As more and more states in the US decriminalize, medicalize, and legalize marijuana and THC related products, cannabis and sex comes up a lot with my clients. A few months back (2021), I virtually attended the 2021 AASECT Annual Conference and was very impressed by the panel presentation featuring Chelsea Cebara (www.chelseacebara.com) and Jordan Tischler, MD (www.inhalemd.com). I took some notes to write this blog to help my clients and others understand how cannabis can be utilized therapeutically for sexual concerns.

To start, I want to be clear, I am not a cannabis or marijuana expert and do not have the adequate training or experience in cannabis and sex to make any formal recommendations or for you to read this blog and say that I an expert. Just merely reporting a small amount of information that I absorbed from this presentation or my own research.

What Does Cannabis Help With Related to Sex

Cannabis and Pain

Canabanoids are anti-inflammatory and anti-spasmodic and can help with inflammation or spasmodic pain which can contribute to sexual pain and orgasmic functioning. There is over 60-70 years of data on the use of THC and cannabis for the treatment of pain. The sexual issues that cannabis can treat around pain include:

  • The pain and spasmodic pain related symptoms of endomietroisis
  • Symptoms related to menopause such as hot flashes, insomnia, depression/anxiety, decreased libido, sexual pain
  • Vaginismus/Dyspareunia (sexual pain in females)
  • Neuropathy (which can cause sexual pain and sexual disorders)

Cannabis and Mental Health Issues related to Sexual Issues

There is a lot of evidence that having a mental health issue is a contributing factor to having sexual issues, with anxiety and depression being the most common that I see with clients. Cannabis has been shown to help with the following mental health issues (which I find in sex therapy being often comorbid with sexual issues in my clients):

  • Anxiety (a huge contributing factor in sexual issues)
  • Depression
  • Insomnia (if sleep is disturbed, usually sex is as well)
  • Post-Traumatic Stress Disorder

Cannabis and Sexual Issues

  • Helps with delayed orgasm
  • Increases libido and arousal
  • Remarkably helpful in increasing orgasm frequency and intensity of all groups
  • Increase vasodilation which can lead to increased arousal and vaginal lubrication which is a passive process from that peripheral vasodilation
  • Sexual Pain- cannabis can shift the perspectives of pain
  • It can address the things that are hitting the breaks so the gas can emerge (see Nagoski’s work on Sexual Accelerator and Brake Systems)
  • Increase vulnerability,
  • Enhanced embodiment,
  • Enhanced being in the moment and mindfulness

What Evidence Exists for Cannabis and Sexual Functioning

I can’t even begin to say that I’m an expert on this but I’ll offer a few references to some recent studies (last five years) on cannabis and sex. After reviewing these and more studies, it does appear that cannabis has more positive effects on women and sexuality than men (in fact, the research and anecdotal reports seem to align that cannabis actually can contribute greatly to increased sexual functioning issues in men, however, I think for certain issues I have seen it be helpful such as increase sensation, decrease anxiety, hep with pain or neuropathy).

A 2017 study says those that use marijuana have more frequent sex.

A 2017 study concluded that the majority of female marijuana users who used marijuana before sex reported a better overall sexual experience, an increase in sex drive, a more pleasurable orgasm and a decrease in pain.

A 2019 study says that marijuana improves satisfaction with orgasm in women.

A 2019 study reported that many participants in the study found that cannabis helped them relax, heightened their sensitivity to touch, and increased intensity of feelings, thus enhancing their sexual experience, while others found that cannabis interfered by making them sleepy and less focused or had no effect on their sexual experience. 

A 2019 study suggests that erectile dysfunction is twice as high in cannabis users compared to controls.

A 2020 study concluded that increased frequency of marijuana is associated with improved sexual functioning in women.

How Should One Consume Cannabis for Sexual Healing

The real key to this in finding a way to consume cannabis to minimize the intoxication (high) while maximizing the benefit of the THC says Tischler (2021). If there is really no intoxication/high its unlikely that it is going to work so the goal in treating someone with cannabis is finding a minimum effective dose. Maximize benefit, minimize that side effect (intoxication). Additionally, intoxicated sex comes with risks, requires planning, and a huge focus on consent.

According to Dr. Tischler (2021) inhaled cannibus is particularly good with sexuality and partners and he recommends vaporizers, suppositories, capsules, and THC lube. Topicals are mostly recommended for sexual issues because they can be localized. Best practices for consumption are topical, ingested, and vaporized. THC “pens” or cartridges are not recommended and Tischler recommends “straight up flower” for vaporization. Combusting the flower (smoking, joints, bowls, bongs, blunts, etc.) is not recommended due to the fact that the heat can actually damage the THC content and that transmission into the body can be very harmful.

Tischler (2021) recommends THC content to be between 15-20%. If you start using the 30% pure THC, Tischler says, that is pharmaceutical grade, its not a very effective medicine and is often a dysphoric experience. He suggests 15-25 mg of THC for the average person and dosing is very important.

A note about CBD, according to Tischler (2021), CBD is at best supportive but hasn’t been really shown much significant impact on sexual systems. Tischler also warnes about some potential interactors so doing your research and consulting with a qualified health professional is recommended.

You’ll see I recommend you consulting with a qualified healthcare provider before experimenting with any of this. There are potential complications related to cannabis use such as Cannabinoid hyperemesis syndrome (CHS). CHS is a condition that leads to repeated and severe bouts of vomiting. It is rare and only occurs in daily long-term users of marijuana. Marijuana has several active substances. These include THC and related chemicals.

Recommended Products

There are some products that are specifically designed for sexual and intimacy and include:

Foria THC (only available in some states, cannot ship cross state lines)

Velvet Swing (only available in Washington and Oregon): This is the only THC lube that is barrier compatible. Everything else out there is going to be oil-based and not compatible with barriers (condoms, dental dams, etc.)

Best Practices around Cannabis and Sex

Tischler and Cebara (2021) shared some best practices when trying out integrating cannabis into your solo and partner sexuality. Here are some highlights:

  • Consult with a qualified health professional before trying any substances.
  • When trying something new, start with just yourself and then masturbate. If you have a positive or neutral experience a few tries, invite in a trusted partner.
  • Open up and be present to the possibilities. Try things without expectation or judgment.
  • Focus on what feels good: PLEASURE IS THE MEASURE. There is no “shoulds”.
  • Journal after the experience to reflect on it and keep track of what works for you.

All this being said, it is important that you work with a qualified health provider and a sex therapist to discuss cannabis as an option for the treatment of sexual issues or symptoms associated with sexual dysfunction. It is important that you don’t DIY your own therapy and sex therapy without thoughtful intention, especially when substances and sex are involved. If you would like to work with me on this, please feel free to reach out!