Does cannabis cause erectile dysfunction?
This question was brought to mind having seen forums where individuals who used cannabis regularly seemed, to me, to complain of erectile dysfunction more commonly than those who were not regular cannabis users. Was this a cognitive bias? The answer is most likely. But what does the science say?
With the growing trend of cannabis use and legalization, research into cannabis has become more important in order to build a complete and comprehensive drug profile that everyone can access.
Erectile dysfunction is the most common sexual dysfunction that males experience with approximately 35% of males experiencing this issue. It is known in the medical community that smoking is strongly associated with erectile dysfunction. This leads one to postulate whether cannabis (which is primarily smoked) will also lead to erectile dysfunction.
A recent meta-analysis and systematic review published in 2019 by Pizzol et al. decided to investigate this question. There were five case control studies that were analysed. In total data from 3395 men, 1035 using cannabis and 2360 not using cannabis, were included. They found that the prevalence of erectile dysfunction was 69.1% in cannabis users which is almost twice that on the non-cannabis users (34.7%).
How does cannabis cause erectile dysfunction?
Whilst correlation does not necessarily imply causation, it is postulated that this occurs through interference with the receptors in the hypothalamus (which is part of the brain that contributes to sexual desire and erectile function). Whilst this is interesting, it is yet to be proved.
Other studies by Gunderson et al. and Nassan et al. have shown that cannabis inhibits testicular function.
The issue with the study by Pizzol et al. is that there are multiple limitations. First and foremost, there were only a few studies used. Duration and amount of cannabis use was only reported by one study which is important to differentiate between whether acute or chronic cannabis consumption results in erectile dysfunction. Furthermore, erectile dysfunction has multiple causes, and its definition may differ between different individuals. Lastly, how the cannabis was consumed is not available in all the studies used. It would be important to know whether smoking cannabis would be worse than eating cannabis (which one might assume to be the case).
In conclusion, data is limited with regards to cannabis use and erectile dysfunction, however, there does appear to be a correlation with no known method of causation at this point in time.