The short answer: More than I thought. 

Many of the women I see in my office tell me about their therapeutic use of marijuana. They take it to lessen their body pain, to get to sleep and to feel less anxious. We list it in their chart on their list of medications.  When doing this I never thought to ask them about what it did for their sex lives. Not once. Not having used pot since we used to sneak it into the dorms, I didn’t know it did anything specific for sex. Sitting here compiling what I have learned this year I feel like a girl late to the party. There is more promise here than I ever expected.

The biggest piece to me is that THC, in some doses, can be a vasodilator. In the world of sexual medicine that is big news. The category of vasodilator includes Viagra, and Levitra.  It also includes the ‘scream creams’, which are topical arousal aids.   Getting more blood in the genitals is what those of us in sexual medicine want to see happen for women.  We want woman to have enough blood flow that she feels turned on and excited (and we want her to be turned on and excited enough that it triggers good blood flow).  The vascular areas around the clitoris, that encircle the urethra, and are adjacent to the legs of the clitoris are designed to engorge with blood. Dilating blood vessels is a very good thing for women and sex.

This vasodilation effect could explain why research shows that female orgasms can be more intense or prolonged with marijuana use. The most recent study, published in Journal of Sexual Medicine last year, was a survey done at an OB/GYN practice.  It was voluntarily completed by 373 women.  127 of those women reported having used cannabis before having sex.  Women who reported using marijuana regularly before sex had a 2.1 times higher odds of reporting satisfactory orgasms than those who didn’t use it regularly. That is big news from this botanical. 

There are multiple other studies on cannabis with reports of prolonged orgasm or more intense orgasm.  There are also reports of heightened skin sensations, increases in sexual desire, and reports of a slowing of the perception of time so that pleasure feels prolonged. Reduced desire is reported too, mostly linked with higher doses and heavier use. 

Each of our bodies has cannabinoid receptor sites spread throughout it. This was ‘discovered’ in the 1990’s when the first receptors CB1 and CB2 were identified.  Historically it has been very difficult to get a license to legally research our innate cannabinoid system or our body’s reaction to the cannabis that we ingest. This has made data limited. All the survey results noted above are based on individuals self-reporting.  This is valuable info, and it is not the same as giving a woman a certain amount of THC and/or CBD and documenting her experience and measuring her actual hormone or neurotransmitter levels. 

Animal studies have been done with precise amounts of drugs, and changes in behavior and the physiology has been recorded. In these studies scientists have discovered what many humans have personally experienced for years — that the cannabis we smoke or ingest, interacts with our hormones and our neurotransmitters. 

One sex positive finding from the animal studies is that intermittent or light use of cannabis can cause the release of dopamine, the feel good neurotransmitter, aka the neurotransmitter of pleasure.  This finding, like the vasodilation finding, hits at the heart of drugs currently used in sexual medicine to optimize sexual experiences.  Wellbutrin, an antidepressant which increases dopamine, has been prescribed for years to augment sexual satisfaction.  This drug is used either alone or is prescribed to counterbalance the unfriendly sexual side effects that can come with raised serotonin levels from SSRI anti-depressants. And ADDYI, the first ever libido drug for women approved in 2015 works in part because it raises dopamine levels.  

The endocannabinoids (cannabinoids we naturally produce in our body) also interact with our hormones (testosterone, estrogen and progesterone), as well as our neurotransmitters. Receptor sites for this innate ECS (Endocannabinoid system) are widespread and include our central nervous system.

Of the 80 different compounds in the cannabis plant THC and CBD are the two well-known ones and they are the most researched overall.  In terms of sexual effects THC is more researched than CBD.  Other cannabinoids, CBDA, THCA, CBN, CBDV… are mysteries yet to be investigated. 

Cannabinodiol, the compound in cannabis called CBD, has promise for the anxious woman, or the woman with too many things on her plate. Women I see often have too much going on in their lives and no true down time.  They juggle roles and tasks from sunup until they hit the bed– where their pillow often looks better than their partner.  Small daily deadlines have been shown to be as detrimental to a woman’s arousal and orgasm capacities as major stresses such as a death or divorce. For many females it is go go go day after day. CBD products may be one of many answers to help her let go of her day and yield to receiving pleasure in the bedroom. 

Not getting turned on in bed for many women is a disappointing and frustrating experience. 

We need many diverse approaches to changing that fact. I could go on and on about why I think it is vital that we do that for her health and the health of the world. And we want to be intelligent about how we do change it. There are a lot of interesting positives here about cannabis and sex and they do not wipe out the potential negatives. 

Marijuana use has known sinkholes. Concerns about its use are real. The serious concerns come mostly with its overuse.  You probably know these already: Marijuana is dangerous to the forming brain of the teenager and young adult.  There can be brain changes and loss of IQ points that do not reverse.  It can be harmful to the pregnant and breastfeeding woman and baby. You want to keep cannabis away from these groups.  

 Heavy use can affect you sexually in ways you won’t like, for instance it can lower your dopamine levels, decrease your sexual desire, and mute your overall personal motivation. Being constantly stoned can decrease your emotional connection with everyone including your partner. It can slow down your physical movements and coordination, creating accidents.  Marijuana is substantially less dangerous than alcohol and it is still dangerous to be high and drive.  

My friend calls the last two paragraphs my CYA section, and in a sense she is right. I don’t want you to get in any trouble when you experiment.  I want you to talk to those who have experience using, and to remember that there is more THC in the strains out there than there was in the 80’s. Three wise friends of mine have separately ended up in our local ER after using. 

Their stories are funny now, my husband and I roared with them in the retelling. Yet when it was happening our friends were highly uncomfortable and frightened and one felt terribly embarrassed. 

So far our FDA has approved four drugs made from the cannabis plant. Three are synthetically made drugs for the nausea related to chemotherapy, and for neuropathic pain, and in 2018 they approved one RX from naturally extracted cannabis for seizures.  More approved drugs are on the way, and I expect later in the pipeline some will be specific for female sexuality.

Right now, available for use, there are prepackaged OTC products, like AROUSE. These specify the amount of THC and CBD. These are vaping products designed for sexual pleasure.  They are not FDA approved. Your neighborhood dispensary may have a wide variety of other similar products.  

I find it wryly amusing that this botanical we snuck around smoking actually matches up with a system we already had in our body.  And the purpose of this innate system is thought to promote homeostasis, i.e. internal balance.  How wrong can that be? It brings up the question of what else we don’t know about the internal workings of our bodies and what we don’t know yet about the cannabis plant.

I want you to be safe, and I also want you to have the best time possible.  

So be smart and have fun exploring your erotic options. There is a lot of treasure (and pleasure) to be found in doing so.  

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For those of you interested in more detail re research here are two links. 

This link is to a review article from the Journal of Sexual Medicine listing all the qualified research on marijuana use and female sexual health.  There are 12 human studies and 8 animal studies, with a summary of each study.  Link:

This link is to an FDA teleconference.  Our FDA is, and I quote, “actively exploring potential regulatory pathways for the lawful marketing of appropriate cannabis products.” On November 19, 2020 the FDA convened experts to discuss effects of marijuana use on women as differentiated from the effects on men.  The Conference title: “CBD and other Cannabinoids:  Sex and Gender differences in Use and Responses”.  This link gives you an overview of what the FDA botanical review team is up to. It includes national and international experts and the FDA’s Directors.  The keynote speaker is on from minute 11 to minute 27.  After that there are multiple experts speaking that include research on pain, anxiety, pregnancy, breast feeding and more. The entire conference is five hours long. I was impressed by their commitment to cannabis research. 

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