Cannabis
Can Cannabis Cause ED? The Science Behind Performance
Lead Psychologist
Sep 3, 2025
Can cannabis cause ED, or is it just another internet myth? For many men, especially younger users, the link between marijuana and sexual performance feels personal. Some report cannabis makes sex better. Others find long-term use leaves them struggling with erections, low testosterone, or reduced desire.
Large population studies now show cannabis abuse and dependence are linked to up to 4× higher risk of erectile dysfunction and a 2× higher risk of testosterone deficiency.1 Genetic research even suggests this link may be causal, not just correlation.2
This article unpacks the science—how cannabis affects erections, why dose and frequency matter, and how recovery is possible.
Key Takeaways
Yes, cannabis can cause ED: chronic users face higher risks of erectile dysfunction and testosterone deficiency.
Causal link confirmed: Genetic evidence suggests cannabis isn’t just correlated with ED—it may contribute directly.
Mechanisms include penile fibrosis, disrupted blood flow, hormonal imbalance, and receptor-level changes.
Dose matters: small amounts may enhance desire, but heavy or long-term use worsens performance.
Recovery is possible: CB1 receptors normalise within 4 weeks of abstinence, with sexual function often improving soon after.
Treatment considerations: cannabis can alter ED medication effectiveness, requiring medical oversight.
Cannabis, ED, and Testosterone — What the Big Studies Reveal
The strongest evidence linking cannabis to erectile dysfunction comes from large-scale population studies. One analysis of claims databases examined over 30,000 cannabis users compared to 1.4 million control subjects. Results showed cannabis dependence was associated with a fourfold higher risk of ED and a twofold higher risk of testosterone deficiency.1
Younger men were especially affected. Those under 40 who abused cannabis were far more likely to be prescribed PDE5 inhibitors (like Viagra), showing that ED isn’t just an “older man’s” problem when cannabis is involved.
Adding weight to this, a genetic study using Mendelian randomisation confirmed an association that suggests cannabis itself—not just lifestyle factors—may contribute to increased ED risk.2 This makes cannabis one of the few recreational substances with direct evidence linking use to sexual dysfunction.
Table 1. Population-Level Evidence on Cannabis and ED
Study Type | Sample Size | Key Findings |
Claims database (2025) | 30,964 cannabis users vs. 1.47M controls | 4× higher ED risk, 2× higher testosterone deficiency, strongest in men <401 |
Mendelian randomization (2024) | Genetic analysis | Cannabis use causally linked to higher ED risk2 |
Together, these studies show the link between cannabis and ED isn’t just coincidence. The risks are measurable at the population level and likely driven by biological mechanisms we’ll explore in the next sections.
The Biological Pathways — How Cannabis May Cause ED
If cannabis is linked to ED, the next question is: how? Research points to several overlapping biological mechanisms. A systematic review and meta-analysis found evidence that cannabis may disrupt erectile function through both vascular and neurologic pathways.3
Vascular effects: Cannabis can impair blood vessel dilation, reducing the flow of blood into the corpora cavernosa—the sponge-like tissue responsible for erections.
Neurological effects: CB1 receptors in the brain and penile tissues affect signalling pathways that regulate sexual arousal and erection. Chronic overstimulation of these receptors may blunt responsiveness over time.
Hormonal effects: As seen in population studies, cannabis use is linked to testosterone changes, further undermining erectile capacity.
These mechanisms explain why some men experience a decline in sexual performance after long-term use, even if short-term cannabis use seems to enhance desire or sensation.
Cannabis and Male Sexual Function — Subjective vs. Objective Evidence
The relationship between cannabis and sexual performance is often contradictory. On one hand, many men say cannabis enhances desire, sensitivity, or intimacy. On the other hand, clinical studies show measurable declines in hormonal and erectile health.
A long-term, single-centre study followed over 7,800 men for 10 years. Cannabis users in this group reported higher sexual frequency but also showed worse androgen deficiency scores compared to non-users (52% vs. 46% with positive ADAM scores).4
This highlights the paradox: while cannabis may feel like it boosts performance, it may be silently undermining the hormonal foundation of male sexual health. In other words, subjective pleasure doesn’t always equal objective function.
Cannabis Frequency and Erectile Function Scores
Survey data add another layer of evidence. A study of 325 men found that more frequent cannabis use was associated with lower scores on the International Index of Erectile Function (IIEF).5
Occasional users reported relatively normal erectile function.
Heavy users (6+ times per week) showed significantly lower erectile scores.
The relationship was statistically significant, though the drop wasn’t always severe enough to be clinically disabling.
This study suggests a dose–response relationship: the more often cannabis is used, the higher the risk of erectile problems. While some men still perceive sexual benefits, objective measures tell a more cautionary story.
Table 2. Short-Term vs. Long-Term Effects of Cannabis on Sexual Function
Effect Type | Short-Term / Occasional Use | Long-Term / Heavy Use |
Sexual desire | Often increased | Frequently decreased |
Subjective experience | Heightened sensitivity, relaxation | Reports of apathy, anxiety, or performance decline |
Erectile function (IIEF) | Usually within normal range | Lower scores in frequent users |
Hormonal impact | Minimal | Increased risk of testosterone deficiency |
Mechanistic Insights — How Cannabis Alters Penile Tissue
Animal research helps explain why cannabis may impair erectile performance. In one study, combining a high-fat diet with oral cannabis extract significantly increased fibrosis in the corpora cavernosa, the erectile tissue of the penis.6 Fibrosis reduces elasticity, making erections more difficult to achieve and maintain.
Paradoxically, cannabis has also been linked to priapism—prolonged, often painful erections that occur without sexual stimulation. A case report described a 32-year-old man experiencing recurrent priapism episodes after cannabis use.7 This illustrates that cannabis can cause both erectile dysfunction and abnormal hyper-erections, depending on the individual and context.
Table 3. Biological Pathways Linking Cannabis to Erectile Outcomes
Pathway | Effect on Sexual Function | Evidence |
Vascular (blood flow) | Impaired vasodilation reduces erection quality | Meta-analysis of cannabis–ED mechanisms |
Fibrosis (tissue damage) | Collagen buildup stiffens erectile tissue | Mouse study with cannabis and a high-fat diet |
Neurologic (CB1 activation) | Chronic overstimulation blunts arousal pathways | Endocannabinoid receptor studies |
Hormonal | Testosterone disruption increases ED risk | Population and hormone studieS |
Paradoxical priapism | Abnormally prolonged erections | Case report in male user |
The Endocannabinoid System and Male Sexual Health
Cannabis affects sexual performance by interacting with the body’s endocannabinoid system. Both CB1 and CB2 receptors are present in penile tissue, as well as in brain regions that regulate arousal.
A comprehensive review in urology highlighted how these receptors influence erectile function:
CB1 receptors: located in neural and vascular pathways, they regulate arousal signals but can impair erectile response when overstimulated.
CB2 receptors: found in immune and vascular cells, they may play a more protective role, but their activation is less directly tied to performance outcomes.
This receptor-level interaction helps explain the dual nature of cannabis in sexual health: some men report enhancement, while others develop dysfunction. In short, cannabis is not simply an aphrodisiac—it’s a neuromodulator with complex, dose-dependent effects.8
Dose-Dependent Effects on Desire and Performance
Not all cannabis use affects men the same way. Evidence shows a dose-dependent pattern:
Low doses are often associated with increased sexual desire and heightened sensations.
High doses or chronic use tend to decrease sexual desire and impair erectile performance.
A recent review on cannabis and human sexuality confirmed this split, noting that men may initially feel cannabis enhances sex, but heavy use leads to performance decline over time.9 The review also found gender differences—women sometimes report stronger libido increases than men at similar doses, further highlighting the complexity of cannabis’s sexual effects.
The clear takeaway for men is that frequent and heavy cannabis use increases the likelihood of erectile problems.
Can Sexual Function Recover After Quitting Cannabis?
The good news: many of cannabis’s sexual effects are reversible. Research shows that during cannabis withdrawal, CB1 receptors in the brain begin to normalize within about four weeks of abstinence.10 Although receptor data mostly comes from PET imaging & animal studies, not always direct clinical measures.
Since CB1 overactivation is one pathway linked to erectile dysfunction, this timeline provides a neurobiological explanation for why sexual function often improves after stopping cannabis.
Clinically, this means:
Withdrawal symptoms (like irritability, low mood, and cravings) typically peak within a few days and resolve within 1–2 weeks.
Sexual recovery tends to follow receptor normalisation, often noticeable after a month of abstinence.
This recovery window offers hope for men struggling with cannabis-related ED: improvements are possible with sustained reduction or cessation.
Perception vs. Reality: Why Men Report Better Sex on Cannabis
One of the most confusing aspects of cannabis and ED is the gap between what men report and what studies measure.
In a study of over 400 participants, more than half reported greater sexual desire and satisfaction when using cannabis.11 Many users describe longer sessions, heightened sensation, and improved confidence.
But here’s the catch:
These findings are self-reported and not backed by objective measures of erectile function.
Clinical assessments often show the opposite — reduced performance, lower erectile function scores, and greater ED prevalence in heavy users.
This mismatch highlights a critical point: cannabis may feel like it enhances sex in the moment, but underlying physiological effects often point toward long-term dysfunction.
Cannabis and ED Medications: A Hidden Interaction Risk
Many men turn to ED medications like Viagra (sildenafil) to restore sexual performance. But research shows cannabis can interfere with how these drugs work.
Cannabis smoking inhibits the CYP3A4 enzyme, which is responsible for breaking down sildenafil in the liver. This can increase drug levels in the bloodstream, raising the risk of side effects such as headaches, flushing, or dangerously low blood pressure.12
Table 3: Cannabis & ED Medication Interactions
Medication | Normal Action | Effect with Cannabis | Clinical Concern |
Sildenafil (Viagra) | Improves penile blood flow | Slower breakdown → higher blood levels | Increased side effects (headache, hypotension) |
Tadalafil (Cialis) | Longer-acting PDE5 inhibitor | Possible altered metabolism | Prolonged effects, risk of hypotension |
Vardenafil (Levitra) | Shorter-acting ED medication | Potential increased drug exposure | Unpredictable response, side effect risk |
This means men using both cannabis and ED medications may face unpredictable results — stronger effects in some cases, but also higher risks.
Cannabis, Hormones, and Sexual Function
Erectile function is not just about blood flow — hormones like testosterone play a critical role. A large study of over 1,200 young men found cannabis use had complex effects on male hormones.13
Some users showed slightly higher testosterone levels, but chronic heavy use was linked to hormonal disruption, including changes in sperm quality and reduced reproductive health.
This paradox helps explain why some men may initially feel a boost in sexual desire with cannabis but later develop endocrine-related sexual dysfunction. Over time, these hormonal shifts can contribute to persistent erectile problems.
Recovery Timeline: How Long Until Erectile Function Improves?
The good news is that cannabis-related ED is often reversible. Research on cannabis withdrawal shows that most symptoms peak within 2–3 days of quitting and typically resolve in 1–2 weeks.14
Sexual function tends to improve in parallel. CB1 receptors, which play a role in erectile signalling, usually return to baseline within 4 weeks of abstinence.
Clinical intervention studies further confirm that men who reduce or stop cannabis use report measurable improvements in quality of life and sexual health.15 Importantly, even a partial reduction in cannabis frequency can lead to better performance and recovery outcomes.
Many men worry that cannabis-induced ED might be permanent, but current research suggests that this is rarely the case. Unlike age-related erectile decline, cannabis-related dysfunction is often tied to reversible neurochemical and vascular changes. Factors such as duration of use, dose, diet, and overall health can influence how quickly recovery happens. This means that men who stop or even cut back on cannabis use often see meaningful improvements in performance without the need for long-term medical treatment.
Frequently Asked Questions (FAQs)
1. Can cannabis really cause ED?
Yes. Evidence shows cannabis can impair erectile function through vascular, hormonal, and neurological pathways. The risk is higher with frequent or heavy use.
2. Is cannabis-related ED permanent?
No, it’s usually not permanent. Most men see improvements within weeks of reducing or stopping use, as the body’s cannabinoid and hormonal systems recover.
3. Can cannabis lower testosterone and affect sexual hormones?
Yes. While some short-term hormonal fluctuations may occur, chronic or heavy cannabis use is linked to hormonal imbalances, reduced fertility, and erectile issues.
4. Does cannabis affect ED medication like Viagra?
Yes. Cannabis can alter how ED medications are metabolized, sometimes reducing their effectiveness or increasing side effects. Men combining both should use caution.
5. Does the dose or frequency of cannabis matter for sexual function?
Absolutely. While higher or frequent doses are strongly linked to decreased performance and ED risk, lower doses may temporarily increase sexual desire.
6. Can quitting cannabis improve erections and sexual performance?
Yes. Many men experience significant improvements in erections, testosterone balance, and overall sexual satisfaction after reducing or quitting cannabis use.
7. Are there lifestyle changes that help recovery from cannabis-related ED?
Yes. Regular exercise, a balanced diet, adequate sleep, and reducing other substances like alcohol or tobacco can accelerate recovery and improve sexual health.
Conclusion: Can Cannabis Cause ED — And Can You Recover?
So, can cannabis cause ED? The science is clear: while cannabis may temporarily heighten desire in small doses, heavy or long-term use is linked to erectile dysfunction, testosterone imbalance, and impaired sexual performance. The good news is that these effects are rarely permanent.
With just a few weeks of reduced or stopped use, the brain’s cannabinoids, hormones, and vascular functions begin to normalise. Many men report stronger erections, higher energy, and improved confidence within a month of abstinence.
If you’re struggling with ED and cannabis use, remember that recovery is possible — and it doesn’t have to happen alone. Tools like the SunflowerSobriety app can help you track your progress, build healthier habits, and stay motivated along the way.
Taking back your sexual health isn’t just about performance — it’s about reclaiming confidence, intimacy, and long-term well-being.
References
Sun AJ, Eisenberg ML. Association Between Marijuana Use and Sexual Frequency in the United States: A Population-Based Study. J Sex Med. 2017;14(11):1342–1347. doi:10.1016/j.jsxm.2017.09.005. Available at: https://pubmed.ncbi.nlm.nih.gov/29066194/
