Cannabis and Sexuality


Purpose of the Review

The purpose of this study is to review the impact of cannabis use on sexual functioning.

Recent Findings

The effects of cannabis on human sexuality have been known for centuries and explored for decades. The aphrodisiac effect of acute cannabis use has been frequently promoted, while the negative effect of its chronic use, especially in higher doses, has been less recognized and appreciated. The mechanism of cannabis effect on sexual functioning is not well understood, though results of some studies suggest a possible and controversial endocrinological explanation such as lowering of testosterone levels.


Cannabis has bidirectional effect on sexual functioning. Low and acute doses of cannabis may enhance sexual human sexual functioning, e.g., sexual desire and enjoyment/satisfaction in some subjects. On the other hand, chronic use of higher doses of cannabis may lead to negative effect on sexual functioning such as lack of interest, erectile dysfunction, and inhibited orgasm. Studies of cannabis effect on human sexuality in cannabis users and healthy volunteers which would implement a double-blind design and use valid and reliable instruments are urgently needed in view of expanded use of cannabis/marijuana due to its legalization and medicalization.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.

    • Koff WC. Marijuana and sexual activity. J Sex Res. 1974;10:194–204. One of the first systematic studies of the relationship between cannabis/marijuana and sexual functioning demonstrating its effect on sexual desire and enjoyment.

    CAS  Article  PubMed  Google Scholar 

  2. 2.

    Cohen S. Cannabis and sex: multifaceted paradoxes. J Psychoactive Drugs. 1982;14:55–8.

    CAS  Article  PubMed  Google Scholar 

  3. 3.

    Halikas J, Weller R, Morse C. Effects of regular marijuana use on sexual performance. J Psychoactive Drugs. 1982;14:59–70.

    CAS  Article  PubMed  Google Scholar 

  4. 4.

    Weller RA, Halikas JA. Marijuana use and sexual behavior. J Sex Res. 1984;20:186–93.

    Article  Google Scholar 

  5. 5.

    Gorzalka BB, Hill MN, Chang SCH. Male-female differences in the effects of cannabinoids on sexual behavior and gonadal hormone function. Horm Behav. 2010;58:91–9.

    CAS  Article  PubMed  Google Scholar 

  6. 6.

    Scher J. The marihuana habit. JAMA. 1970;214:1120.

    CAS  Article  PubMed  Google Scholar 

  7. 7.

    • Chopra GS, Jandu BS. Psychoclinical effects of long-term marijuana use in 275 Indian chronic users. A comparative assessment of effects in Indian and USA users. Ann N Y Acad Sci. 1976;282:95–108. This study findings illustrate the initial stimulating effect of cannabis on sexual functioning (e.g., orgasmic experience) and the negative impact of chronic cannabis use.

    CAS  Article  PubMed  Google Scholar 

  8. 8.

    Johnson SD, Phelps D, Cottler LB. The association of sexual dysfunction and substance use among a community epidemiological sample. Arch Sex Behav. 2004;33:55–63.

    Article  PubMed  Google Scholar 

  9. 9.

    Aversa A, Rossi F, Francomano D, Brizziches R, Bertone C, Santiemma V, et al. Early endothelial dysfunction as a marker of vasculogenic erectile dysfunction in young habitual cannabis users. Int J Impot Res. 2008;20:566–73.

    CAS  PubMed  Google Scholar 

  10. 10.

    Smith AMA, Ferris JA, Simpson JM, Shelley J, Pitts MK, Richters J. Cannabis use and sexual health. J Sex Med. 2010;7:787–93.

    Article  PubMed  Google Scholar 

  11. 11.

    Androvicova R, Horacek J, Stark T, Drago F, Micale V. Endocannabinoid system in sexual motivational processes: is it a novel therapeutic horizon? Pharmacol Res. 2017;115:200–8.

    CAS  Article  PubMed  Google Scholar 

  12. 12.

    •• Kolodny RC, Masters WH, Kolodner RM, Toro G. Depression of plasma testosterone levels after chronic intensive marihuana use. New Engl J Med. 1974;290:872–4. This is the first study that demonstrated lowering of testosterone due to cannabis use.

    CAS  Article  PubMed  Google Scholar 

  13. 13.

    •• Cohen S. The 94-day cannabis study. Ann N Y Acad Sci. 1976;282:211–20. Another study demonstrating lowering of testosterone due to cannabis use and its increase after cannabis was stopped.

    CAS  Article  PubMed  Google Scholar 

  14. 14.

    • Mendelson JH, Kuehnle J, Elingboe J, Babor TF. Plasma testosterone levels before, during and after chronic marijuana smoking. N Engl J Med. 1974;291:1051–5. This study did not replicate the lowering effect of cannabis on testosterone levels, though its design did not allow to fully disprove it.

    CAS  Article  PubMed  Google Scholar 

  15. 15.

    • Dalterio S, Bartke A, Mayfield D. Delta9-tetrahydrocannabinol increase plasma testosterone concentrations in mice. Science. 1981;213(4507):581–3. This study demonstrated acute increase of testosterone after THC administration in mice, followed by testosterone decrease after higher doses of THC.

    CAS  Article  PubMed  Google Scholar 

  16. 16.

    Hollister L. Drugs and sexual behavior in men. Life Sci. 1975;17:661–7.

    CAS  Article  PubMed  Google Scholar 

  17. 17.

    Buffum J. Pharmacosexology: the effects of drugs on sexual function. A review. J Psychoactive Drugs. 1982;14:5–44.

    CAS  Article  PubMed  Google Scholar 

  18. 18.

    Cone EJ, Johnson RE, Moore JD, Roache JD. Acute effects of smoking marijuana on hormones, subjective effects and performance in male human subjects. Pharmacol Biochem Behav. 1986;24:1749–54.

    CAS  Article  PubMed  Google Scholar 

  19. 19.

    Block RI, Farinpour R, Schlechte JA. Effects of chronic marijuana use on testosterone, luteinizing hormone, follicle stimulating hormone, prolactin and cortisol in men and women. Drug Alcohol Depend. 1991;28:121–8.

    CAS  Article  PubMed  Google Scholar 

  20. 20.

    Gorzalka BB, Morrish AC, Hill MN. Endocannabinoid modulation of male rat sexual behavior. Psychopharmacology. 2008;198:479–86.

    CAS  Article  PubMed  Google Scholar 

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Correspondence to Richard Balon.

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Richard Balon declares no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Current Controversies

The terms cannabis and marijuana are used interchangeably in this article, as it reflects the interchangeable use of these two terms in the literature.

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Balon, R. Cannabis and Sexuality. Curr Sex Health Rep 9, 99–103 (2017).

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  • Cannabis
  • Marijuana
  • Sexuality
  • Sexual dysfunction
  • Testosterone