Every Friday on the blog, I answer people’s questions about sex, love, and relationships. This week’s question comes from a reader who wanted to know whether substance use can lead to problems “keeping it up” during sex.

What does it mean when men in college can't stay hard during sex? If you smoke a lot of weed, does that make it more difficult to stay hard in the same way alcohol does?

Good question. There are a wide range of factors, both physical (e.g., substance use) and psychological (e.g., stress), that can lead to erectile difficulties in college-age guys like yourself. But to stick to your question, let's look at how drugs affect men's sexual health. Most guys are aware that alcohol can interfere with sexual arousal and response, such that if you drink too much in one sitting, you may end up with what many of my students refer to as “whisky d*ck.” The reason for this is because alcohol has a depressant effect on your nervous system when consumed in sizeable quantities. It's important to note that while episodic binge drinking may lead to occasional erectile difficulties, chronic alcoholism can cause even more problems. For instance, in one recent study of 100 men aged 20-50 who checked into an alcohol dependence clinic, fully 72 met criteria for one or more sexual dyfunctions [1]! Thus, if you're worried about your sexual performance, it's important to watch what you drink.

Beyond alcohol, a variety of recreational and illicit drugs have been linked to erectile difficulties, including marijuana, ecstasy/MDMA, and “poppers.” However, research on all of these drugs has produced conflicting results (i.e., the effects do not seem to be consistent across men). Part of this is due to the fact that measurement has not been standardized across studies, but it’s also because we don’t know exactly how to interpret what participants are telling us in much of this research. Let's take a closer look at research on marijuana in particular, given that it happens to be the most commonly used illegal drug. If you ask men how this drug impacts their sex life, a few studies have found that a majority of guys say that marijuana increases their sexual stamina [2]. However, is this because marijuana really gives them longer-lasting erections, or because the drug has altered their perception of time? Most scientists suspect the latter--and this is one of the major reasons why research based on self-reports makes it hard to know what kind of conclusions to draw.

In an attempt to clear up this confusion, biomedical researchers have begun to look at the specific biological effects that marijuana has on the body. Animal studies have found that cannabis has inhibiting effects on certain receptors in the penile tissue, meaning that marijuana is capable of decreasing both quantity and quality of erections [2]. Like alcohol, however, it appears that dosage is important. In small quantities, marijuana may produce aphrodisiac effects (i.e., increased sexual desire and arousal), but in larger quantities, it is linked to sexual problems. Consistent with this idea, a study of daily marijuana smokers compared to non-smokers found that the rate of erectile dysfunction was three times as high among those who were toking up every day [3].

In short, there does seem to be something to the idea that smoking a lot of weed could potentially undermine sexual potency. As a result, you may want to cut back on the pot and see if your erections improve. If not, it would be worth consulting a sex therapist because many factors contribute to arousal difficulties, and it's possible that the answer may be more complex than what you're smoking and drinking.

For past Sex Question Friday posts, see here. Want to learn more about The Psychology of Human Sexuality? Click here for a complete list of articles or like the Facebook page to get articles delivered to your newsfeed.

[1] Arackal, B. S., & Benegal, V. (2007). Prevalence of sexual dysfunction in male subjects with alcohol dependence. Indian Journal of Psychiatry, 49, 109.

[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.

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