The research is thin, but anecdotal experience suggests that the right dose and delivery method can make a positive difference for some people.
A few weeks ago, the (New York Times) Ask Well column highlighted treatments for low libido in women. Afterward, several readers wanted to know if cannabis could be added to the list of potential remedies.
It’s a question that is especially relevant now that the U.S. House of Representatives has passed a bill decriminalizing marijuana at the federal level.
Marijuana, the most commonly used drug that is federally illegal, is currently allowed for medical use in 37 states, and in 18 states for adult recreational use. According to a 2020 survey, nearly 18 percent of Americans age 12 or older had used it within the past year, and more than two-thirds of Americans support legalizing it, according to various polls.
To learn more about cannabis and sex we turned to several experts, including a gynecologist who has surveyed women about their marijuana use.
The bottom line: It’s hard to say with certainty that cannabis will increase desire or improve your sex life, but anecdotal evidence suggests that the right dose of cannabis can make a woman’s orgasms more satisfying and increase sex drive. This is in part because cannabis can enhance the senses and also alleviate some of the symptoms that inhibit desire, like anxiety, sleeplessness or pain. It can have positive effects for men, as well, but also several negative ones, and women should be aware of its potential downsides, too.
What does the research say?
Both men and women have long reported that cannabis alters their sexual experience. In an essay published in 1971, the astronomer Carl Sagan, a longtime marijuana user, wrote that cannabis “enhances the enjoyment of sex” and “gives an exquisite sensitivity.”
There is very little research on cannabis and libido, however, in part because cannabis research has been notoriously difficult to fund and it remains a federally illegal drug in the United States. Most of the research that does exist relies on data from questionnaires, which are heavily skewed toward people who already use cannabis and are not representative of the general population, making it difficult to draw firm conclusions. In addition, the surveys do not provide reliable and precise information about dosage, delivery method or timing.
But based on the limited evidence, the drug does seem to enhance the sexual experience among many women who already use it.
“I’ve had several patients come to me and say, ‘I have low libido. Can you help me? And, oh, by the way, if I use marijuana, I can orgasm, no problem,’” said Dr. Becky K. Lynn, a sexual medicine and menopause expert and the founder of Evora Women’s Health in St. Louis. “They also tell me that low libido improves with marijuana.”
Dr. Lynn, who also teaches at the Saint Louis University School of Medicine, is the lead author of a study published in 2019 that surveyed 373 women about cannabis at an obstetrics and gynecology clinic in Missouri. Of those, 34 percent reported having used marijuana before sexual activity and most of them said it resulted in an increased sex drive, improved orgasm and decreased pain.
Studies have also found that some women use cannabis to help manage menopause symptoms like hot flashes, night sweats, insomnia and vaginal changes, such as dryness, all of which may contribute to lower libido when untreated.
In addition, an online survey of more than 200 women and men who use cannabis found that nearly 60 percent said cannabis increased their desire for sex; almost 74 percent reported increased sexual satisfaction. But the study, which was conducted by researchers in Canada and published in The Journal of Sexual Medicine, also said that 16 percent reported sex was better in some ways and worse in others, and a little under 5 percent said it was worse.
Research on cannabis use and sexual function among men is likewise sparse and can be contradictory. According to the International Society for Sexual Medicine, some men report that their sexual performance improves when they use marijuana, while others may experience problems such as less motivation for sex, erectile dysfunction, trouble reaching orgasm or premature ejaculation. Cannabis use has also been associated with reductions in sperm count, concentration, motility and viability.
‘Start low and go slow’
All drugs have risks and potential side effects, cannabis included.
If your doctor has cleared you to try cannabis in a state where it is legal, Dr. Peter Grinspoon, a primary-care doctor at Massachusetts General Hospital Chelsea HealthCare Center and a medical-cannabis consultant, advised taking a “teeny bit” in a tincture if you’re new to it — in some cases as little as 1 milligram of THC, the main psychoactive ingredient in weed — before slowly working your way up.
“At low doses, cannabis helps libido, but at high doses, it often isn’t as effective,” he said, adding that the wrong amount will lead some people to become paranoid and anxious. The drug could also inhibit orgasm, creating the opposite effect of what was intended.
Dr. Lynn agreed. “Start low and go slow,” she said.
How much is too much marijuana? That will vary from person to person.
And because cannabis is known to impair judgment, coordination and reaction time, those who use psychoactive drugs before or during sex “must take into consideration whether people using the product and their partners can have safe and consensual sex,” said Dr. Stacy Tessler Lindau, a gynecologist at the University of Chicago Medicine and the creator of WomanLab, a website about sexual health.
Given that cannabis can compromise judgment about contraception or the ability to consent, she added, women can either look to avoid products with psychoactive components or, if they wish to use them, increase safety by having sex with a trusted partner.
“Sex with a stranger ideally would not involve any intoxication of anyone involved,” she said.
Dr. Jordan Tishler, a former emergency medicine doctor and president of the Association of Cannabinoid Specialists, recommended trying cannabis alone for the first few times and masturbating, in order “to understand what it does to the body and sensations.”
What is the best cannabis delivery method?
Smoking marijuana or using oil vape pens should be avoided, because they can harm the lungs, the experts said.
Dr. Lynn typically recommends tinctures, which are concentrated cannabis extracts that are taken by mouth. It is easy to measure the number of milligrams you want to use, she said.
Dr. Tishler usually advises his clients to start with 5 mg of THC. Taking one puff on a cannabis flower vaporizer before having a sexual experience can work faster and more predictably than edibles or lubricants infused with THC, he said.
“I teach patients to take a puff in a particular manner,” Dr. Tishler added: “a very deep, slow inhalation that allows us to estimate how much dose they are getting.”
Remember that libido is complicated
There are multiple factors that can affect someone’s sex drive and sexual function, some of which could be addressed by seeing a physician or a mental health provider.
If a woman had pain with intercourse, for example, she would need to be referred to a gynecologist for a full evaluation, Dr. Grinspoon said. Cannabis could potentially help, but there would be more to investigate and consider in anyone who is experiencing uncomfortable physical symptoms.
“You can be treating the symptom while looking at the underlying cause,” he said. “It’s not mutually exclusive.”
A version of this story originally appeared here on nytimes.com