computer Software] (2004). Available from

Download references


This work was supported from the Ministry of interior of the Czech Republic (grant VG20122015080), from the Internal Grant Agency of the Ministry of Health of the Czech Republic (grant number IGA MZCR NT 13145–4/2012), by the project “Sustainability for the National Institute of Mental Health”, (grant number LO1611), with a financial support of the Ministry of Education, Youth and Sports of the Czech Republic (program NPU I). Further, it was supported from the Ministry of Health of the Czech Republic, by the projects PRVOUK34 and GAUK232415 from the Charles University, Prague, and from the Slovak Research and Development Agency (grant number APVV-14-0840).

Authors would like to thank Marketa Lichnovska (National Institute of Mental Health, Klecany, Czech Republic), Ludmila Zilava (Slovak Academy of Sciences, Bratislava, Slovak Republic), Tim Wells (National Institute of Mental Health, Klecany, Czech Republic), Tomás Novak (National Institute of Mental Health, Klecany, Czech Republic), and Martin Kanovsky (Comenius University in Bratislava, Slovak Republic) for their support and assistance with this project.

Compliance with ethical standards

This study was approved by the Ethical committee of the National Institute of Mental Health, the Czech’s Ministry of Internal Affairs of Czech Republic, and complies with Czech laws. Prior to the study, every participant had to sign an Informed consent.

Author information

Authors and Affiliations


Corresponding author

Correspondence to R. Androvicova.

Electronic supplementary material


(DOCX 3.21 mb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Androvicova, R., Horacek, J., Tintera, J. et al. Individual prolactin reactivity modulates response of nucleus accumbens to erotic stimuli during acute cannabis intoxication: an fMRI pilot study. Psychopharmacology 234, 1933–1943 (2017).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • Cannabis
  • Hypoactive sexual desire
  • Nucleus accumbens
  • Hypothalamus
  • Prolactin
  • Dopamine
  • Cortisol
  • fMRI