“I can’t have sex with you,” I said. My date looked confused, and with good reason. We had done enough heavy petting that sex was definitely on the table. “It’s not you,” I added quickly. “You are unbelievably hot and I want to have sex with you. I’m trying to focus on my recovery.” She understood immediately. “I wondered about that,” she said, buttoning her blouse. She was also in recovery. “It’s okay,” she said. It felt good to say that I needed time, but it felt really hard to pass up on sex that I wanted to have. This was the first of my confusing adventures in sober sexuality.
Most people assume that sex after sobriety is probably boring at best, awkward and clunky at worst, but that it gets better with time. That’s what I assumed, too. But, in reality, it hasn’t been that straightforward. For me, sober sex has been a journey from celibacy to erotic epiphany to neurotic dry spell. And I am really, really, really hoping this isn’t how the story ends. “Death by dry spell” is not what I want on my tombstone.
Before I went into recovery for opioid addiction, I could have counted the number of times I had had sober sex on both hands. Also, before I got sober, I often used sex in unhealthy ways that had nothing to do with drugs. Sex was a way to escape both pain and routine. It was a way to feel okay about myself when self-acceptance seemed impossible. I don’t consider myself to be a sex addict, but I didn’t want to recreate any of those patterns in my new sober life, either.
And so I stayed celibate the first six months of my sobriety. This is a strategy that a lot of 12-step programs recommend to keep you from using sex and relationships as a way to escape from the discomfort of dealing with sober life. To be frank, those six months sucked. I developed a lot of fear that I had forgotten how to have sex or that sober sex would be boring and awkward.
But all of my assumptions about sober sex, and even my own awkwardness, turned out to be incorrect — at least at first. After my stint with celibacy, sex and dating felt like a magical revelation. Sober sex was amazing and nuanced. Because I had been doing a lot of deep personal work and had been practicing my ability to set healthy boundaries, I felt a lot more capable of communicating my desires and a lot more comfortable asking other folks to tell me theirs. Being sober — instead of making me awkward and boring — made me better able to tap into to all the feelings and sensations that make sex so much fun.
That lush revelatory feeling, unfortunately, was temporary. I’ve been sober 2.5 years and now it feels like sobriety is, actually, giving me sex anxiety. As of recently, all the self-awareness that felt amazing at first is starting to feel like crippling self-consciousness.
I guess I should have assumed that my sexuality would continue to evolve in tandem with my sobriety, but this is not the linear progress narrative that I expected. Now, it’s like I am working so hard to stay mindful that I’ve become borderline prudish, and I no longer have chemical courage to keep my ego bolstered.
In every sexual exchange, no matter how subtle, I am consumed with anxious thoughts. Do I look hot right now? How am I doing? Am I communicating enough? Too much? Should I move my hand? Why can’t I relax and enjoy this? WTF is wrong with me? This distressing ovethinking, no matter how shitty it feels, isn’t personal. Obsessive rumination, according to neuroscience, can be part of the process of recovery.
I am not the only one who’s experienced this flip-flop from sober sex epiphany to sober sex anxiety. “In my first few years sober, I could have sex with just about anyone,” Christopher Gerhart, an Alabama-based substance abuse counselor tells me. Yep, sounds familiar. Or rather, I don’t actually remember any of those people’s names and it’s not because I was drunk. There were just too many of them (hi mom, sorry about this). It was joyful and consensual play. “But the longer I remained sober, the more I had to pay attention to my inner voice,” Gerhart continues. Yes. That’s the voice constantly interrogating my make outs.
I ask Gerhart, only a little desperately, if his anxiety ever went away. “As I grow in sobriety that internal dialog becomes a more functional part of my mind. It allows me to feel empathy, compassion, grief, and connection both with others and myself,” Gerhart explains. His words give me comfort and his explanation is consistent with my experience. This anxious internal dialogue is then, perhaps, just part of the process of me learning to think clearly when I’m exchanging fluids with another human instead of running blind on adrenaline and booze.
Other people are real to me now in new ways and I expect intimacy to reflect this. Now when I connect with someone, I feel very very aware that I am a complex human and that they are another complex human. When you put my newfound sex anxiety in the context of becoming more complex and empathetic, maybe this new way that I’m thinking isn’t bad, but instead is evidence that I’m learning to connect more authentically.
“Sex involves vulnerability,” Asher Gottesman, mental health counselor and founder of Transcend Recovery Community, a sober living outpatient program operating in Los Angeles and Manhattan, who works with sex addicts. “But it’s never about the sex itself. It’s always about the internal messages that we have whenever we are in a vulnerable state.” He explains that inebriated people don’t hear those internal messages. So it’s not that my anxieties are necessarily new, it’s just that I am only now noticing them now that I am fully experiencing the world and other people as this new, and evolving, sober person.
All of this is a reassuring reminder that I am becoming the actually sensitive and caring person that I always wanted to be, which is great, but, um, I still want to get laid. So, what do I do about this very unsexy headspace I’ve found myself in?
“Be patient with yourself,” says Gottesman. That’s all? Just be patient? I’m thirsty for an action step (amongst other things). Gottesman suggests that I should probably talk these things out. “I wouldn’t necessarily speak out all your fears to a partner,” he continues. “Find someone else to talk to, whether it’s a trusted friend or a therapist. When you share your fears, you will often find you aren’t alone.” So it’s not that I necessarily need an extra therapy appointment, it’s just that sharing my experience with a comrade may help me feel better about it. “Friends also may be able to give you tips on how they have sex sober,” he adds. Fingers crossed that they also have intel on someone crush-worthy and a little patient.
I spoke with widows, newlyweds, monogamists, secret liaison seekers, submissives and polyamorists and found there was no such thing as desire too high or low
By Katherine Rowland
Male desire is a familiar story. We scarcely bat an eyelash at its power or insistence. But women’s desires – the way they can morph, grow or even disappear – elicit fascination, doubt and panic.
In 2014, as experts weighed the moral and medical implications of the first female libido drug, I found myself unsatisfied with the myths of excess and deficit on offer, and set out to understand how women themselves perceive and experience their passions.
Over the course of five years, I talked with 120 women and dozens of sexual health professionals. My reporting took me from coast to coast, and spanned conversations from a 22-year-old convinced she was sexually damaged to a 72-year-old learning how to orgasm. I spoke with widows, newlyweds, committed monogamists, secret liaison seekers, submissives and proud polyamorists.
I also dropped in on psychotherapy sessions, consulted sexologists, went inside the battle to get “female Viagra” FDA approved and profiled practitioners blurring the lines between sex work and physical therapy. In Los Angeles, I sat with a group of determinedly nonplussed sex coaches as they took in a live flogging demonstration, while in New York I stood among a thousand women whipped into a fist-pumping frenzy by a guru who declared the time had come for them to reconnect to their sensuality.
Against the background claims that women are disordered patients who require a pharmaceutical fix, or that they are empowered consumers who should scour the market for their personal brand of bliss, I found that there was no such thing as desire too high or low. Rather, desire contains as many tones as there are people to express it.
Low desire isn’t a symptom
In five years of conversations, I heard frequent variations on a common story. Somewhere in the mix of parenting, partnering and navigating the demands of professional life, women’s desire had dimmed to the barest flicker. In place of lust, they acted out of obligation, generosity or simply to keep the peace.
“What’s wrong with me?” many asked of their medical providers, only to come away with confounding answers. “Your flatlined libido is perfectly normal,” they were told. “But it’s also a medical concern.”
Just what constitutes normal stirs intense debate, in part because female sexuality shoulders an immense weight. It’s where observers have long looked for clues about human nature and for proof of immutable differences between men and women. The chief distinction, we’re told, is that women are less desirous than men.
And yet, low desire is often cast as an affliction that women are encouraged to work at and overcome. Accordingly, some women I talked to consulted therapists to understand why intimacy was tinged with dread. Others tried all manner of chemical interventions, from antidepressants and testosterone supplements to supposedly libido-rousing pills. A number of women accumulated veritable libraries of spice-it-up manuals. No matter the path, I heard time and again how women compelled themselves to just do it, committed to reaching a not necessarily satisfying but quantifiable end.
Low desire is a healthy response to lackluster sex
However, as women further described their malaise, their dwindling desire seemed less the result of faulty biology than evidence of sound judgment. It was a consequence of clumsy partners, perfunctory routines, incomplete education, boredom and the chafe of overfamiliarity.
In short, it was the quality of the sex they were having that left them underwhelmed. As one woman put it: “If it’s not about your pleasure, it makes sense you wouldn’t want it.”
Straight women are struggling the most in their erotic lives
While all women, regardless of sexual orientation, experience dips in drive, the utter depletion of sexual interest might be more common to heterosexual women, because their desires are less clearly defined to begin with.
“I spent most of my life with no sense of what I want,” one straight woman in her late 40s told me. Another, also in her 40s, reflected that she and her husband “did sex the way [she] thought it was supposed to look”. However, she said: “I don’t know how much I was really able to understand and articulate what I wanted.”
For both women, along with dozens of others that I spoke to, dwindling desire was an affront to identity. It exposed the limits of what they had expected of themselves, namely that they should settle down with one man and be emotionally and physically content from there on out. Their experiences mirror what researchers have uncovered about the so-called orgasm gap, which holds that men are disproportionately gratified by sex.
The picture subtly shifts when you look at which women are enjoying themselves. A 2017 survey of more than 50,000 Americans found that lesbians orgasmed 86% of the time during sex, as opposed to 65% of straight women (and 95% of straight men). Investigators speculate that lesbians and queer women enjoy greater satisfaction because of anatomical familiarity, longer sexual duration and not revering penetration as the apex of erotic mingling.
I would further surmise that queer women are often more satisfied because, unlike a lot of straight women, they have fundamentally considered the nature and object of their desires.
There’s nothing funny about faking it
The subject of faking it tends to seed jokey reactions, which frame the issue of female pretending as a slight to the man’s self-esteem. When she fakes it, he is the wounded party: her absent climax becomes his loss.
According to one well-trafficked 2010 report, 80% of heterosexual women fake orgasm during vaginal intercourse about half of the time, and another 25% fake orgasm almost all of the time. (When CBS News reported on this study, the headline opened with “Ouch”; there was no editorializing on shabby male technique – all the focus was on the bruising consequences of women’s inauthentic “moaning and groaning”.)
Faking it was ubiquitous among the women I spoke with. Most viewed it as fairly benign, and I largely did too. That is, until the subject cropped up again and again, and I found myself preoccupied with an odd contradiction: as women act out ecstasy, they devalue their actual sensations.
On the one hand, this performance is an ode to the importance of female pleasure, the expectation held by men and women alike that it should be present. But on the other, it strips women of the physical and psychological experience of pleasure. Spectacle bullies sensation aside.
Women aren’t looking for a magic pill
One might think from the headlines that equal access to pharmacopeia ranks high among women’s sexual health concerns. After all, men have a stocked cabinet of virility-boosting compounds, while women have paltry options. But this was not my takeaway.
While some women opined that it would be nice to ignite desire with a pill, few saw the benefit of boosting appetite if the circumstances surrounding sex remained unchanged. While desire was frequently tinted by a sense of mystery, its retreat was rarely presented in a black box. Almost across the board, women spoke of their sexuality in contextual terms: it changed with time, with different partners and different states of self-knowledge.
In 2018 an article in the Archives of Sexual Behavior surmised “Research has not conclusively demonstrated that biology is among the primary mechanisms involved in inhibiting sexual desire in women.” Rather, the authors said, body image, relationship satisfaction and learned values intervene to shape women’s experiences of lust. Even though FDA-approved drugs like Addyi and Vyleesi are marketed to suggest that desire dips independently of life circumstances, those involved in drug development are certainly aware of these other influences. The strength of their impact on women’s minds and bodies may even be contributing to the challenge of developing effective pharmaceuticals.
In the case of Viagra and its competitors, it’s assumed men want to have sex, but physically cannot, and so a feat of hydraulics allows them to consummate the act. But for women, the problem is more, well, problematic: they might be physically capable, but emotionally disinclined. Insofar as that is the case, we need to attend the reasons behind their reluctance.
Desire comes from liberating the erotic imagination
In the course of my reporting I attended a training session known as SAR, for Sexual Attitude Reassessment. The two-day workshops designed for sexual health professionals are intended to inundate participants with sexual material in order to highlight where they hold biases or discomfort, and they showcase a lot of explicit content.
The session I attended featured media depicting a gay head-shaving fetish, a medical-latex threesome and a wincing scene involving male genitalia, a typewriter and a miniature cactus. It also included frank confessionals from people whose bodies and lifestyles don’t necessarily accord with the culture’s rigidly gendered and ableist stereotypes – such as what it’s like for a trans woman to experience pleasure, or how a little person (the preferred term for adults with dwarfism) self-stimulates when his or her fingers cannot reach the genitals.
The idea, beyond highlighting all the “inscrutable, mystical loveliness” of sex, in the words of one facilitator, is to get participants to seek out what turns them on or disgusts them, or both.
In my recollection, the word “dysfunction” never surfaced in the programming. Rather, sexuality was framed in terms of accessing delight and accepting nonconformity. The subject of low desire was not viewed as a matter of sexual disinterest, but rather a result of how, owing to the greater culture, women hold themselves back, condemn their fantasies, foreclose on what they really want and sell themselves short on the idea that sex and love must look a certain way.
Women push themselves toward physical encounters that they either do not want, or for which they have not allowed desire to adequately develop. I came away with the impression that sexual healing had little to do with tricks or techniques, and almost everything to do with the mind, with sensing an internal flicker of I want that – and feeling empowered to act accordingly.
After a marijuana experience, lighting an old-fashioned cigarette after sex seems slightly outdated. As a matter of fact, when discussing cannabis, you’ll probably want to light it before you engage in sexual activity.
Excited yet? Despite some of us seeming pretty calm, we can still feel a nerve twitch when we hear promises of sexual exhilaration. Well, the tale about marijuana and sex that you’ve just stumbled upon will undoubtedly touch that nerve!
The relationship between pot and sexuality goes a long way and is not as charming as you might think. While some stories portray sensual symbiosis, others may argue that weed can crush your libido like a sledgehammer.
The truth is that marijuana can heat and cool both women and men. So then, is it an aphrodisiac, or a mood breaker?
Keep on reading and you’ll find out the pros and cons of marijuana use in the sweet game of sexuality.
A Short History of Cannabis and Sex
The Ancients Knew About Its Effects
According to research, the positive effects of marijuana on the sexual behavior of women was well known in ancient Mesopotamia; it was used during childbirth and for treating menstrual problems as well. Also, the first records of rectal cannabis preparations can be found in ancient Assyrian manuscripts.
Later, in ancient Egypt, cannabis was mixed with honey and introduced vaginally to relieve cramps. This is also where we find the first written records of the relationship between marijuana and sex drive. In addition, hemp seeds were originally used to influence fertility in men.
Throughout history, cannabis has been used both in gynecology and obstetrics, where the first sexological practices come from.
Both Ayurvedic and Arabian medicines recorded the use of marijuana as an aphrodisiac and for pain relief. It was applied vaginally, rectally, orally, and through fumigation. In China, cannabis was used for menstrual difficulties and postpartum problems. African men used it for erectile dysfunction (ED).
Western medicine also used marijuana for sex-related problems. In the 17th and 18th centuries, physicians mixed pulverized cannabis with other herbs to produce combined drugs. Furthermore, with the medical use of marijuana, sex-related issues were clarified and studied.
In Central Europe, in the 19th century, tinctures with cannabis were widely used for breast swelling, menstrual problems, and childbirth difficulties. Court physicians prepared concoctions for wealthy women which were used as a form of sexual relief during first-night intercourse.
Modern Times Try To Reveal the Mystery
The popularization of marijuana in the 20th century has given birth to its massive, worldwide use. Both medical and recreational testimonials state the potential health benefits and pleasures of having sex while high.
The physiological potency of the plant was scientifically documented and explained. Today, we know that certain chemicals in marijuana plants affect the whole organism in a profound way.
According to Psychology Today, the first modern medical evidence of the sexual impact of marijuana dates from the 1970s. Since then, numerous studies have tried to answer the question: is marijuana a stimulant or not?
However, most of the research coming from the previous century is inconclusive. The majority of studies that process the topic are self-reported observational studies and are limited due to the subjectiveness of the questioned participants.
In order to asses the topic of marijuana and sex, we have to consider both medical and experiential aspects of the herb.
Marijuana Effects on the Body
It is a well-known fact that the chemicals in marijuana plants have significant physiological actions. Cannabinoids bind to endocannabinoid receptors and interfere with their main function — homeostasis maintenance.
Both THC and CBD affect our whole organism, thus regulating numerous biochemical reactions. Sometimes it results in the pleasure of being “high,” or it can just have a therapeutic purpose. Overuse, on the other hand, is more likely to induce the negative effects of weed.
The connection between weed and sex can be explained by its pharmacological traits.
Blood Flow
By acting on cannabinoid receptors in blood vessels, cannabinoids induce peripheral vasodilatation. This means that more blood flows into different organs, such as the lungs, the glands, or the brain. The mucous membranes on sexual organs get more blood, which stimulates their metabolism and boosts their function.
The drop in blood pressure is followed by an increased heart rate. Meanwhile, your heart is pumping all the oxygen your lungs can get into your body. This stimulates the senses as well as tactile perception.
Basically, while having sex on weed, your body is more attuned to external influences than in regular cases.
The Brain
Cannabinoids act on various brain structures and interfere with hormones and neurotransmitters. Marijuana effects on the brain can both aid sexuality or destimulate it.
Weed increases dopamine and serotonin levels, which introduce the sense of pleasure, or even happiness. Additionally, this causes altered sensory perception, such as touch, smell, and taste.
Marijuana acts on inhibition functions, therefore relieving stress and anxiety. This also causes peripheral muscles to relax, while the dilated blood vessels pump oxygen into them.
Physiologically, indulging in sex while high can be quite relaxing and enjoyable, with lower inhibitions and attuned senses.
Cannabinoids also have anti-inflammatory properties, which are experienced as pain-relief. This is the reason why in some countries in Eastern Europe, people used to take marijuana to facilitate the first-night sexual experience of women.
Hormones
THC affects the brain and glands, which regulate certain functionalities, and significantly influence sexuality.
It has been reported that, in regular users, THC decreases total cortisol levels. This stress hormone is associated with a higher state of alertness and agility. In other words, with the use of cannabis, the sex drive can be inhibited too! Additionally, THC can sometimes elevate cortisol levels in infrequent users, hence inducing a state of anxiety.
THC briefly inhibits the thyroid hormone secretion. In heavy users, this reveals a dose-dependent mechanism. Meaning, the more you smoke weed, the more you are likely to gain weight, experience fatigue, or libido decrease.
Chemicals in marijuana act on sexual hormones differently. Light marijuana use (once a week) is not associated with any consequences. However, as reports state, smoking pot heavily (six times a week) can lower testosterone levels and sperm count in men. In women, it causes vaginal dryness and irregularity in menstrual cycles.
The hormonal connection between marijuana and sex is still not crystal clear. Overall, the available data states that cannabinoids cause hormone levels to fluctuate, which can affect reproduction and sexuality in different ways.
The Effects of Marijuana on Sexuality
In contrast to physiology, sexuality is a more complex part of an individual. It fuses both biological and psychological factors and is expressed through emotions, thoughts, and behaviors towards others. One can be sexually attracted to a person’s looks, emotions, attitudes, or actions.
Although a subjective category, there is data that shows that having sex while high on weed can be an entrancing experience.
Desire
People used to “spice things up” with clothing, alcohol, and adventures. However, with the growing marijuana market, there is a high chance that this “spice” might, in fact, be cannabis.
Sexual appetite, or libido, is both a hormonal and a psychological issue. It is determined by our sexual urge for another person.
According to a 2017 population-based study, public marijuana use is associated with increased sexual frequency in both men and women. After the assessment of more than 50,000 people, the authors concluded that among the consumers of marijuana, sex drive increased significantly.
Another study confirms that marijuana can increase libido. Researchers state that compared to non-users, weed consumers are twice as likely to have more than two sexual partners a year. Nevertheless, men were also more likely to have difficulties in reaching an orgasm.
Arousal
Sexual excitement is primarily a hormonal factor but can be influenced by psychoneural activity. There is evidence that cannabis can both induce and decrease sexual potency. Additionally, the two sexes express precisely the opposite arousal effects on weed.
Women
As said, marijuana use can increase female libido. When turned on while high, women tend to experience common vaginal dryness. This unfortunate event can present a problem in the initial contact but can be overcome with the right amount of tender foreplay. With the right amount of lubrication, this intense arousal can endure during the entire intercourse.
Men
In men, weed can increase the sex drive. On the other hand, studies show that a significant number of them have trouble maintaining arousal during sex.
In contrast to women, arousal in men is enhanced by the above-mentioned effects of marijuana. In most cases, during intercourse, the overall penile blood flow decreases. These effects remain until the high wears off.
The connection between marijuana and ED has long been an issue. However, the exact mechanism for this is unknown. It is usually associated with declining testosterone levels. Some authors conclude that this is a dose-dependent effect.
The bottom line is that, while stoned, sex can present a challenge for men.
Sensuality
The mystical traits of weed are considered to be the most valuable by most people. This is an effect primarily achieved by the ability of THC to alter the senses.
Studies show that enhanced visual, auditory, and tactile experiences enhance the ongoing sexual act, i.e., orgasm, masturbation, or desire. In surveys, people who enjoy pot and sex describe the high as “transcendent” or “spiritual.”
Intimacy
Although an aphrodisiac for women and a sexual appetite booster for men, marijuana can adversely affect the intimacy in couples.
Intimacy is a deep sense of connection with somebody both on an intellectual and physical level. According to research, the increase of libido and sensuality is associated with the focus on the more hedonistic effects of sexual contact, neglecting the aspects of personal attachment in the process.
Additionally, some cases reported increased intimacy levels in mature couples, which is associated with a sense of relaxation.
Highgasm
Women
A study from 2019, which followed 373 female participants, revealed that those who smoked marijuana prior to intercourse were two times more likely to achieve an orgasm than in a non-consuming group.
This evidence validly shows that among the participating women, 68.5% had more pleasurable sex while marijuana-high. Among them, 60.6% noticed an increase in sexual desire, and 52.8% reported an increase in satisfying orgasms.
Men
Evidence reports that orgasm in men, though, is experienced quite differently.
Men, who practiced sex and marijuana smoking were four times less likely to achieve a climax than the non-smoking group. Furthermore, pot-smokers were three times more likely to orgasm too quickly, and two times more likely to finish too slowly than the abstinents.
In general, both men and women are more sexually inhibited by marijuana in the long run. Chronic use potentiates the adverse hormonal effects and impacts physiology. But occasionally treating yourself with the sweet cannabis-infused sexual stimuli can rarely go wrong.
How to Dose the Best Pot for Sex
Choosing the best pot out there is certainly important. However, there are side effects of weed that need to be considered.
Both the positive and negative effects of weed are dose-dependant. Sometimes, one puff makes the difference between being stoned and being sexually blissed.
High doses of THC can cause a series of sexually-unwanted events, such as nausea, headache, anxiety, paranoia, or sexual depersonalization.
Some sources advocating the pros of marijuana use and sex advise us to keep lower doses in mind. In order to sexually transcend with pot, we need just the amount that can get our blood, brain, and senses going.
Marijuana and Sex Frequency
The relationship between these two changes with time; you might say that they mature together.
In light users, the achieved effect is mainly an occasional increase in sensuality. However, in heavy users, the long-term effects of weed are more likely to be displayed.
According to a few sources, chronic marijuana use is consistent with behavioral problems in relationships, which include aggressive behavior and mood changes. This leads to sexual and emotional detachment and creates the need for high marijuana doses.
In frequent users, the sexual side effects of weed include low energy and libido. This is associated with the pot’s effect on testosterone and pituitary hormones.
Other adverse effects include low desire, erectile dysfunction, and orgasm irregularities in men. Women tend to have progesterone variations, which is expressed as menstrual problems and could lead to depression.
In predisposed people, heavy marijuana use can onset panic, fears, memory decline, and even psychotic episodes.
Choosing the Right Strain for Sex
Everybody reacts to cannabinoids differently. Nevertheless, there are certain aspects of physiological actions that can be attributed to the potency of the marijuana strain.
When choosing the best marijuana for sex, some basic facts need consideration.
Three distinctive variations of cannabis plants used — Cannabis Sativa, Cannabis Indica, and Cannabis Ruderalis. The first two are more common and more popular.
Sativa produces a “head high,” making you more alert, inspired, and cerebrally driven. Indica has more body-relaxation effects and is used more to soothe pain and ease stress. Nevertheless, hybrids can display more potent, combined effects.
Some strains cater to sex more than others. In general, Sativa-derived ones could be considered as the best strains for male arousal, while women react better to Indica. Still, as sources claim, the reactions are mostly individual.
The perfect combination for sex would imply infrequent use to avoid the chronic impact on testosterone for men, and less estrogen-inhibiting THC products for women.
Sativa Strains for Sex
Asian Fantasy — Famous for its fruity flavor, this strain has energetic, and relaxin properties. Asian Fantasy is considered an arousing weed.
Ultimate Trainwreck — With its cerebral action, it enhances focus, energy, and a sense of happiness. Ultimate Trainwreck has a mild citrusy flavor, and i is one of the best marijuana strains for sex, as it increases arousal in men.
Green Crack — This Sativa strain can unleash your basic instinct. Green Crack is great for libido, potency, and could intensify an orgasm; the best part: you can repeat it again and again.
Potent Hybrids
Sour Dream — Although somewhat hard to find, this hybrid first calms and then arouses. Sour Dream can also potentiate euphoria, and even laughter, so it is the right choice for spicing-up the intimacy.
Purple Princess — It enhances creativity, energy, and euphoria. This strain can give you an exhilarating night in the sack and is considered as one of the best strains for female arousal and orgasm.
Indica Strains for Sex
Hindu Skunk — It relaxes slowly, and prolongs the intercourse, keeping your undivided attention on the partner. Hindu Skunk is a great choice for lazy-day intimacy.
Yumbolt — Mainly preferred by women, it is a calming and easing strain, that can help you orgasm, and sleep afterward.
Chocolate Chunk — It is an easing, soft acting strain, with a sweet and nutty flavor.
Grandaddy Purple — It is a strong Indica strain. It alleviates pain, eases stress, relieves anxiety, and energizes. Grandaddy Purple can be great for sexual desire but without the unnecessary euphoria.
Best Weed Strain for Sex: Sexxpot
According to yours truly, the best of the best would be Sexxpot. This hybrid came to light after years of practice and cultivation. It is a low-THC, high-CBD strain that relaxes the body while introducing desire and sensuality.
It takes the edge off and introduces you to the state of sweet delight. Sexxpot promises full relaxation, long sex-duration, and smooth sleep.
Selecting the Right Product
Deciding on the best weed for sex is essential. However, not all lovers out there enjoy smoking weed. Fortunately, today’s market has a variety of accessories and products for various user needs.
In a weed dispensary, you can find a spread of:
vapes and inhalants that contain cannabis-derived active principles;
oils and tinctures, which contain a concentrated amount of THC, and should be dosed lightly;
edibles that are becoming more popular by the minute — mints, brownies, chocolates, cakes, and other culinary delicacies.
Come Valentine’s, a THC-based sugary dish, or a wrapped-up stoner gift could turn the odds in your favor. While at that, it’s rumored that men prefer chocolate, while blueberry cakes could be considered the best edibles for female arousal.
Other Cannabis-Infused Sex Aids
Marijuana can be sexually helpful in more than one way. In other words, you don’t have to smoke it or eat it. The market is abundant with:
topical use products, which intensify the scenes peripherally;
marijuana suppositories, which have been out there for years now, and are used primarily for pain relief;
weed lube, which is cannabis-based and is used to treat vaginal dryness;
marijuana tampons with relaxing and protective properties.
The combination of sex products and cannabis shows promises of desire, arousal, sensuality, intimacy, and potential orgasms.
FAQs
Do you last longer when high?
While it can change the perception of time, marijuana does extend sexual intercourse in both women and men. There is evidence that supports its effects on libido, sensuality, and orgasm.
Cannabis has been scientifically proven to increase female sexual experience. On the other hand, there is evidence that smoking weed could result in erectile dysfunction in men.
Can being high make you not get hard?
Men who often smoke marijuana can sometimes experience erectile dysfunction. In chronic users, marijuana can decrease testosterone levels and affect arousal.
Hence, smoking weed in moderation is highly advised for men (so as to achieve the most optimal performance).
What’s more, some sources even claim that choosing the right strain could help overpass these issues entirely.
What are the best weed strains for sex?
Various marijuana strains have been praised as powerful sexual aids. The science states that Sativa strains work better in men. Indica strains have less THC and are better suited for women.
Some of the more popular sexual weeds are Sexxpot, Asian Fantasy, Sour Dream, Granddaddy Purple, Hindu Skunk, Green Crack, and more.
Can using cannabis for sex cause infertility?
There is no conclusive evidence that confirms that smoking marijuana can leave you infertile.
However, compulsive pot smoking is associated with low sperm count in men and menstrual irregularities in women.
Conclusion
It is true — marijuana enhances sexuality. However, frequent use can lead to unwanted side effects and can even cause sexual dysfunction.
Anyone can smoke and strip. Nevertheless, if you are about to indulge in a unique sexual adventure, do so wisely. With the proper strain pick and an adequate product selection, you can find yourself in a highly tantric experience.
Weed can be used as an aphrodisiac, arouser, intimacy enhancer, or as an orgasm intensifier. The intriguing connection between marijuana and sex has long been out there, and for good reason — it works.
Cannabis is used for an incredible array of health issues: it can alleviate anxiety, help with sleep, increase appetite, and treat chronic pain. It’s also a safer alternative to alcohol. And in the modern legal marketplace, many women are incorporating cannabis into their wellness routines as an alternative to prescription drugs and over-the-counter remedies aimed at reproductive and sexual health.
A recent survey of 1,011 women across the United States found that two-thirds of respondents said they use cannabis products, while more than one-third of them claimed to have used it to treat gynecological issues. There’s also evidence, as reported by Project CBD, that cannabis can have a positive effect on sexual health by reducing anxiety and pain, which are common barriers to a positive sexual experience for many women.
The conversation about women’s health and self-care products has come a long way from Summer’s Eve and scented tampons. Today, cannabis products for women range from THC tinctures and bath soaks to cannabis suppositories and CBD oils.
The conversation about women’s health has evolved
Women have found relief with cannabis for centuries, especially when it comes to menstrual pain. In “Women and Cannabis: Medicine, Science, and Sociology,” authors Ethan Russo, Melanie Creagan Dreher, and Mary Lynn Mathre note that cannabis suppositories were used in Egyptian pharmacopeia, documented as long ago as 3,000 BCE.
Recently, Weedmaps reported that some cannabis brands are prioritizing the health of their workers with a focus on women’s wellness. LH Manufacturing, the parent company of Whoopi & Maya, enacted a “moon day” policy for workers, allowing them to take a day off during their menstrual cycle. The company also provides free sanitary products for employees.
Peak Extracts, a woman-owned and run cannabis company in Oregon, provides samples of their products to employees coping with menstrual cramps. And Quim co-founders Cyo Ray Nystrom and Rachel Washtien have committed to keeping women’s health a priority in their business. “Our mental, physical and general health is the most important thing,” Washtien said.
On the Weed+Grub podcast (disclosure: I host this podcast), Nystrom said the core mission of Quim is to create products that help foster sustainable practices of self-care. And by that, “We mean including your vagina in your self-care routine.”
The conversation surrounding women’s health has evolved as more workplaces are placing a greater emphasis on women’s health and wellness — including cannabis companies.
While studies have found that cannabis can provide painrelief, and improve libido, there haven’t been any high-quality studies to determine whether cannabinoids can be effective in helping endometriosis, fibromyalgia, and other female-specific infections. Still, many women try cannabis products to help with their female-specific ailments and report finding relief. Nystrom developed Quim after years of suffering from a cycle of urinary tract infections and yeast infections. After researching other vaginal health products, she decided to make her own with cannabis as a main component. A CBD topical can be helpful as an anti-inflammatory post-sex, or if you experience pain from penetration or menstrual cramps, Nystrom said.
Kiana Reeves, chief brand educator for Foria, said on Weed+Grub that the conversation surrounding pain relief specifically for women has shifted and that some OB/GYNs are now recommending cannabis products to alleviate symptoms associated with menopause, pelvic pain, painful intercourse, vaginal dryness and more.
Cannabis products for women’s health and sexual wellness
There are a variety of cannabis-infused products designed for women who want to incorporate THC and/or CBD into their wellness routine. Applied in topical form, THC is non-intoxicating — the cannabinoid penetrates skin and muscles for localized relief. Topicals can be a good choice for someone seeking the therapeutic benefits of cannabis without the “high” associated with smoking, vaping or eating THC.
On the other hand, tinctures containing THC are absorbed into the bloodstream and have an intoxicating effect. If you’re seeking pain relief, a THC-rich tincture may be the answer — just make sure you start with a small amount and go slowly to find the correct dosage for your system.
And for those in states without access to legal cannabis, there is an ever-evolving selection of CBD products on the market — even at your local drugstore. Walgreens recently announced that it will sell hemp-derived CBD topicals and sprays. Additionally, many CBD companies will ship directly to the consumer, so you can shop from home.
Cannabis products for menstrual pain
Founded by Whoopi Goldberg and award-winning topicals and edibles maker Maya Elisabeth, Whoopi & Maya‘s bath Soak and Rub body balm are designed specifically to relieve menstrual discomfort with THC and CBD. The medical cannabis soak combines Epsom salts with cannabis and deliciously scented therapeutic essential oils, promoting a state of deep relaxation and relief as you bathe. Rub is a beeswax-based topical containing 50 milligrams of THC per jar which can alleviate cramping and provide relief from sore joints and back pain.
Cannabis products, formulated with THC and/or CBD, are made specifically to help with pain associated with menstrual cramps.
Whoopi & Maya is only available in California and Colorado. In Colorado, you can try Relax, a 100 milligram THC tincture containing herbs like motherwort and cramp bark, which are thought to benefit the female reproductive system.
Foria Relief is a unique offering: it’s a cocoa-butter suppository that delivers 60 milligrams THC and 10 milligrams CBD of full-spectrum cannabis directly to the vagina to soothe menstrual and pelvic pain. If you’re not in California or Colorado, a CBD version of Relief is available.
Cannabis products for sexual pleasure
Vaginal serums and lubricants make up a significant portion of topicals aimed at women. One newly launched CBD topical, Vella, is designed to enhance sexual pleasure. Vella has a “proprietary liposomal nanoencapsulation formulation,” according to the company’s website, and promotes muscle relaxation and increased blood flow. It’s compatible with condoms, so it’s a good option for partners practicing safer sex.
Quim also offers a line of self-care plant-based health products for women. This woman-owned and operated company has several topicals for “humans with vaginas, and humans without vaginas who love vaginas” in both THC and CBD formulations. Happy Clam Oil, with 30 milligrams of hemp-derived CBD per bottle, which, according to Quim’s website, is intended for daily use and to be thought of as “an eye cream for your vagina.” Night Moves intimate oil and Oh Yes! Latex-safe serum both contain THC and are only available in California dispensaries. Quim’s Smooth Operator is an intimate serum-containing hemp CBD and is available to ship nationwide.
Dazy CBD Lube is another intimate oil that’s safe to use with silicone toys and latex condoms. XES is a hemp-CBD vaginal serum that features a uniquely designed ergonomic applicator. Kush Queen Ignite CBD lube, Infinite CBD Big Bang, High On Love Stimulating Oil — there are plenty of options to try if you’re interested in incorporating CBD into your sex life.
Even if you’re not partaking in Dry January, you probably know someone who is. Giving up alcohol for an entire month following the festive excess of December has become an increasingly common New Year health kick. In fact, one in five Americans said they were attempting the boozeless challenge in 2019 (but it’s untold who actually made it the full 31 days).
It’s not tricky to figure out exactly why Dry January has become so popular. Those abstaining from alcohol are more likely to save money, sleep better and enjoy an array of health and wellness benefits like improved skin and reduced blood pressure. If you’re a regular drinker, you’ll also give your liver a well-deserved break.
All that said, while Dry January may be admirable, it’s also highly challenging — especially if you’re aiming to stay active on the dating scene. “Dating during January can be overwhelming for people undertaking the Dry January challenge,” House of Ardent’s sex and relationships expert Lianne Young. “I mean, what do you drink when you’re out on a date if it’s not something to help relax your nerves?”
However, Young points out that while alcoholic drinks “might help with nerves,” they should never be allowed to become “a crutch or personality replacement.”
“It’s good to get to know someone sober because that way you get to know the real them, and that’s really what is important,” she adds.
With this in mind, here’s a guide to dating during Dry January that’ll hopefully remove any pre-meetup anxiety knowing alcohol won’t be in play.
1. It’s Completely Fine to Feel a Little Nervous
“Being nervous before a date is normal,” says Dru Jaeger, co-author of “How to Be a Mindful Drinker: Cut Down, Stop For a Bit, or Quit,” a guide to help moderate your drinking habits. “It’s tempting to try to cover up those nerves with a drink, but it’s a quick and dirty fix. It’s better to acknowledge your nerves and then focus on the other person.”
Jaeger says this approach has two clear benefits: It’ll distract you from feeling nervous, and “it will probably make your date feel really good that you’re paying them so much attention.”
2. Be Upfront About the Fact You’re Doing Dry January
If you’re used to going on dates that revolve around alcohol, you might feel self-conscious about telling your date that you won’t be drinking. After all, there’s a lingering stigma around being teetotal that might make you worry you’ll come off as boring without a beer in your hand. Whatever you do, don’t let this play on your mind.
“It might feel like a big deal for you, but [your not drinking] is just another fact about you for them,” notes Jaeger. “If they react badly, don’t stress about it. You wouldn’t want to date someone who doesn’t support your choices anyway.”
3. Expand Your Idea of What a Date Should Be
A somewhat obvious alternative to meeting for drinks? Convening for coffee instead. “Coffee dates are great if you’re looking to build a long-term relationship because they’re slower and more absorbing,” says Young.
However, Young concedes that coffee dates have a tendency to become a bit bland over time, suggesting to use your creative side when thinking about ways to get to know one another.
“Remember that dates don’t have to be hours long, and they don’t have to be in the evening,” states Jaeger, who recommends “a trip to a gallery or a walk in the park” as relaxing options, and rollerskating or rock climbing as more energetic ones. “But really, the options are as endless as your imagination.”
Once you get beyond the idea that dating has to involve drinking, you might find it becomes a more stimulating and rewarding process. Even if there’s no romantic spark between you and your date, you’ll still have shared an enriching life experience.
4. If You End Up at a Bar Anyway, Mocktails Can Be Your Friend
Classic cocktails without the booze have come a long way since your parents would treat you to a Shirley Temple on family holidays. Ask your bartender to rustle up something surprising and booze-free, and they’ll almost certainly oblige.
5. Remember the Positive Effects That Come With Sober Dating
“The main benefit of sober dating is that you’re going to remember your date,” says Jaeger. “Whether it goes brilliantly, terribly or most likely somewhere in between, you can be confident that you stayed in control, presented your best self and were really able to pay attention to the person you dated.”
You’re also more likely to know for sure whether you want to see that person again, which is crucial to dating efficiently and successfully.
And you’ve heard of a little thing called whiskey d*ck, right? Even the great William Shakespeare rather cutely referred to alcohol’s negative effect on our sexual endeavors as “brewer’s droop.” It’s worth remembering that another highlight of dating without alcohol during Dry January could be more adventurous and engaging sex (that you actually remember, too).
Sexual wellness is a subject sweeping the globe that is expected to trend upwards in the years to come.
An April 2019 Arizton Advisory and Intelligence report on the global sexual wellness market projects it will rise to around $39 billion in value by 2024, with a CAGR of over 7%.
Little to no data on the cannabis sexual wellness market has been published at this time. Yet two once-taboo subjects have become more mainstream in recent years, with varying public acceptance.
Now, with consumers and a few lab studies suggesting efficacy exists, the market may be poised for significant growth.
Anecdotal evidence has long suggested there is a benefit to combining cannabis and sex.
Cannabis In The Bedroom
CBD use results in more intense orgasms as well as enhances a couple’s satisfaction in the bedroom, according to a survey conducted by Remedy Review.
Daniel Saynt, the founder and “chief conspirator” of NSFW, a cannabis and kink community in New York City, discussed why cannabis may help sex.
“Cannabis is a social lubricant. Smoking the right strain is more effective than alcohol in making you feel comfortable in a sexual situation.”
Zachary Zane is a freelance writer who covers subjects including sex and cannabis.
Cannabis helps Zane to not “overthink” in the act, he said.
“Cannabis allows me to be more present in the moment and to really enjoy the experience.”
The Research On Cannabis And Sex
In 2009 a research report concluded that endocannabinoid receptors are found throughout the human body, including sexual organs.
Dr. Sadie Allison, a sexologist, author and sexual wellness entrepreneur, recently expanded into the CBD space with the launch of GoLove CBD Sensual Lubricant.
The sexologist entered the market after research on the subject produced “very promising results,” she said.
Rachel Braun Scherl leads the female sexual health unit at biotech startup Manna Molecular Science in Massachusetts.
Scherl spoke directly to how she said CBD can benefit a woman’s sexual health.
“CBD is a clitoral and vaginal smooth muscle relaxant that, thus, facilitates clitoral engorgement and vaginal lubrication and ultimately orgasm.”
Alison Krongard, a co-founder of the recently launched Her Highness cannabis line, touched on the different applications cannabis has for men and women. Krongard, whos company produces CBD and THC sexual wellness products, said the rise in the number of products targeting females is a reflection of how much women love the plant.
And it’s healthier than many alternatives, she said.
“A lot of women finish the day with a glass of wine and a Xanax.”
Cannabis Sexual Wellness For Men, Gender Neutral Consumers
For men, NSFW’s Saynt said cannabis can desensitize the genitals due to its anti-inflammatory properties.
A potential area of benefit in Saynt’s view is cannabis suppositories, for those who enjoy anal stimulation.
“There is some demand, but there’s a lack of education and very little is being done to target the gay and bi community with these products,” he said.
GoLove’s Allison said she has seen an uptick in men purchasing sexual wellness and pleasure products over the past two decades, noting the expanding array of choices as a factor.
“Men are historically the largest buying segment of cannabis and cannabis-related products, [and] I have no doubt that the demand for male-focused cannabis sex products will grow in the same way as the adult products industry.”
Manna’s Scherl highlighted the importance of gender fluidity and gender neutral products.
“Today, we know so much more about the fluidity of gender, but as a society, we still have so much more to learn,” said Scherl. “It is no longer sufficient to have solutions focused on people who identify only as male or only female.”
On the other hand, Zane said many products like cannabis lubes can already be enjoyed by all genders.
“[Men and gender neutral people] don’t necessarily need specific products if it can work for all genders,” the writer said. “That said, if there are sexual issues and topics that specifically pertain to men and GNC folks that cannabis can help, let’s do it!”
Cannabis Sex Product Development
To ensure product quality and safety, companies often engage in years-long research.
Krongard said Her Highness worked for roughly three years on its product development.
“We went through a couple of different formulators before we found the team that really understood what we were doing.”
Saynt and NSFW are developing a strain of cannabis flower aimed at enhancing sexual wellness.
In collaboration with Cherry Kola Farms, the duo combined three separate strains known for their stimulating properties.
Club members have responded well to test runs, Saynt said.
“We’re hoping to create our own line of lubricant with this custom strain, as we feel the type of cannabis you use in your lube is important,” he said.
The Challenges Ahead
While cannabis and sex are more widely accepted now, Krongard said it’s far from universal.
“I had one meeting with the guy who owns a dispensary who just could not wrap his head around talking to women about a pleasure oil.”
Others echoed a need for additional education and acceptance. They also believe a change could come through the marketplace. The interest and investment in the sectors will create a “sea change,” said Manna’s Scherl.
“We are already seeing consumers, buyers and patients voting for the products and solutions they want, and will pay for in dozens of categories related to both sex and cannabis.”
As legalization brings cannabis out into the open, sex is becoming a major area of interest for brands as well as smokers. It may even make some consider turning to cannabis instead of the most well-known sex-enhancing drug, alcohol. How exactly, then, do the two substances compare?
According to a new survey by the vibrator startup Lioness, the answer is unequivocal: Cannabis wins. Of 432 people surveyed, 66% said cannabis makes orgasms more intense, compared with only 2% who said the same of alcohol. Similarly, 55% said cannabis led to more satisfying foreplay, compared with 3% saying the same of alcohol, and cannabis gave 57% of people longer sessions (though it decreased the time it took to reach an orgasm), while alcohol did the same for just 6%.
While this study was sponsored by a cannabis company and is not the most objective, there’s other research supporting this point. A 2007 study in the Journal of Pharmacology compared people’s reports of sex with alcohol and sex with illicit drugs, including cannabis and ecstasy. While cannabis wasn’t studied individually, the researchers found that people reported greater willingness to experiment and more satisfying experience overall with illicit drugs compared to alcohol.
Dr. Becky Lynn, Director of the Center for Sexual Health and Associate Professor of Obstetrics and Gynecology at Saint Louis University, who studies how cannabis affects women’s sex lives, says her own patients are more likely to report enhanced libido and orgasm with cannabis than alcohol. Some women with severe pain during sex find alcohol more useful, she says, but this comes at the cost of being less present during the encounter.
Sex coach and CannaSexual creator Ashley Manta says her clients also much prefer cannabis as a sexual aid. “The phrases I hear most often from clients with regard to alcohol and sex are ‘disconnected,’ ‘sloppy,’ and ‘numb,’ ” she said. “With cannabis, I hear ’embodied,’ ‘heightened sensation,’ and ‘euphoric.’”
Dr. Nikola Djordjevic, family physician and medical adviser for loudcloudhealth.co, agreed with Manta.
“Alcohol tends to numb us,” Djordjevic said, while “sex on marijuana makes us more aware and enhances our sensations.” Issues such as erectile dysfunction, vaginal dryness, and falling asleep during sex are also more likely to happen with alcohol, he said. However, cannabis is more likely to cause anxiety and paranoia, which can certainly hinder one’s sexual enjoyment.
One advantage to cannabis is that there are more ways to use it, Manta points out. There are even cannabis sex products that won’t intoxicate you at all, such as topicals and cannabidiol (CBD) products. Lynn cautions, however, that there isn’t solid evidence to support the effectiveness of cannabis lube.
Stoned Sex is the Best Sex
Many people agree based on personal experience that stoned sex is superior.
“On booze, sex is sloppy, graceless, incoherent, and too often incomplete,” said Russel Barth, a 50-year-old author and cannabis advocate in Ottawa. “On cannabis, sex is like a ballet with full-orchestra crescendo. On booze, you are not completely present in the moment. With cannabis, you are deeply in tune with the moment and with the person you are interacting with. The climax can be transcendental.”
“Getting high [on cannabis] makes me ridiculously horny because every sensation is amplified,” said Suzannah, a 23-year-old student in South Africa. “I enjoy having sex while I’m tipsy, but the drunker I get, the more numb everything is, and I also just generally don’t enjoy not remembering a lot of it.”
Some sexual advantages of cannabis for sex are indirect. It makes Michele Parrotta, a 55-year-old entrepreneur in Ontario, Canada, “way less nervous” during sex. Ryan, a 33-year-old who works in sales in Washington, D.C., says cannabis actually makes him shier, but that has the benefit of making him more gentle and giving, while alcohol can make him overly bold, selfish, and rough.
Not everyone feels that way, though. Shad, a 26-year-old marketing professional in San Diego and Los Angeles, actually prefers tipsy sex (though not full-on drunk sex) to stoned sex. With weed, “neither person has as much energy and is more likely to chill out vs. get creative and have a great orgasm,” he said.
Joe, a 31-year-old writer in Southern California, sees pros and cons to both. While drunk sex is “more adventurous,” stoned sex is “deliciously slow and contemplative,” he said.
Emma Biddulph, a 25-year-old graduate student in Portland, Oregon, says sober sex is the best of all, but stoned sex can occasionally be fun because it makes partners “giggly” and more comfortable expressing what they want.
Risky Business
Another perhaps surprising difference is, research shows that cannabis actually decreases sexual risk-taking, while alcohol increases it, said Matthew Johnson, associate professor of psychiatry at Johns Hopkins University School of Medicine in Baltimore. A study in the Archives of Sexual Behavior found that alcohol is more likely to make someone sleep with a stranger, but cannabis is more likely to make them sleep with someone they already know.
“A very likely reason is that alcohol has major effects on GABA, the major inhibitory neurotransmitter in the brain, and drugs that work on this system tend to have strong disinhibiting effects,” Johnson said. “People don’t put their mental brakes on, so to speak. But cannabis affects the endocannabinoid system, which plays much more of a modulatory role.”
There also might be an upside to cannabis’s potential to induce paranoia, he said: People may be more likely to worry about things like pregnancy and sexually transmitted infections (STIs).
Whichever substance you are using, doing it in excess can hinder your sex life more than it helps. One study in the Journal of Sexual Medicine, for example, found that men who used cannabis daily were at higher risk for sexual dysfunction such as inability to orgasm, premature ejaculation, and delayed ejaculation.
So, while many people have long been singing the praises of stoned sex and will likely continue to do so, it’s still not a cure-all, and there can be too much of a good thing.
There is some good news out about how women’s sexuality, long overlooked in the medical community, is treated now. Amid much hype and interest, the U.S. Food and Drug Administration (FDA) approved Vyleesi (bremelanotide), an injection designed to improve female sexual interest arousal disorder (FSIAD) — also known as hypoactive sexual desire disorder — in premenopausal women, in June 2019.
Is Sexual Interest Arousal Disorder the Same as Sexual Desire Disorder?
Formerly called hypoactive sexual desire disorder (HSDD), the term for a lack of desire for sexual activity was recently updated in the Diagnostic and Statistical Manual of Mental Disorders (DSM–5). The disorder is when women are distressed by the fact that they have little to no desire for sexual acts and the lack isn’t due to medication, disease, relationship problems, or psychological issues. The low desire is chronic (six months or longer), present at all times (not just during certain situations), and is associated with personal distress. (The distress must be the woman’s, and not the partner’s. There is nothing wrong with a woman with low desire who isn’t upset with the status. There is a difference between dysfunction and disinterest.)
New Drug Helps Validate Women’s Sexual Experiences
“The whole concept of minimizing women’s sexual health issues is important. In the past, if women had sexual problems, they were just told they were hysterical. Now their issues are coming to the forefront, and at least the release of Vyleesi may indicate that women’s sexual health is becoming more of a priority. It’s empowerment for women that they now have choices and options,” says Michael Krychman, MD, executive director of the Southern California Center for Sexual Health in Newport Beach.
Leah Millheiser, MD, director of the female sexual medicine program at Stanford Health Care in California, adds, “It is a coup for women that the FDA is recognizing chronically low libido as an important health issue.”
New Libido Drug Is Not a Cure for All Sexual Problems
There has been some controversy, however, over the release of Vyleesi, in that it may promise more than it can deliver. First, to be clear, the injections are not a silver bullet. Women’s sexuality is a complex interplay of medical, psychological, situational, and relationship status.
“Female sexual health and wellness are multifactorial. Vyleesi provides one facet to help but it’s important to appropriately assess the woman first. If the woman has complaints, she needs to be offered an intervention: Not just medical, but sometimes also psychological input and counseling are also very appropriate. In my clinical experience, women can benefit from medical intervention and some sort of counseling as well,” says Dr. Krychman.
You May Still Need Sex Counseling to Get Back on Track
Reality check: You will still have to work on your relationship. Women and their partners have to remember that if they have had long-term concerns with desire, they may need help via sex therapy on getting back to intimacy. “It’s challenging to go from 0 to 10. You have to relearn sexual trust and intimacy. Simply giving yourself a shot is not necessarily going to be a panacea. Vyleesi improves desire, but don’t expect to feel like you’re in your sexual prime again. It’s a subtle improvement, but that might be enough to improve intimacy and sexual self-esteem,” says Dr. Millheiser.
Vyleesi Is Not Appropriate for Women With Low Libido Who Do Not Have Arousal Disorder
Vyleesi is only for premenopausal women with female sexual interest arousal disorder. For women who have low sexual desire — and would like to have more — their first stop should be to a clinician who can assess where the issue is. If sexual dysfunction is ruled out, making behavioral changes is more effective than medication. “As you age, spontaneous sex is harder to come by. Making time, relationship and sex counseling, finding private time, getting into a new environment, sex toys, and working on body image can all help. Women may not start out with spontaneous desire, but can develop responsive desire in the act,” says Millheiser, who also recommends “pregaming.” Self-stimulate, or read or watch something arousing, so you can develop responsive desire prior to engaging with your partner.
Not Female Viagra: Vyleesi Does Not Work the Way Viagra Does
There is also a prevalent misconception that Vyleesi, the second medication of its kind to come to market following the release of Addyi (flibanserin), is a female Viagra (sildenafil), referring to the male medication for erectile dysfunction. Vyleesi works on desire, while Viagra works on arousal. “Clinicians really want to move away from comparing women’s drugs with men’s. Viagra increases blood flow to the penis but men have to have desire in order for it to work. Vyleesi alters neurochemicals in the brain so women can feel desire,” says Millheiser.
Has the Public Been Provided Enough Information About the Drug?
The National Women’s Health Network, a consumer activist group, says that the FDA rushed Vyleesi to market too soon. In a statement about the approval, Cynthia Pearson, executive director, said, “The National Women’s Health Network is disappointed in the U.S. Food and Drug Administration’s (FDA) decision to approve the drug bremelanotide (brand name: Vyleesi) and urges women to avoid using the drug until more is known about its safety and effectiveness. Women simply do not have enough information to make an informed decision about whether the drug is safe and effective. The FDA did not call on their advisers to review the drug publicly, and the sponsor has not yet published full clinical trial results. The limited data that has been published leaves many important questions unanswered. For example, it appears that hundreds of women enrolled in the pivotal trials were not included in the company’s presentation of the results. What happened to those women?”
The organization also points out the potential side effects: severe nausea, and skin and gum darkening, which did not go away after stopping treatment in about one-half of cases.
There Are Concerns About Side Effects, Safety, and Effectiveness
“We respect the ability of women to make good decisions if they have good information. We are not saying side effects are a reason why women shouldn’t use it; the issue is how much do we know? Can you get enough information to make an informed decision? A very determined person could get more info by reading the detailed label on the FDA website, but it still feels like the FDA didn’t do women good service here by the rush,” says Pearson, adding, “I’ll be surprised if it takes a very big place in the arsenal. It is not very effective and makes a lot of women very uncomfortable. My prediction is it is going to be something of a flop.”
Krychman disagrees with this assessment: “The product has been extensively studied. I think it’s appropriate for the FDA to make its own judgment. They evaluated and assessed the clinical program, which was very robust, and they have a competent group of advisors.”
Millheiser concurs, “The drug company behind Vyleesi has provided sufficient data on safety and efficacy. If there hadn’t been, the FDA would not have approved it.”
Have you ever wondered, somewhere in the back of your mind (minimized to a tiny voice so as to not freak yourself out) whether the weed you smoke affects your erection?
Yeah, we all have. At least those who are equipped to get erections.
And it’s no wonder. The internet is full of anecdotal descriptions of marijuana-triggered erections, something Urban Dictionary contributors call “stoner boner.” To quote the entry, this is “an erection obtained for no reason other than the fact that the obtainee was too damn high.” (Let’s face it. That’s way better than whisky dick.)
And there is maybe even more content out there about how marijuana impedes the boner. So, what’s real?
As far as we can tell, you can rest easy, brother. The facts about weed use and erections are uncertain at best, with one investigation suggesting that frequent cannabis use caused the men in their study to reach orgasm too quickly, too slowly, or not at all.
And then there’s this other study, which suggests that cannabis could be used to treat erectile difficulties in men with high cholesterol.
In short? The jury is still out. If you’re concerned about how marijuana affects your bedroom presence, try out some different strains and consumption methods. It’s certainly more fun that way, and you can see how each one affects your desire and ability to perform. Bring on the boner!
Ever wished you could reciprocate your partner’s hopeful gaze in the evening instead of losing your desire under layers of anxiety and to-do lists? Or to enthusiastically agree with your friends when they talk about how great it is to have sex six times a week?
Perhaps you just need to find that “switch” that will turn your desire on – big pharma has been trying for years to medicalise women’s sex drive, and to “solve” low libido.
One US company has just released a self-administered injection that promises to stimulate desire 45 minutes after use.
In late June, the US Food and Drugs Administration (FDA) approved Vyleesi (known scientifically as bremelanotide), the second drug of its kind targeting hypoactive sexual desire disorder (HSDD), a medical condition characterised by ongoing low sexual desire.
Vyleesi will soon be available on the market, and women will now have two drugs to choose from, the other being flibanserin (sold under the name Addyi), which comes in pill form.
Many experts are sceptical of medication being marketed as treatment for HSDD and the constructs underpinning research into the condition.
Yet many experts are highly sceptical of medication being marketed as treatment for HSDD, and also of the scientific constructs underpinning the research into the condition.
What is female hypo-active sexual desire disorder?
Hypo-active sexual desire disorder (or HSDD) was listed in the DSM-4, and relates to persistently deficient (or absent) sexual fantasies and desire for sexual activity, which causes marked distress and relationship problems.
“The problem is, it is very hard to describe what this medical condition actually is, because its construction is too entangled with the marketing of the drugs to treat it,” says Bond University academic Dr Ray Moynihan, a former investigate journalist, now researcher.
His 2003 paper, and book, The making of a disease: female sexual dysfunction, evaluates the methods used by pharmaceutical companies in the US to pathologise sexuality in women, focussing on the marketing campaign of Sprout Pharmaceuticals’ drug flibanserin, an antidepressant eventually approved by the US Food and Drug Administration (FDA) as a treatment for women experiencing sexual difficulties.
“This campaign, called Even the Score, was happening in real time as I was working as an investigative journalist and author.
“I got to see and document the way in which the very science underpinning this construct called FSD – or a disorder of low desire – was being constructed with money from the companies which would directly benefit from those constructs.”
The campaign was heavily criticised, mainly for co-opting language of rights, choice and sex equality to pressure the FDA to approve a controversial female “Viagra” drug.
During his research, Dr Moynihan says he found “blatant connections between the researchers who were constructing the science, and the companies who would benefit from this science”.
“The basic structures of the science surrounding this condition were being funded by industry,” he says.
What does the science say?
The biological causes of the condition have been widely researched. A quick search comes up with more than 13,000 results for HSDD, and a whooping 700,000 for what the condition used to be called (female sexual dysfunction).
Some of these studies show that women with the condition experience changes in brain activity that are independent of lifestyle factors, and other research has found that oestrogen-only therapies can increase sexual desire in postmenopausal women.
Others look into the effectiveness of a testosterone patch increasing sexual activity and desire in surgically menopausal women. Most say there is little substantive research in the field, and even less conclusive evidence.
“Oh, there are … studies galore, but mostly they are done by the industry or industry supporters – that’s one problem,” says Leonore Tiefer, US author, researcher and educator who has written widely about the medicalisation of men’s and women’s sexuality.
“There is no such thing as ‘normal’ sexual function in women,” says Jayne Lucke, Professor at the Australian Research Centre in Sex, Health and Society at La Trobe University.
“Sexual function and desire changes across the lifespan, and is influenced by factors such as different partners, life experiences, having children, going through menopause.”
Using the word ‘normal’ is very powerful, because it puts pressure on women about our idea of what is a ‘normal’ woman’.
Professor Jayne Lucke
Professor Lucke has studied women’s health and public health policy for years, and believes our need to understand female sexuality and its triggers has created a rush to medicalise a condition which may not even exist.
“Using the word ‘normal’ is very powerful, because it puts pressure on women about our idea of what is a ‘normal’ woman’,” she says.
The studies submitted by AMAG (Vyleesi) and flibanserin (Sprout Pharmaceuticals) for approval from FSD have been criticised for their connection to industry, as well as the small differences between the drugs effects and those of the placebo.
For example, Vyleesi was found to increase desire marginally (scoring 1.2 on a range out of 6) in only a quarter of women, compared to 17 per cent of those taking a placebo. A review of flibanserin studies, including five published and three unpublished randomised clinical trials involving 5,914 women concluded the overall quality of the evidence for both efficacy and safety outcomes was very low.
Side effects were also an issue with both medications.
Flibanserin never sold well, partly due to problems with its manufacturer and partly due to its use terms: that women would have to take it daily and avoid alcohol to experience a marginal increase in their sexual experiences.
“I’m just unsure of the mechanism of action with these drugs – they seem to be using the model of male sexual desire as a baseline,” Professor Lucke says.
“In the heterosexual male model of sexuality, the man has the erection, then there is penetration, hopefully an orgasm for both: that’s the model this is targeting”.
That said, it doesn’t mean that women don’t suffer from authentic sexual difficulties – the preferred term by many physicians, including the head of Sexual Medicine and Therapy Clinic at Monash Health and a sex counsellor at The Royal Women’s Hospital, Dr Anita Elias.
“I don’t use terms like ‘dysfunction’, or worry about the DSM’s classification system,” she says.
“Clinically, I wouldn’t waste too much time reading the DSM: we’re dealing with a person, not a classification.”
She says she prefers to talk about “sexual difficulties” rather than sexual “dysfunction” because often a sexual problem or difficulty is not a dysfunction, but just a symptom of what is going on in a woman’s life (involving her physical and emotional health, relationship or circumstances, or in her beliefs or expectations around sex).
She prefers ‘sexual difficulties’ rather than ‘dysfunction’ because often … (it) is a symptom of what is going on in a woman’s life.
“It’s the reason you don’t feel like having sex that needs to be addressed rather than just taking medication,” she says.
Dr Elias believes silence and shame that surrounds the topic of female sexuality is impacting how these conditions are being dealt with at a medical and societal level.
“Sexual pain and issues just don’t get talked about: if you had back pain, you’d be telling everyone –but anything to do with sex and women is still taboo”.
Dr Amy Moten, a GP based in South Australia who specialises in sexual health, says sexual difficulties are not covered well enough during medical training.
“While training will include a component of women’s sexual health, this tends to refer to gynaecological conditions (such as STIs) rather than sexual function and wellbeing.”
She says many GPs won’t think to ask a woman about sexual issues unless it’s part of a cervical screen or conversation about contraception, and that many women are reluctant to have such an intimate conversation unless they trust their GP.
“We need to think more about how to have these conversations in the future, as we’re living at a time of general increased anxiety, a lot of which can relate to sexual health.”
As for medication? It may be available in the US, but the Australian Therapeutic Goods Administration (TGA) has confirmed no drug under that name has been approved for registration in Australia – yet.
Erectile dysfunction (ED) has been getting the millennial marketing treatment recently. On London transport earlier this year, you may have seen a ‘quirky’ ad campaign for a viagra delivery service called Eddie, which urged men not to be shy about the condition, proclaiming “ED isn’t an ‘old man problem'”. Men’s health company Numan, which manufactures treatments for ED, uses a minimal, earthy-toned colour palette for its packaging – clearly targeted towards the same younger audience. In the US, the hipster-friendly viagra company Hims (with its cacti motif) has even been credited with making erectile dysfunction ‘trendy'</a
It’s refreshing that brands are trying to de-stigmatise an issue that can emasculate men – and it makes sense, given that there’s cause to believe younger men are increasingly finding it difficult to get or maintain an erection for long enough to have sex. A study of 2,000 British men last year found that half of men in their 30s and 35% of men in their 20s are “struggling in the bedroom”, with stress, tiredness, anxiety and boozing too heavily cited as the predominant causes. The ubiquity of porn is also named as a possible cause.
The Instagram-ready billboards might do something to tackle the stigma surrounding ED for some men but certainly not all – a recent study of 1,000 men and 1,000 women by Numan found that less than half (42%) of men who have experienced ED took steps to fix it. Nor is the taboo lifting among the sexual partners of those with the condition. The fallout and shame arising from ED remains far worse for men themselves, of course – nearly 50% of men with ED told Numan’s survey they felt self-conscious during sex, while nearly 20% avoided it altogether, and 79% were experiencing anxiety of some kind – but its impact on their romantic partners and relationships shouldn’t be overlooked.
How do affected couples communicate about an issue that is so sensitive? How does it make them feel about themselves? And how does it affect their own sexual satisfaction and experience of sex? Sex and relationship experts advise “talking to him and letting him know that he has nothing to feel ashamed of” and suggesting that he seek professional help if the problem persists. But it can be difficult squaring your partner’s wellbeing, self-esteem and masculine identity with your own needs, as two women in heterosexual relationships told Refinery29
Jo, 36, a strategist and self-described serial monogamist, was in a relationship with a man with erectile dysfunction which was “cut short due to ED and how it manifested in the relationship,” she says.
“The situation was twofold; he’d had health issues in the past brought on by a partying lifestyle that resulted in a mild heart issue, and he previously had an addiction to pornography, which he felt had warped his mind and changed how his body responded in intimate situations. I didn’t know any of this, of course, but I sensed a disconnect when we were intimate. Like his mind went somewhere else. I found out a few months in that he regularly used Viagra to deal with it. He hadn’t spoken to anyone else before and god knows where he was getting the medication.
During the next few months, sex changed… I acted more like a sex therapist than a girlfriend. It was probably the first time he’d discussed it with anyone. I wished there was someone else, like a professional, who he could speak to, to take the pressure off me. Sex became less about my enjoyment and more about ‘fixing’ him. I did a lot of research but didn’t really know what to do in this situation and if I was being a ‘good’ girlfriend or not. Was I making it worse or better? I was kind and patient for sure but pushed my needs and feelings aside as a result.
The ED took over everything. If we wanted guaranteed sex then it had to be planned, so it was less spontaneous and felt fake. I think he possibly took too strong a dose or was on the wrong medication too, because I felt he changed a bit as a person sexually. As I say, it felt like a therapy session, which brought us closer together in a way but also got boring very quickly for me. I sound like a bitch even now saying it, but that’s the truth.
The experience gave me a good insight into how hard it can be to be a man in 2019 and opened my eyes to how modern lifestyles, porn and mental health can really affect the physiology of a human; we all need to get to know and understand our bodies better. It taught me to be more patient and how to have tough conversations. Moreover, it taught me to care about my own feelings more, when to set boundaries and when to cut out.”
Melissa (not her real name), 29, who works in recruitment, saw a man for several months from September last year, and it soon became clear that his religious beliefs were hampering his ability to have sex.
“I was really excited about him as we clicked on so many levels. Before we’d slept together, he told me he was quite religious and that he’d probably want to explore it more when he got older and settled down. I’m not religious, but I didn’t think too much of it. On another occasion, he started talking about certain foreplay things he liked to do and asked if I was game – I was. Back at mine we started getting into it and he focused his attention on me during foreplay. He didn’t let me pay much attention to him. He had an erection at the time. However, when it came to having intercourse he lost it, proceeded to hug me and said that what we had just done was so amazing, etc. The foreplay was good and I’d been hoping we’d go the whole way since the dirty talk at dinner. I brushed it off.
We met up again and the same thing happened – he couldn’t get hard to have sex. We tried and it got a little hard but he lost it immediately. I could see that he was frustrated, but I could also sense he knew what was going on. I told him he could feel comfortable speaking to me about it, as we’d already had several deep conversations. Eventually, he told me his ex-girlfriend of five years was very religious and only wanted to have sex once she was married. He’d had a few sexual partners before her and was willing to wait. In the last year of his relationship they began to experiment with foreplay and when they eventually had sex, at his insistence, it didn’t feel right and they ended up splitting up. Essentially, he could only get hard off his kinky foreplay fantasy and had gone so long without intercourse that when it came to it, he had a mental and physical block.
We got on well but the lack of sex and his unwillingness to address it meant we didn’t see much of each other after that. I was willing to try and help out, be understanding and patient but he kept me at a distance and ultimately didn’t want to talk to me about it. Since he’d been so forward about what he wanted in bed I felt deflated that he couldn’t go the whole way. It made me think I was the problem. I now realise this wasn’t the case, but if your partner has ED and doesn’t admit it, doesn’t talk about it and distances themselves, it doesn’t make you feel good. Men rarely talk about it and women are often embarrassed to talk about it with their friends to avoid embarrassing their partner, so seek your own advice and if your partner is hesitant, broach the subject yourself. Give them resources or solutions and let them know it’s a common problem. Help them to find out what really might be causing it.”
A new study led by the Saint Louis University School of Medicine has found that marijuana can greatly improve sexual experiences for women. Based on information from hundreds of women, the researchers found that using marijuana prior to sex doubled the likelihood that they would have an orgasm.
It has been commonly reported that marijuana increases sexual arousal and results in higher satisfaction during sex. While the science underlying these sexual benefits is not yet clear, experts theorize that they may result from heightened senses and reduced stress.
“It has been postulated that it leads to improvement in sexual function simply by lowering stress and anxiety,” wrote the study authors. “It may slow the temporal perception of time and prolong the feelings of pleasurable sensations. It may lower sexual inhibitions and increase confidence and a willingness to experiment.”
“Marijuana is also known to heighten sensations such as touch, smell, sight, taste, and hearing.”
To investigate the link between marijuana and sexual satisfaction, the researchers developed a Sexual Health Survey that addressed topics such as sex drive and lubrication. “To limit bias, the authors embedded the questions about marijuana deeper into the questionnaire,” wrote the researchers.
The investigation was focused on the survey responses of 373 women who were both marijuana users and non-users. Of the 47 percent of participants who were marijuana users, 34 percent reported using it before sex.
The study revealed notable differences in the sexual experiences of the women based on whether or not they used marijuana beforehand.
“Most women reported increases in sex drive, improvement in orgasm, decrease in pain, but no change in lubrication.” Overall, women who smoked pot were 2.13 times more likely to report having “satisfactory orgasms.”
“Marijuana appears to improve satisfaction with orgasm. Women who used marijuana before sex and those who used more frequently were more than twice as likely to report satisfactory orgasms as those who did not use marijuana before sex or used infrequently,” wrote the study authors.
“Our study is consistent with past studies of the effects of marijuana on sexual behavior in women.”
Sex can be painful for women. There, we’ve said it. Now let’s talk about natural ways to deal with it.
We’ve all heard that women experience vaginal dryness after menopause, but what some of us on the Ellementa team have experienced goes way beyond a moisture-free environment.
“It feels like jagged razor blades slicing me up inside during penetration,” she said.
“It’s like having little elves with knives inside my vagina, cutting away.”
That is what we were hearing around our virtual water cooler when the topic of menopause and sex came up.
Being on a mission to help women better understand the health and wellness benefits of cannabis and CBD, one of our intrepid founders decided to try cannabis and CBD products to address unpleasant symptoms from menopause. She confessed that for the past year she had been experiencing mind-blowing pain that put a damper on any possibility of mind-blowing sex.
“Here I was telling women how beneficial cannabis and CBD can be for our health, and I wasn’t addressing a very real health and wellness issue of my own,” she said.
One evening, she decided to try some of the sample products she had received to review. And they worked!
Here is the recipe for relief that she found useful:
Use a natural vaginal lubricant daily. Many women don’t realize you can apply lubricants daily, particularly after a shower or bath, inside your vagina. We’re not talking about drowning your vagina in oil but applying it internally using a small amount on your finger. Organic coconut oil can be a natural vaginal lubricant, and can be used intra-vaginally if you’re not allergic to coconut. Other fast-absorbing oils include Jojoba and Sweet Almond.
Use a THC-based sexual lubricant or topical 20-30 minutes before sex. Note that many of the THC-infused sexual aids may not be very lubricating but are more warming as well as offering the analgesic effects of THC. THC shouldn’t actually numb the vaginal area but instead reduce the sensation of pain while increasing blood flow to the vagina.
Add a CBD-based lubricant. Our intrepid team member tried a sample packet of Privy Peach’s Personal Lubricant with 250mg CBD. The product claims to “help stimulate your body’s own lubrication, increase circulation, and alleviate any present discomfort.” Note: NOT FOR USE WITH LATEX CONDOMS as any oil may degrade latex.
The results? Nearly pain-free penetration, and definitely pain-free, awesome sex.
This information was a revelation for another one of our founders who went into surgical menopause after a hysterectomy.
“I was just so unprepared for menopause,” she said. “I had no idea my sex life would end, and that I’d have my own private desert.”
As with many other women, she hadn’t looked up THC- or CBD-infused sexual products.
“I’m always taking care of everybody else,” she admitted but vowed to search her market for the right products to relaunch her sex life.
It’s Not Just Older Women Experiencing Painful Sex
“I personally faced quite the battle with my vagina the minute I started having sex,” Cyo Ray Nystrom, the founder and CEO of QuimRock, recalls. “I’ve had years of awful UTIs, forcing me to take intense rounds of antibiotics that, in turn, killed off all the natural vaginal flora and caused yeast infections. It affected my life and sex life greatly as vaginal health is such an important part of intimacy and sex for so many people.”
QuimRock is a cannabis-infused self-care line for women’s intimate care.
Cyo says cannabis can be “powerful sex-medicine for anyone using it intentionally and with her own personal needs in mind.” She also notes that the shame that’s historically associated with vaginal health issues, including those related to menopause, can be “particularly scarring.”
“Personally, cannabis has always been a great tool for getting me into my body, which is essential for me to really show up in my sex life,” Cyo explains, adding, “Cannabis has helped me in many ways—from cramp relief after getting a UTI to pain relief-focused topicals to the amazing benefits of cannabis-infused lubricants.”
What Does a Medical Expert Say About Cannabis to Relieve Painful Sex?
One of our Ellementa Advisors, Dr. Elaine Burns is the founder and medical director of Southwest Medical Marijuana Evaluation Center and founder of DrBurns’ ReLeaf tetrahydrocannabinol (THC) and cannabidiol (CBD) products. Dr. Burns was working with bio-identical hormones for women before she entered the cannabis industry seven years ago. We asked her about cannabis and specifically CBD for women’s sexual health during peri-menopause and post-menopause.
According to Dr. Burns, menopause is a “multifactorial issue,” meaning no woman can expect that what worked for someone else will work for them, too. She also emphasized that cannabis is only part of an overall health-care plan that could include botanicals (such as black cohosh, evening primrose and chamomile) for women before menopause or bio-identicals—non-synthetic, all-natural hormone replacements—for women no longer experiencing menses. She told us she would never solely recommend cannabis or CBD to relieve menopausal symptoms.
THC, by the way, can also be helpful with low libido and stress related sexual dysfunction. Dr. Burns reminded us there are two parts of support during menopause:
Relief from unpleasant symptoms ranging from vaginal dryness to hot flashes to painful sex.
Prevention of diseases such as osteoporosis.
Depending on your health goals, cannabis—and specifically CBD—can be integrated into your overall care plan to alleviate specific menopause symptoms and also help with general good health as you age.
As Cyo from QuimRock explains, “It’s hugely important to figure out what turns you on and what turns you off.” And that takes time and trying different things. Just as menopause is a journey, so is naturally addressing your sexual health with botanicals like cannabis.”
A tablet of Pfizer’s Viagra, left, and the company’s generic version, sildenafil citrate.
By Michelle Andrews
For some older people, the joy of sex may be tempered by financial concerns: Can they afford the medications they need to improve their experience in bed?
Medicare and many private insurers don’t cover drugs that are prescribed to treat problems people have engaging in sex. Recent developments, including the approval of generic versions of popular drugs Viagra and Cialis, have helped consumers afford the treatments. Still, for many people, paying for pricey medications may be their only option.
At 68, like many postmenopausal women, Kris Wieland, of Plano, Tex., experiences vaginal dryness that can make intercourse painful. Her symptoms are amplified by Sjogren’s syndrome, an immune system disorder that typically causes dry eyes and mouth, and can affect other tissues.
Before Wieland became eligible for Medicare, her gynecologist prescribed Vagifem, a suppository that replenishes vaginal estrogen, a hormone that declines during menopause. That enabled her to have sex without pain. Her husband’s employer plan covered the medication, and her co-payment was about $100 every other month.
After she enrolled in Medicare, however, her Part D plan denied coverage for the drug.
“I find it very discriminatory that they will not pay for any medication that will enable you to have sexual activity,” Wieland said. She plans to appeal.
Under the law, drugs used to treat erectile or sexual dysfunction are excluded from Part D coverage unless they are used as part of a treatment approved by the Food and Drug Administration for a different condition. Private insurers often take a similar approach, reasoning that drugs to treat sexual dysfunction are lifestyle-related rather than medically necessary, said Brian Marcotte, chief executive of the National Business Group on Health, which represents large employers.
So, for example, Medicare may pay if someone is prescribed sildenafil, the generic name for Viagra and another branded drug called Revatio, to treat pulmonary arterial hypertension, a type of high blood pressure in the lungs. But it typically won’t cover the same drug if prescribed for erectile dysfunction.
Women such as Wieland may encounter a similar problem. A variety of creams, suppositories and hormonal rings increase vaginal estrogen after menopause so that women can have intercourse without pain. But drugs that are prescribed to address that problem haven’t generally been covered by Medicare.
Sexual-medicine experts say such exclusions are unreasonable.
“Sexual dysfunction is not just a lifestyle issue,” said Sheryl Kingsberg, a clinical psychologist who is the chief of behavioral medicine at University Hospitals MacDonald Women’s Hospital in Cleveland. She is the immediate past president of the North American Menopause Society (NAMS), an organization for professionals who treat women with these problems. “For women, this is about postmenopausal symptoms.”
Relief may be in sight for some women.
Last spring, the federal Centers for Medicare and Medicaid Services sent guidance to Part D plans that they could cover drugs to treat moderate to severe “dyspareunia,” or painful intercourse, caused by menopause. Plans aren’t required to offer this coverage, but they may do so, according to CMS officials.
“Dyspareunia is a medical symptom associated with the loss of estrogen,” Kingsberg said. “They had associated it with sexual dysfunction, but it’s a menopause-related issue.”
For men who suffer from erectile dysfunction, treatment can confer both physical and emotional benefits, sexual health experts said.
“In my clinical work, I see a lot of older couples,” said Sandra Lindholm, a clinical psychologist and sex therapist who is also a nurse practitioner in Walnut Creek, Calif. “They are very interested in sex, and they feel like they’re able to embrace their erotic lives. But there may be medical issues that need to be addressed.”
About 40 percent of men over age 40 have difficulty getting or maintaining an erection, studies show, and the problem increases with age. A similar percentage of postmenopausal women experience genitourinary syndrome of menopause, a term used to describe a host of symptoms related to declining levels of estrogen, including vaginal dryness, itching, soreness and pain during intercourse, as well as increased risk of urinary tract infections.
Low sexual desire is another common complaint among women and men. A drug called Addyi was approved in 2015 to treat low sexual desire disorder in premenopausal women. But many insurers don’t cover it.
Unfortunately, medications that treat these conditions may cost people hundreds of dollars a month if their insurance doesn’t pick up any of the tab. A 10-tablet prescription for Viagra in a typical 50-milligram dose may cost more than $600, for example, while the price of eight Vagifem tablets may exceed $200, according to GoodRx, a website that publishes current drug prices and discounts.
In recent years, much more affordable generic versions of some of these medications have gone on the market.
Generic versions of Viagra and Cialis, another popular erectile dysfunction drug, may be available for just a few dollars a pill.
“I never write a prescription for Viagra anymore,” said Elizabeth Kavaler, a urogynecologist at Lenox Hill Hospital in New York City. “These generics are inexpensive solutions for men.”
There are generic versions of some women’s products as well, including yuvafem vaginal inserts and estradiol vaginal cream.
But even those generic options are often relatively pricey.
Some patients cannot afford $100 for a tube of generic estradiol vaginal cream, said Mary Jane Minkin, a clinical professor of obstetrics, gynecology and reproductive medicine at Yale School of Medicine.
“I’ve asked, ‘Did you try any of the creams?’ And they say they used up the sample I gave them. But they didn’t buy the prescription because it was too expensive,” she said.
For people who have depression, even the most basic activities can seem daunting—and that includes sex. But because both depression and sexual problems are things that are difficult to talk about, even with intimate partners, the issues surrounding having sex while dealing with depression often wind up being ignored. As mental health advocate and writer JoEllen Notte puts it: “It’s the intersection of two taboo topics.” And it can lead to even more problems relating to a person’s mental and physical well-being.
Notte breaks the negative sex experience that comes with depression into two categories: loss of interest and side effects of medication. Notte says about the former: “I tend to reinterpret [it] as ‘everything seems incredibly hard and not worth doing’… Not wanting to be touched, and not wanting to deal with people.” While that applies to people who have depression and both are and aren’t on medication, the side effects specific to medication are a significant problem, too, and include, Notte says, “erectile dysfunction, vaginal dryness, genital numbness, delayed orgasm, and what’s usually referred to as ‘lost libido.'”
This loss of libido is symptomatic of a larger problem of depression: anhedonia, which Dr. Sheila Addison, a licensed marital and family therapist, tells me is “a loss of pleasure in ordinary things.” One of the things people with depression do to combat anhedonia is try to self-medicate and force pleasure, including through sex. Addison explains, “People with depression sometimes wind up chasing ‘peak’ experiences, little bursts of endorphins that seem to cut through the depression for a moment, but it’s a short-term fix for a long-term problem. And if it turns into having sex that they don’t really want, hoping to feel better, it can contribute to feelings of emptiness and self-loathing.”
The best thing to do when dealing with depression is to seek out a doctor, but even if you are comfortable seeking out help for depression, it can be difficult to broach the topic of sexual health, without feeling anxious. As Notte points out, “So many people have had bad experiences with doctors not wanting to deal with [sex] or prioritizing it as a topic.” My own doctor’s flippancy toward the subject was enough to shut me down for months, and it seems like this is all too common, leading to further stigmatization of this sensitive topic. Notte says, “All of the data that says these [sexual] side effects don’t happen is skewed, because people aren’t reporting them.”
Nevertheless, each person I talked to stressed that even though it’s difficult, if you are having issues with sex and experience depression, talk to a doctor first. Addison says that online forums can be the source of “a lot of unsolicited advice, pseudoscientific ‘cures,’ and supposed remedies that will lighten your wallet more than your mood.” And if you find the first doctor to be unsympathetic to your problems, then look for another one.
But how to find the right doctor? Notte recommends looking for keywords like “sex-positive” and “trauma-informed,” as it often means they’ll be more willing to discuss sexual issues or at least be able to point you in the right direction to someone who could. Addison herself is a member of LGBTQ Psychotherapy organization GAYLESTA and listed amongst kink-friendly professionals. These keywords tend to suggest the doctor has a more nuanced, whole-body approach to understanding and treating mental illness, but, of course, it may take a bit of searching to find someone whose methods you are comfortable with.
Once you find a doctor with whom you’re comfortable talking, you can also utilize them when you want to talk with your partner about any problems you might be having with regards to sex. “People often don’t know that you can bring anyone with you to your doctor visit if you want,” Addison points out. “Sometimes it’s easier to have the doctor talk directly to your partner because it’s not so personal.” Addison advises that the partner who isn’t experiencing depression seek care as well, saying, “Get support for yourself, from a therapist or from a group for partners of people with mental illness. Take good care of yourself, physically and emotionally
The main theme here, as with any taboo topics, is that talking about them is key, and the only way to remove the stigma. It’s particularly apt in this situation, though, as conversation, and communication in general, are also at the core of maintaining healthy romantic and sexual relationships no matter what your mental state.
But even though we know we should communicate openly, it can be difficult to get started. That’s why Allison Moon, sex educator and author of Girl Sex 101, recommends beginning conversations with “I statements” when breaching the topic of sexual issues. “It’s easy for people to catastrophize when partners bring up sexual issues, and they may be tempted to take responsibility for the issues of their partners,” Moon says. “It’s a good idea to use extra care when explaining one’s own experience, and be clear that the partner isn’t at fault or causing anything.” When considering the problem as a whole, Notte advises a team mentality for couples. She says, “What happens a lot is it gets treated as an issue of the healthy partner versus the other partner and their depression, and if we can be couples who are working on one team while the depression is on the other team, it’s a much healthier dynamic.”
Moon also recommends “speaking in concretes” when describing the ways depression affects your life and sexual experience to your partner. “Because mental health is so individuated, saying something like, ‘I have depression’ doesn’t always convey what one intends. Instead, I suggest discussing how something like depression manifests in a way the partner can understand. For instance, rather than saying ‘Depression makes me insecure,’ you could say, ‘Sometimes I need extra verbal validation from you. Can you tell me you find me sexy and wonderful? Can you remind me that I’m a good person?'”
Describing symptoms associated with depression can be difficult, though, and Notte often advises individuals to use what she refers to as “accessible” resources (“things that are not scary, that are not medical journals”) to work on coming to a mutual understanding of what you are going through. “Find things that are the language you and your partner speak,” she says; she sends her own partner comic strips and had them play Depression Quest, a role-playing game in which you navigate tasks as a person with depression.
We treat mental health very different than physical health,” Notte points out, adding, “If I were dating somebody and I had diabetes and wanted them to know I’d have to inject myself with insulin at some point, I wouldn’t have to be embarrassed to tell them that.” As with any disease, depression shouldn’t be treated as a liability in dating, and people who would treat it as such are not worth your time. Addison tells me, “Anybody who’s going to make you feel bad or weird about how your body works, does not deserve access to it. Disability rights folks have taught me, don’t apologize for how your body works or feel like you need to make someone else feel okay with you. If they can’t handle you, they can’t get with you.”
But that doesn’t mean it will always be easy—for either of you. So being present with your feelings and communicating them to your partner is vital. Moon says, “When you notice something coming up for you, whether it’s an emotion, a sensation, or a memory, practice giving it attention and letting it give you information.” Perhaps there is a “need attached to the emotion that you can turn into a request,” like needing more lube, or a moment to process your feelings before hooking up, etc. “If you notice that you’re going to cry, for instance, you can mention that so it doesn’t scare your partner,” Moon suggests. “Saying something like, ‘I’m having a great time, but I’m noticing some sadness come up. So if I start to cry, that’s okay, you’re not doing anything wrong. I’ll let you know if I want to stop, but I don’t want to right now.'”
Likewise, Addison recommends acknowledging the experience in the moment in a way that reassures your sexual partner that you don’t blame them for what’s happening. You can do this, she suggests, by saying something like: “This is just a thing my body does sometimes, and I”m not worried about it, so you shouldn’t worry about it either. Thanks for understanding. And I’m really enjoying [kissing you] so let’s do more of that.”
While the physical manifestations of depression in sexual relationships cannot be solved by medication, Notte recommends “workarounds” to address your specific sexual issue. Notte recommends using lubricants and not shying away from toys if experiencing anorgasmia, genital numbness, or erectile dysfunction. Exploring these types of options are especially great for people whose depression-related sexual problems manifest as specifically physical.
While all of this information is important for people with depression, it’s also essential for the partners who don’t have depression to understand how to respond in these situations. Addison tells me the best way is the simplest—nothing more than a “thanks for letting me know.” She explains, “Viewing someone as broken, or suffering, or in need of special treatment, is actually a poor way to approach sexual intimacy. If someone trusts you enough to let you know what’s going on with them, appreciate the gift that has been given to you, and treat it accordingly, with respect. [If your partner says,] ‘I don’t come through intercourse, and I might or might not finish myself off afterward,’ it is not an invitation for you to try to complete the Labors of Hercules to prove what an awesome lover you are. It’s information for you to let you know how this person’s body works, so be grateful that they trusted you enough to share something private with you, and act accordingly.”
And, she points out, “There’s nothing wrong with enjoying your climax when you’re with someone who’s said, ‘I probably won’t get off, but it’s still fun for me.'” Above all, Addison states, “Treat them like the expert on their own body, and you’ll be on the right track.”
Of course, finding people who will do that, especially at the beginning of a relationship or when dating around, can be difficult, but Addison advises to “decide what you’re looking for and what you’re willing to do or not do in order to get it… then screen your dates accordingly.” Finding someone who is comfortable with and respectful of your depression and sexual issues is a trait that can be filtered right in with your usual set of dating criteria. Addison says, “If you say, ‘Hey, I have medication that means I probably won’t come, and I’m looking for a partner who won’t be hung up about it—are you cool with that?’ and they try to inform you about how they’re going to be the one who makes you scream down the rafters, that’s a good reason to swipe left.” After all, she explains, “You can’t fuck somebody out of depression with your Magic Penis or Magic Vagina.”
If you or a loved one are seeking out further information about experiencing the sexual side effects of depression, seek out a psychologist or psychotherapist near you, and remember, as Addison says, “The only people who deserve to get close to you are people who can understand your needs and treat you with appropriate respect and care.”
You must be logged in to post a comment.