The Relationship between Marijuana Use Prior to Sex and Sexual Function in Women: Marijuana appears to improve satisfaction with orgasm

Lynn BK, López JD, Miller C, et al. The Relationship between Marijuana Use Prior to Sex and Sexual Function in Women. Sex Med 2019;7:192-197. https://doi.org/10.1016/j.esxm.2019.01.003

Abstract
INTRODUCTION: Scientific research on the effects of marijuana on sexual functioning in women, including libido, arousal, orgasm, and satisfaction, is limited.

AIM: To evaluate women's perceptions of the effect of marijuana use before sexual activity.

METHODS: A cross-sectional design, from March 2016-February 2017, within a single, academic, obstetrics and gynecology practice, was performed. Patients were given a questionnaire at their visit and asked to complete it anonymously and place it in a locked box after their visit.

MAIN OUTCOME MEASURES: The primary outcome was satisfaction in the sexual domains of drive, orgasm, lubrication, dyspareunia, and overall sexual experience. The secondary outcome was the effect of the frequency of marijuana use on satisfaction.

RESULTS: Of the 373 participants, 34.0% (n = 127) reported having used marijuana before sexual activity. Most women reported increases in sex drive, improvement in orgasm, decrease in pain, but no change in lubrication. After adjusting for race, women who reported marijuana use before sexual activity had 2.13 higher odds of reporting satisfactory orgasms (adjusted odds ratio = 2.13; 95% CI = 1.05, 4.35) than women who reported no marijuana use. After adjusting for race and age, women with frequent marijuana use, regardless of use before sex or not, had 2.10 times higher odds of reporting satisfactory orgasms than those with infrequent marijuana use (adjusted odds ratio = 2.10; 95% CI = 1.01-4.44).

CONCLUSION: Marijuana appears to improve satisfaction with orgasm. A better understanding of the role of the endocannabinoid system in women is important, because there is a paucity of literature, and it could help lead to development of treatments for female sexual dysfunction.

KEYWORDS: Epidemiology; Female Sexual Response; Health Behavior and Attitudes; Women’s Sexuality

Introduction

Over the last decade, marijuana use and the legalization of marijuana, medically and recreationally, has continued to increase in the United States.1 The internet is rife with claims of the beneficial effects of marijuana on several aspects of sexual function including libido, arousal, and orgasm. However, our scientific research on the effects of marijuana on sexual functioning is limited. Recently Palamar et al2 evaluated self-reported sexual effects of marijuana, ecstasy, and alcohol use in a small cohort of men and women aged 18–25. They found that the majority of marijuana users reported an increase in sexual enjoyment and orgasm intensity, as well as either an increase or no change in desire.2

Endocannabinoids, which are structurally similar to marijuana, are known to help regulate sexual function.3 The cannabinoid receptor, discovered in the 1990s, has been mapped to several areas of the brain that play a role in sexual function.3 Cannabinoids and endocannabinoids interact with the hormones and neurotransmitters that affect sexual behavior. Although these interactions have not been clearly illuminated, some studies in rodents have helped to clarify the relationship between cannabinoids and the hormones and neurotransmitters that affect sexual behavior.4 Although there is less data on human subjects, some studies have measured patient’s perceptions of the effects of marijuana on sexual function. Studies have reported an increase in desire and improvement in the quality of orgasm.5 Most recently, Klein et al6 evaluated the correlation between serum levels of 2 endogenous endocannabinoids and found a significant negative correlation between endocannabinoids and both physiological and subjective arousal in women. Sumnall et al7 reported that drugs such as cannabis and ecstasy were more frequently taken to improve the sexual experience than was alcohol.

The primary aim of this study was to determine how women perceive the sexual experience, specifically overall sexual satisfaction, sex drive, orgasm, dyspareunia, and lubrication, when using marijuana before sex. The magnitude of the change was also evaluated. The secondary aim sought to understand the effect of the frequency of marijuana use, regardless of marijuana use before sex, on satisfaction across the different sexual function domains.