ArticleLiterature Review

Impact of Cannabis Use on Male Sexual Health

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Abstract

Cannabis (marijuana) is the most widely used illicit drug globally. Given the prevalence of nonprescription illicit drug abuse, there is a growing interest in the study of its potential effects on male sexual health. In this review, we discuss the effects of cannabis on male sexual health. In this review, we discuss the effects of cannabis on male sexual health. METHODS AND MAIN OUTCOME MEASURE: Critical review of scientific literature examining the impact of cannabis use on male sexual health. Studies examining the effects of cannabis use on male sexual function have been limited in both quality and quantity. Most results of these studies are conflicting and contradictory. While some did outline the beneficial effects of cannabis in enhancing erectile function, others did not. However, recent animal and in vitro studies have identified potential links between cannabis and sexual health. It appears that cannabis may actually have peripheral antagonizing effects on erectile function by stimulating specific receptors in the cavernous tissue. Given the prevalence of cannabis use, and the potential relationships between use and the development of potentially hazardous effects on male sexual function, we encourage renewed use of research resources to determine in-depth mechanistic knowledge, and new clinically oriented studies examining the effect of cannabis on male sexual function.

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... Cannabis is consumed in its main forms as herb (marijuana) or resin (hashish) and remains the world's most widely used illicit drug [18]. The main active metabolite in cannabis is tetrahydrocannabinol (THC), which may serve as a hallucinogen and/ or a central nervous stimulant or depressant [25]. The effects of cannabis are mediated through at least two cannabinoid receptors that have been identified: CB 1 and CB 2 . ...
... Despite the wide prevalence of cannabis use, little is known from human studies on the effects of cannabis on sexual function. Both possible aphrodisiacs properties and possible detrimental effects of cannabis use on erectile function are discussed [25], while causal relations are not well understood. One possible pathway to a positive experience following cannabis use may be that cannabis rush induces more focused attention to sexual sensation and pleasure [25]. ...
... Both possible aphrodisiacs properties and possible detrimental effects of cannabis use on erectile function are discussed [25], while causal relations are not well understood. One possible pathway to a positive experience following cannabis use may be that cannabis rush induces more focused attention to sexual sensation and pleasure [25]. In contrast, other studies indicate a clear connection of cannabis use to adverse sexual health outcomes, e.g., decreased erectile functioning. ...
Chapter
While some users show increased sexual functioning due to substance use, the chronic use of legal and illicit drugs increases the rates of sexual dysfunctions. Especially in connection with substance use, it remains difficult to disentangle cultural, social, psychological, and biological etiological factors in sexual dysfunctions. This chapter, however, reviews the existing empirical data on substance-related disorders and sexual dysfunctions and intervention programs. Moreover, it will discuss if there are any substances with potentially enhancing effects on sexual functioning. The first part of the chapter consists of a general introduction and classification of substance-related disorders and sexual dysfunctions in DSM-5 and ICD-11. The second part presents empirical findings on various substances and sexual functioning in greater details. The last part presents possibilities of prevention and intervention of sexual dysfunctions in association with substance and two case reports. Furthermore, the reader will find take-home messages at the end of this chapter.
... With regards to more direct sexual effects, studies have found an increase in male and female sexual arousal (Shamloul & Bella, 2011) and effects on the duration of sexual encounters both in prolonged orgasm and inability to achieve orgasm (Smith et al., 2010). Marijuana use has also been found to be associated with inability to maintain an erection (Shamloul & Bella, 2011). ...
... With regards to more direct sexual effects, studies have found an increase in male and female sexual arousal (Shamloul & Bella, 2011) and effects on the duration of sexual encounters both in prolonged orgasm and inability to achieve orgasm (Smith et al., 2010). Marijuana use has also been found to be associated with inability to maintain an erection (Shamloul & Bella, 2011). Similar to alcohol, more studies are needed to determine the direct sexual effects of marijuana. ...
... However, for women, sexual dysfunction was more often associated with marijuana and ecstasy use than with alcohol. Previous studies have found an association between erectile dysfunction and use of marijuana (Shamloul & Bella, 2011) and ecstasy (McElrath, 2005;Schmidt et al., 2012;Zemishlany et al., 2001). Studies on female sexual dysfunction are often contradictory. ...
Article
Alcohol, marijuana, and ecstasy (3,4-methylenedioxymethamphetamine [MDMA], ‘Molly’) are among the most prevalent substances used by young adults; however, few studies have focused on the specific sexual effects associated with use. Examining subjective sexual effects (e.g. increased libido) associated with use can inform prevention efforts. Data were analysed from 679 nightclub and dance festival attendees in New York City (ages 18–25) to examine and compare self-reported sexual effects associated with use of alcohol, marijuana, and ecstasy. Results suggest that compared to marijuana, alcohol and ecstasy were more strongly associated with heightened perceived sexual effects (i.e. perceived sexual attractiveness of self and others, sexual desire, length of intercourse, and sexual outgoingness). Increased body and sex organ sensitivity and increased sexual intensity were most commonly associated with ecstasy use. Sexual dysfunction was most common while using alcohol or ecstasy, especially among males, and females were more likely to report sexual dysfunction after using marijuana. Post-sex regret was most common with alcohol use. Alcohol, marijuana, and ecstasy each have different sexual effects; therefore, each is associated with different risks and benefits for users. Findings can inform prevention and harm reduction as young adults are prone to use these substances.
... Long-term alcohol, cocaine, marijuana, amphetamine, and opioid abuse seems to be associated with sexual dysfunction (SD) in almost all domains of sexual human response with great impact on the quality of life of substance-dependent individuals and their sexual partners (Babakhanian, Alam Mehrjerdi, & Shenaiy, 2012;Chao, Ma, Lin, Chiang, & Hwang, 2015;Yee, Loh, Hisham Hashim, & Ng, 2014;Shamloul & Bella, 2011). ...
... Nevertheless, this study showed no single associations between DOC and ED, even to crack users. There is evidence of the impact of cannabis (marijuana) on male sexual health (Shamloul & Bella, 2011), but results are contradictory as some studies show beneficial effects of cannabis. Studies in rats showed that cannabis might have peripheral antagonizing effects on erectile function by stimulating specific receptors in the cavernous tissue (Shamloul & Bella, 2011). ...
... There is evidence of the impact of cannabis (marijuana) on male sexual health (Shamloul & Bella, 2011), but results are contradictory as some studies show beneficial effects of cannabis. Studies in rats showed that cannabis might have peripheral antagonizing effects on erectile function by stimulating specific receptors in the cavernous tissue (Shamloul & Bella, 2011). ...
Article
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Objective: To assess erectile dysfunction (ED) symptom prevalence, sexual behavior conditions, and risk factors associated to ED in a male polydrug dependent sample. Methods: A cross-sectional design study was conducted with 102 substance-dependent male polydrug users who sought outpatient treatment in São Paulo, Brazil. Sociodemographic data, drug of choice, chronic disease questions, sexually transmitted infections, International Index of Erectile Function (IIEF) scale, Sexual Addiction Screening Test (SAST), and WHOQOL-Bref instrument were used. Results: The erectile dysfunction prevalence was 32.3% and it was related to the marital status (single) (p < 0.001), occupational status (fully unemployed) (p < 0.001), presenting a chronic disease (p = 0.027), and with types of sexual partnerships (occasional partner) (p < 0.001). Alcohol (73.5%), tobacco (79.4%), cannabis (83.3%), and cocaine (snorted 78.4% and smoked 42.2%) were the drugs of choice. The ED risk decreased when marital status was married (odds ratio = 3.2 CI95% 1.411-7.518) and with chronic disease (odds ratio 0.06 CI95% 0.00-0.97), while having occasional sexual partners increased 14 times ED risk (OR 14.0 CI95%1.62-122.18). There were no significant associations between quality of life, DOC and ED. Conclusion: Approximately one third of the substance dependents in this sample presented ED. There is a need to integrate psychiatric and clinical care in substance treatment services, and to improve the provision of sexual health care and support available for this population.
... Regarding the literature, clinical studies focused on the effects of cannabis on sexual function are limited and present conflicting results (Shamloul & Bella, 2011). A limited number of studies conducted with female patients show that cannabis primarily increases sexual stimulation and desire. ...
... On the other hand, in males, both increasing and inhibiting effects of cannabis are reported extending from the increase of sexual desire to erectile dysfunction, independent from the amount of consumption (Gorzalka et al., 2010). Some investigators suggested that the increased tactile sensitivity, increased focus on the sexual experience through slowed temporal cognition caused by cannabis use, may be responsible for the positive effects on the sexual function (Kolodny et al., 1974;Shamloul & Bella, 2011). However, there is currently insufficient data to support these results. ...
... The subjective assessment of patients and the evaluation of sexual function with non-validated scales in the studies con- ducted so far may be the reasons for these conflicting results (Shamloul & Bella, 2011). The objective of this study was to evaluate the sexual function of male patients with cannabis use disorder by a validated and reliable questionnaire and to compare them with a healthy control group. ...
Article
Full-text available
Background: Studies about the effects of cannabis on male sexual function have contradictory results. This contradiction is thought to depend on the subjective assessment of the patient or on the use of non-validated questionnaires. Aims: The objective of this study was to evaluate the sexual function of male patients with cannabis use disorder by a validated questionnaire and to compare them with a healthy control group. Methods: 47 male patients with cannabis use disorder and without any comorbid psychiatric disorders were included in this study. The education level and age of the patients were matched with 33 healthy male participants. In addition to the sociodemographic characteristics, the pattern of cannabis use and sexual life were also questioned. Sexual function was evaluated by International Index of Erectile Function. Results: The scores of erectile function and orgasmic function in the patient group were found significantly lower than the control group. Erectile dysfunction was significantly more frequently reported in the patient group than the control group. Sexual desire, intercourse satisfaction, and overall satisfaction scores did not differ significantly between groups. Conclusions: Our findings indicated that sexual function should be inquired in men with cannabis use disorder. These findings could be used in prevention studies focused on cannabis use disorder.
... Regarding the literature, clinical studies focused on the effects of cannabis on sexual function are limited and present conflicting results (Shamloul & Bella, 2011). A limited number of studies conducted with female patients show that cannabis primarily increases sexual stimulation and desire. ...
... On the other hand, in males, both increasing and inhibiting effects of cannabis are reported extending from the increase of sexual desire to erectile dysfunction, independent from the amount of consumption (Gorzalka et al., 2010). Some investigators suggested that the increased tactile sensitivity, increased focus on the sexual experience through slowed temporal cognition caused by cannabis use, may be responsible for the positive effects on the sexual function (Kolodny et al., 1974;Shamloul & Bella, 2011). However, there is currently insufficient data to support these results. ...
... The subjective assessment of patients and the evaluation of sexual function with non-validated scales in the studies con- ducted so far may be the reasons for these conflicting results (Shamloul & Bella, 2011). The objective of this study was to evaluate the sexual function of male patients with cannabis use disorder by a validated and reliable questionnaire and to compare them with a healthy control group. ...
Article
Full-text available
Background: Studies about the effects of cannabis on male sexual function have contradictory results. This contradiction is thought to depend on the subjective assessment of the patient or on the use of non-validated questionnaires. Aims: The objective of this study was to evaluate the sexual function of male patients with cannabis use disorder by a validated questionnaire and to compare them with a healthy control group. Methods: 47 male patients with cannabis use disorder and without any comorbid psychiatric disorders, were included in this study. The education level and age of the patients were matched with 33 healthy male participants. In addition to the sociodemographic characteristics, the pattern of cannabis use and sexual life were also questioned. Sexual function was evaluated by International Index of Erectile Function. Results: The scores of erectile function and orgasmic function in the patient group were found significantly lower than the control group. Erectile dysfunction was significantly more frequently reported in the patient group than the control group. Sexual desire, intercourse satisfaction, and overall satisfaction scores did not differ significantly between groups. Conclusions: Our findings indicated that sexual function should be inquired in men with cannabis use disorder. These findings could be used in prevention studies focused on cannabis use disorder.
... Animal studies have elucidated that the paraventricular nucleus of the hypothalamus and its communication to other brain centers are involved in the control of penile erection. This effect has been shown to be modulated by CB1R antagonists [60,61]. The animal studies have used variable doses of CBD and found that the response was different in high versus low doses [27]. ...
... The effect of cannabis use on human sexual function differs on duration of use. Studies support that libido may be augmented after acute use, but there are reports of erectile dysfunction with chronic use [54,61,77,78]. Impaired epithelium-dependent vasodilation has been noted more frequently in frequent cannabis users with organic erectile dysfunction [79]. ...
Article
Full-text available
With the increase in cannabis use due to policy changes and areas of decriminalization, it is important to recognize the potential impact of these substances on endocrine processes. Cannabinoids have many effects by activating the endocannabinoid system. This system plays a role in the normal functioning of nearly every organ and consists of the body’s natural endocannabinoids, the cannabinoid receptors, and the enzymes and processes that regulate endocannabinoids. Exogenous cannabinoids such as Δ9-tetrahydrocannabinol (THC) are known to act through cannabinoid type 1 and 2 receptors, and have been shown to mimic endocannabinoid signaling and affect receptor expression. This review summarizes the known impacts of cannabis on thyroid, adrenal, and gonadal function in addition to glucose control, lipids, and bone metabolism, including: reduced female fertility, increased risk of adverse pregnancy outcomes, reduced sperm counts and function, lower thyroid hormone levels with acute use, blunting of stress response with chronic use, increased risk of prediabetes but lower risk of diabetes, suggested improvement of high density lipoproteins and triglycerides, and modest increase in fracture risk. The known properties of endocannabinoids, animal data, population data, and the possible benefits and concerns of cannabinoid use on hormonal function are discussed. The interconnectivity of the endocrine and endocannabinoid systems suggests opportunities for future therapeutic modalities which are an area of active investigation.
... When it comes to male reproductive system, CB1 is present in nerves in corpus cavernosum [319] and is responsible for Cannabis-related erectile dysfunction [320]. While designing CB1 agonists, one may expect possible sexual adverse effects. ...
... To avoid these adverse effects, peripheral CB1 agonists, CB1 positive allosteric modulators or indirect activation of CB1 via MAGL or FAAH inhibition are usually proposed. Additionally, the CB1 activation may be associated with weight gain [77], inflammation [201], and erectile dysfunctions [320]. Secondly, the CB1 inverse agonism affects in depression, anxiety [10], and nausea [308]. ...
Article
Full-text available
The endocannabinoid system (ECS) is one of the most crucial systems in the human organism, exhibiting multi-purpose regulatory character. It is engaged in a vast array of physiological processes, including nociception, mood regulation, cognitive functions, neurogenesis and neuroprotection, appetite, lipid metabolism, as well as cell growth and proliferation. Thus, ECS proteins, including cannabinoid receptors and their endogenous ligands’ synthesizing and degrading enzymes, are promising therapeutic targets. Their modulation has been employed in or extensively studied as a treatment of multiple diseases. However, due to a complex nature of ECS and its crosstalk with other biological systems, the development of novel drugs turned out to be a challenging task. In this review, we summarize potential therapeutic applications for ECS-targeting drugs, especially focusing on promising synthetic compounds and preclinical studies. We put emphasis on modulation of specific proteins of ECS in different pathophysiological areas. In addition, we stress possible difficulties and risks and highlight proposed solutions. By presenting this review, we point out information pivotal in the spotlight of ECS-targeting drug design, as well as provide an overview of the current state of knowledge on ECS-related pharmacodynamics and show possible directions for needed research.
... Finally, when cannabis is used during pregnancy, it has been reported to be associated with harmful effects on fetal development and reduction in birth weight (Fried, 1993). Moreover, there has been limited emerging evidence that cannabis use may be associated with erectile dysfunction (ED) (Shamloul & Bella, 2011). There are two main mechanisms hypothesized to explain this link: a central pathway via the hypothalamus and a peripheral pathway on the corpus cavernosum (Argiolas & Melis, 2005;Gratzke et al., 2010). ...
... In fact, as well as being the first systematic review and meta-analysis on this topic, this study has considered objective validated tools to asses ED. This study is focused on two emerging conditions that represent an important public health concern: ED which is one of the most common worldwide male sexual disorders and is projected to affect 322 million men in 2025 (Shamloul et al., 2011) and cannabis use, which estimates suggest between 2.7% to 4.9% of the population have at least tried (Anthony et al., 2017). ...
Article
Full-text available
Globally, there is increasing usage and legalization of cannabis. In addition to its reported therapeutic effects, cannabis has several health risks which are not clearly defined. Erectile dysfunction (ED) is the most common male sexual disorder and there are plausible mechanisms linking cannabis use to ED. No attempt has been made to collate the literature on this topic. The aim of this review was to summarize the prevalence and risk of ED in cannabis users compared to controls. A systematic review of major databases from inception to January 1, 2019, without language restriction, was undertaken to identify studies investigating cannabis use and presence of ED. The analysis compared the prevalence of ED in cannabis users versus controls. Consequently, the odds ratio (OR) with 95% confidence intervals (CI) was calculated, applying a random-effect model. Five case–control studies were included with data from 3,395 healthy men, 1,035 using cannabis (smoking) and 2,360 nonusers. The overall prevalence of ED in cannabis users was 69.1% (95% CI: 38.0–89.1), whilst the correspondent figure in controls was 34.7% (95% CI: 20.3–52.7). The OR of ED in cannabis users was almost four times that of controls (OR = 3.83; 95% CI: 1.30–11.28; p = .02), even if characterized by high heterogeneity ( I ² = 90%) and the prediction intervals overlapped 1.00 (95% CI: 0.35–7.26). Data suggest that ED is twice as high in cannabis users compared to controls. Future longitudinal research is needed to confirm/refute this and explore if a dose–response relationship between cannabis and ED may be evident.
... Kannabis kullanımının insan cinsel işlevi üzerindeki etkileri kullanım süresine bağlı olarak farklılık göstermektedir. Literatürde akut kullanımın libidoyu artırabileceği ancak kronik kullanımın erektil disfonksiyona neden olabileceği bildirilmektedir (93)(94)(95)(96). Yapılan bir çalışmada, kannabis kullanan bireylerde hiç kullanmayanlara kıyasla daha düşük TSH (tiroid uyarıcı hormon) seviyeleri ile daha düşük tiroid peroksidaz antikorlarına sahip oldukları bulunmuştur (97). ...
Article
Kannabis (esrar), günümüzde dünya çapında yaygın olarak tüketilen ve sıklıkla suistimal edilen bir maddedir. Vücuda alındıktan kısa bir süre sonra içeriğinde bulunan Tetrahidrokanabinol (THC)'un kullanıcıda keyif, gevşeme ve algıda değişiklikler gibi etkilere neden olduğu bilinmektedir. Kannabis kullanımı ve bunun beraberinde getirdiği sorunlar, dünya genelinde ve ülkemizde hızla artış göstermektedir. Bu durum, sosyal, ekonomik ve sağlık alanlarında ciddi problemler yaratmaktadır. Kannabis bağımlılığı, bireylerin yaşam kalitesini düşürmekle kalmayıp, aile yapısını zedelemekte ve toplumun genel refahını olumsuz etkilemektedir. Ekonomik açıdan, bu mücadele ve tedavi süreçleri büyük maliyetler oluşturmakta, iş gücü kaybına neden olmaktadır. Sağlık açısından ise, çeşitli fiziksel ve psikolojik problemlere yol açmaktadır. Kannabis kullanımının engellenmesi ülkemizin refahı ve geleceğimizin sağlığı için oldukça önemli bir konudur. Bu nedenle; kannabisin iyi tanınması, farmakolojik özellikleri ve kullanıcılarda oluşturduğu etkilerinin iyi bilinmesi gerekir. Bu derlemede, kannabis kullanımı, kannabisin farmakolojik özellikleri ve kullanıcıda oluşturduğu etkiler hakkında genel bilgilere yer verilmiştir. Bu bilgilerin toplum sağlığını koruma ve kannabis kullanımını azaltma hedeflerine yönelik akademik çalışmalara önemli katkılar sağlayabileceği düşünülmektedir.
... En esta línea, Smith et al. [17] también hallaron que los consumidores diarios de cannabis tenían más dificultades para alcanzar el orgasmo. En relación con la función eréctil, los resultados de los estudios son contradictorios, encontrándose en algunos estudios que el cannabis tiene efectos beneficiosos en la función eréctil [18]. Esto podría deberse a que los efectos del cannabis sobre la función eréctil dependen de la dosis [19] y del tiempo de consumo [9]. ...
Article
Full-text available
Substance use affects different areas of life, including the sexual sphere. Drugs and specifically the use of alcohol and cannabis, can influence sexual experience. However, there has been little research and to date none has been carried out in Spain that compares the effect of alcohol and cannabis consumption in the same people on their sexual experience. Therefore, the objective of the study was to analyze and compare the effect of alcohol and cannabis in the same people on their sexual experience. The sample consisted of 483 people who had ever consumed alcohol and cannabis. Participants answered an online questionnaire about alcohol and cannabis use and sexual experience. The results show that despite the fact that when people consume alcohol, they feel more attractive, they feel more attraction towards other people, they are more extroverted, their desire increases and they have longer sexual relations than when they consume cannabis, people who frequently consume when consume cannabis, they have more sensitivity and they are more sexually satisfied than when they consume alcohol. Regarding the sexual experience, although they prefer not to use drugs when they have sex, people who frequently consume prefer to consume more cannabis than alcohol. Therefore, it is concluded that, although alcohol facilitates the sexual encounter, with cannabis people feel more sexually satisfied.
... Female anorgasmia, another sexual disorder, involves marked delay, infrequency, or absence of orgasm and is recognized as the second most common sexual dysfunction in women (Adam et al. 2015). Erectile dysfunction is a prevalent male sexual disorder characterized by the difficulty in achieving or maintaining an erection sufficient for sexual intercourse (Shamloul and Bella 2011). These sexual dysfunctions can impact sexual satisfaction and overall sexual experiences, highlighting the complex interplay between desire, arousal, pain, and orgasm in individuals' sexual lives. ...
Article
Full-text available
Rationale Sexuality is a central aspect of being human that encompasses many facets. Cannabis, a widely used psychoactive substance, has been associated with various effects on sexuality. The relationship between cannabis and sexuality is complex and multifaceted, involving physiological, psychological, and social factors. Objectives This review aims to provide an overview of the current literature on the effects of cannabis on several sexual functions, including sexual desire, arousal, orgasm, and sexual satisfaction. It also discusses the potential mechanisms underlying these effects, as well as the impact of dose and frequency of use. Results This review has revealed a complex relationship between cannabis dosage and its influence on sexuality. It appears that the frequency of cannabis use in humans has been associated with the frequency of sexual activities. Individuals who use cannabis more frequently tend to report higher levels of sexual activity. Moreover, there is a notable gender difference in how cannabis affects sexuality. In addition, we found lower doses of cannabis to be linked to heightened sexual desire and enjoyment, whereas higher doses may lead to a decrease in sexual desire and performance. Conclusions Overall, the association between cannabis and sexuality is complex and warrants further research to better understand the psychological and neurological mechanisms that underlie the effect of cannabis on these sexuality functions and its implications for sexual health. To advance in this endeavor, a crucial step is establishing a precise measurement of dosage in human studies.
... These substances make it difficult for the users to evaluate who they should have sexual intercourse with, thus making sexual intercourse while intoxicated inevitable. Similar findings have been reported by Shamloul and Bella [61]. Although khat has not yet been linked to impairment of rational decision making [62], it is a known stimulant associated with increased energy levels, alertness [62], and user perceived benefits (such as, improved self-esteem and sexual performance). ...
Article
Full-text available
Background The use of psychoactive substances such as alcohol, heroin and marijuana is associated with negative health outcomes such as sexual violence and unintended pregnancies, and risky sexual behaviours. Although there is evidence linking psychoactive substance use and risky sexual behaviours such as inconsistent condom use and multiple sexual relationships, there is limited data on sex under the influence of psychoactive substances among young people. This study aimed to investigate the prevalence and predictors of sex under the influence of psychoactive substances among young people in informal settlements in Kampala, Uganda. Methods A cross-sectional study was conducted among 744 sexually active young psychoactive substance users in informal settlements in Kampala, Uganda. Data were collected through face-to-face interviews using a digitalized structured questionnaire, preloaded on the Kobocollect mobile application. The questionnaire captured data on the socio-demographic characteristics of the respondents, history of psychoactive substance use, and sexual behaviours. Data were analysed using STATA Version 14.0. A modified Poisson regression model was used to determine the predictors of sex under the influence of psychoactive substances.. Adjusted prevalence ratios at a p-value value ≤ 0.05 with a 95% confidence interval were considered. Results About 61.0% (454/744) of the respondents had had sex under the influence of psychoactive substances in the last 30 days. The predictors of sex under the influence of psychoactive substances were being female (PR 1.18, 95% CI: 1.04–1.34), being 20–24 years of age (PR: 1.22, 95% CI: 1.04–1.44), being married (PR 1.15, 95% CI: 1.01–1.31) or divorced/separated (PR 1.43, 95% CI: 1.26–1.61), not living with biological parents or guardians (PR 1.22, 95% CI: 0.99–1.50), earning 71 USD and below (PR 0.86, 95% CI: 0.79–1.03) and using alcohol (PR 1.43, 95% CI: 1.25–1.69), marijuana (PR 1.16, 95% CI: 1.02–1.31) and khat (PR 1.25, 95% CI: 1.10–1.42) in the last 30 days. Conclusion The study found that a high proportion of sexually active young people in informal settlements in Kampala, Uganda had engaged in sex under the influence of psychoactive substances in the past 30 days. The study also identified several factors associated with sex under the influence of psychoactive substances, including being female, being aged 20–24 years, being married or divorced or separated, not living with biological parents or guardians, and using alcohol, marijuana, or khat in the past 30 days. Our findings suggest the need for targeted sexual and reproductive health programs that incorporate risk-reduction interventions aimed at reducing sex under the influence of psychoactive substances, especially among females and those who do not live with their parents.
... This hormone activates Leydig cells in the seminiferous channels, stimulating testosterone release [58]. Although the effects of the drug are credited with improving some aspects of the subjective experience of sexual activity, there is evidence that suggests that marijuana may, in a dose-dependent manner, contribute to erectile dysfunction by activating receptors in the cavernous tissue that are antagonistic to penile erection [94,95]. ...
Article
Full-text available
Several studies show that chronic marijuana use opens doors to several disorders, especially neuropsychiatric disorders. Others consider cannabinoids to be promising in therapeutic practice. Here, we present a literature review, based on selected publications on the Medline and Scielo databases, on health and cannabis use. This review aims to assist health professionals and students in understanding the growing number of marijuana users who look for help in outpatient clinics and offices. Therefore, there is an increase in the frequency of hospital admissions for psychotic disorders in clinics and specific treatment institutions. Research over the past 35 years has shown that marijuana use promotes only momentary anxiolysis. This drug alone or in combination with cigarette, when consumed for a long term, can deteriorate the user’s intellectual capacity, academic performance, and professional achievements and finally results in social isolation. The current situation demonstrates that cannabis usage is a public health issue that needs to be addressed in health policy because the majority of users get sick and lose their ability to work.
... These substances make it di cult for the users to evaluate who they should have sexual intercourse with thereby making engagement in sexual intercourse while under the in uence of psychoactive substances inevitable. Similar ndings have been reported elsewhere (49). Although khat has not yet been linked to impairment of rational decision making (50), it is a known stimulant associated with increased energy levels, alertness (50), and user perceived bene ts (such as, improved self-esteem and sexual performance). ...
Preprint
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Background Psychoactive substance use has an impact on risky sexual behaviour. Globaly, over 275 million people use psychoactive substances, however evidence on the predictors of sex under the influence of these substatnces is scanty. We investigated the prevalence and predictors of sex under the influence of psychoactive substances among young people aged 18–24 years. Methods A cross-sectional study was conducted among 744 sexually active young psychoactive substance users living in informal settlements in Kampala, Uganda. Data were collected through face-to-face interviews using a digitalized structured questionnaire preloaded on Kobocollect. The questionnaire captured data on the socio-demographic characteristics of the respondents, history of psychoactive substance use, and sexual behaviours. Data were analysed using STATA Version 14.0. A modified Poisson regression model was used to determine the factors associated with the outcome variable. Adjusted prevalence ratios at a p-value value ≤ 0.05 with a 95% confidence interval were considered. Results About 61.0% (454/744) of the respondents had sex under the influence of psychoactive substances in the last 30 days. The predictors of sex under the influence of psychoactive substances were being female (PR 1.18, 95% CI: 1.04–1.34), being 20–24 years of age (PR: 1.22, 95% CI: 1.04–1.44), being married (PR 1.15, 95% CI: 1.01–1.31) or divorced/separated (PR 1.43, 95% CI: 1.26–1.61), not living with biological parents or guardians (PR 1.22, 95% CI: 0.99–1.50), earning 71 USD and below (PR 0.86, 95% CI: 0.79–1.03) and using alcohol (PR 1.43, 95% CI: 1.25–1.69), marijuana (PR 1.16, 95% CI: 1.02–1.31) and khat (PR 1.25, 95% CI: 1.10–1.42) in the last 30 days. Conclusion This study revealed a high prevalence of sex under the influence of psychoactive substances among young people in informal settlements in Kampala, Uganda. The predictors of sex under the influence of psychoactive substances were being female, being 20–24 years of age, being married or divorced/separated, not living with biological parents or guardians, and using alcohol, marijuana and khat in the last 30 days. There is a need for sexual and reproductive health programs to incorporate risk reduction interventions that aim to reduce sex under the influence of psychoactive substances among the said categories in informal settlements.
... These substances make it di cult for the users to evaluate who they should have sexual intercourse with thereby making engagement in sexual intercourse while under the in uence of psychoactive substances inevitable. Similar ndings have been reported elsewhere (49). Although khat has not yet been linked to impairment of rational decision making (50), it is a known stimulant associated with increased energy levels, alertness (50), and user perceived bene ts (such as, improved self-esteem and sexual performance). ...
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Background Psychoactive substance use has an impact on risky sexual behaviour. Globaly, over 275 million people use psychoactive substances, however evidence on the predictors of sex under the influence of these substatnces is scanty. We investigated the prevalence and predictors of sex under the influence of psychoactive substances among young people aged 18-24 years. Methods A cross-sectional study was conducted among 744 sexually active young psychoactive substance users living in informal settlements in Kampala, Uganda. Data were collected through face-to-face interviews using a digitalized structured questionnaire preloaded on Kobocollect. The questionnaire captured data on the socio-demographic characteristics of the respondents, history of psychoactive substance use, and sexual behaviours. Data were analysed using STATA Version 14.0. A modified Poisson regression model was used to determine the factors associated with the outcome variable. Adjusted prevalence ratios at a p-value value ≤ 0.05 with a 95% confidence interval were considered. Results About 61.0% (454/744) of the respondents had sex under the influence of psychoactive substances in the last 30 days. The predictors of sex under the influence of psychoactive substances were being female (PR 1.18, 95% CI: 1.04-1.34), being 20-24 years of age (PR: 1.22, 95% CI: 1.04-1.44), being married (PR 1.15, 95% CI: 1.01-1.31) or divorced/separated (PR 1.43, 95% CI: 1.26-1.61), not living with biological parents or guardians (PR 1.22, 95% CI: 0.99-1.50), earning 71 USD and below (PR 0.86, 95% CI: 0.79-1.03) and using alcohol (PR 1.43, 95% CI: 1.25-1.69), marijuana (PR 1.16, 95% CI: 1.02-1.31) and khat (PR 1.25, 95% CI: 1.10-1.42) in the last 30 days. Conclusion This study revealed a high prevalence of sex under the influence of psychoactive substances among young people in informal settlements in Kampala, Uganda. The predictors of sex under the influence of psychoactive substances were being female, being 20-24 years of age, being married or divorced/separated, not living with biological parents or guardians, and using alcohol, marijuana and khat in the last 30 days. There is a need for sexual and reproductive health programs to incorporate risk reduction interventions that aim to reduce sex under the influence of psychoactive substances among the said categories in informal settlements.
... These substances make it di cult for the users to evaluate who they should have sexual intercourse with thereby making engagement in sexual intercourse while under the in uence of psychoactive substances inevitable. Similar ndings have been reported elsewhere (49). Although khat has not yet been linked to impairment of rational decision making (50), it is a known stimulant associated with increased energy levels, alertness (50), and user perceived bene ts (such as, improved self-esteem and sexual performance). ...
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Background Psychoactive substance use has an impact on risky sexual behaviour. Globaly, over 275 million people use psychoactive substances, however evidence on the predictors of sex under the influence of these substatnces is scanty. We investigated the prevalence and predictors of sex under the influence of psychoactive substances among young people aged 18-24 years. Methods A cross-sectional study was conducted among 744 sexually active young psychoactive substance users living in informal settlements in Kampala, Uganda. Data were collected through face-to-face interviews using a digitalized structured questionnaire preloaded on Kobocollect. The questionnaire captured data on the socio-demographic characteristics of the respondents, history of psychoactive substance use, and sexual behaviours. Data were analysed using STATA Version 14.0. A modified Poisson regression model was used to determine the factors associated with the outcome variable. Adjusted prevalence ratios at a p-value value ≤ 0.05 with a 95% confidence interval were considered. Results About 61.0% (454/744) of the respondents had sex under the influence of psychoactive substances in the last 30 days. The predictors of sex under the influence of psychoactive substances were being female (PR 1.18, 95% CI: 1.04-1.34), being 20-24 years of age (PR: 1.22, 95% CI: 1.04-1.44), being married (PR 1.15, 95% CI: 1.01-1.31) or divorced/separated (PR 1.43, 95% CI: 1.26-1.61), not living with biological parents or guardians (PR 1.22, 95% CI: 0.99-1.50), earning 71 USD and below (PR 0.86, 95% CI: 0.79-1.03) and using alcohol (PR 1.43, 95% CI: 1.25-1.69), marijuana (PR 1.16, 95% CI: 1.02-1.31) and khat (PR 1.25, 95% CI: 1.10-1.42) in the last 30 days. Conclusion This study revealed a high prevalence of sex under the influence of psychoactive substances among young people in informal settlements in Kampala, Uganda. The predictors of sex under the influence of psychoactive substances were being female, being 20-24 years of age, being married or divorced/separated, not living with biological parents or guardians, and using alcohol, marijuana and khat in the last 30 days. There is a need for sexual and reproductive health programs to incorporate risk reduction interventions that aim to reduce sex under the influence of psychoactive substances among the said categories in informal settlements.
... Forty percent of our patients reported improved mood, and 72% reported improvement in sleep. In the available literature, there are contradicting results about the influence of cannabis on sexual function, with some articles indicating improvement [45,46] and others highlighting hazardous effects like erectile dysfunction in men [47][48][49]. In our study, 39% of patients reported that cannabis contributed to improvement in sexual function (desire/libido, erection), which may be in part due to mood improvement. ...
Article
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Objectives: Assessing the effectiveness and tolerability of medical cannabis (MC) treatment on Gilles de la Tourette syndrome (GTS) patients. Methods: We report on an open-label, prospective study on the effect of MC on adult GTS patients. MC mode of use was decided by the treating neurologist and the patient. Δ9-Tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD) content within MC product and monthly dose were titrated during the study. Following treatment initiation, patients were assessed after 4 and 12 weeks for efficacy, tolerability, and side effects. Results: Eighteen patients entered the study. Baseline Yale Global Tic Severity Scale- (YGTSS) Total (range 0-100) was 60.3 ± 17.1. Three patients did not reach the end of follow-up period. The most common mode of administration was smoking (80%). Following twelve weeks of treatment, a significant 38% average reduction (p = 0.002) of YGTSS-Total and a 20% reduction (p = 0.043) of Premonitory Urge for Tic Scale (PUTS) were observed. Common side effects were dry mouth (66.7%), fatigue (53.3%), and dizziness (46.7%). Three patients suffered from psychiatric side effects including worsening of obsessive compulsive disorder (stopped treatment), panic attack, and anxiety (resolved with treatment modification). Six patients (40%) reported cognitive side effects regarding time perception, visuospatial disorientation, confusion, slow processing speed, and attention. Conclusions: MC treatment demonstrates good efficacy and tolerability in adult GTS patients. Predilection for smoking rather than using oil drops requires further comparative studies to evaluate the efficacy of each. Cognitive and psychiatric side effects have to be monitored and addressed.
... These high-risk attitudes are frequently associated with increased relaxation, euphoria, disinhibition, decreased self-control, and decreased risk perception caused by psychoactive substances, which cause users to be less cautious and to forget the importance of safe sex [32]. It should also be noted that for the large number of younger populations, alcohol and tobacco consumption is closely related to night-time recreational environments, which are a key element for socialization and where the consumption of different substances can lead to altered decision-making regarding sexual relations, associated with an increase in the likelihood of engaging in risky sexual behaviours [31][32][33]. ...
Article
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The consumption of cannabis and alcohol results in a variety of effects on the psychic functions of young users. Notwithstanding their widespread and prevalent use, the impact of these drugs on sexual health remains unknown. Thus, the aim of this study is to analyse the influence of alcohol and cannabis consumption on sexual function in young people. An observational study was conducted in 274 participants aged 18-30 years. The following selection tools were used: Alcohol Use Disorders Identification Test, Cannabis Abuse Screening Test (CAST), and Changes in Sexual Functioning Questionnaire Short-Form. Participants who were at high risk of having cannabis-related problems performed better on the CAST concerning sexual function, arousal, and orgasm. Participants at high risk had higher arousal and orgasm scores than those who were not at risk for cannabis problems. Improvements in sexual function were found between people who were at high risk of having alcohol problems and those who were not at risk. Sexual function in young people who use cannabis and alcohol more frequently was shown to be better than in those who do not use either, highlighting the need for more information aimed at the young population.
... These effects are not only limited to smoking tobacco but also chronic use of other substances such as dipping or chewing tobacco and cannabis have shown a dose-dependent effect on sperm parameters (Gundersen et al., 2015;Pacey et al., 2014;P€ arn et al., 2015;Said et al., 2005). Though low doses of cannabis have been reported to enhance sexual arousal; chronic use of cannabis is involved in erectile dysfunction and reducing sexual orgasm (Shamloul & Bella, 2011;Sun & Eisenberg, 2017). ...
Article
Substances such as tobacco and cannabis can negatively modulate seminal parameters and sex hormones and lead to fertility problems in males. The present study aimed to determine the effect of cigarettes, dipping tobacco, and cannabis on semen parameters and sex hormones in infertile males. A total of 160 infertile healthy participants (cigarette smokers n = 40, dipping tobacco users n = 40, cannabis users n = 40 and infertile controls n = 40) were included in the study. Fasting blood samples were collected from all the participants using the aseptic technique, and semen samples were collected by masturbation following sexual abstinence of 2–7 days. The levels of serum testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were determined using ELISA. The serum level of FSH was significantly higher in cannabis users relative to the control group (p = 0.043). A mild non-significant decrease in sperm count, serum LH and testosterone levels were observed in all drug users compared to controls. In conclusion, chronic use of tobacco and cannabis mildly modulates semen and hormonal parameters in infertile males.
... 6 With studies suggesting potential adverse effects on erectile function, the impact of cannabis on ED requires further investigation. 5,6,8 An explanation for the paradox between the reported enhancement in sexual experience and impairment in erectile function with cannabis use may be attributed to the ubiquity of endocannabinoid receptors, cannabinoid receptor type 1 (CB 1 ) and type 2 (CB 2 ), throughout the body. Cannabinoids, such as cannabidiol and THC, modulate the activity of dopaminergic and oxytocinergic neurons via brain CB 1 receptors involved in the regulation of pleasure responses and sexual arousal. ...
Article
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Introduction The link between cannabis use and erectile dysfunction remains unclear. Moreover, the effect of cannabis in tandem with current Western dietary habits is an area in male sexual health that has yet to be explored. This study seeks to investigate the impact of diet and cannabis on penile health in an animal model. Aim To determine the effects of diet and oral cannabis extract on fibrosis and oxidative stress within the corpora cavernosa of mice. Methods This is a pilot animal study in which groups of 2-month old C57BL/6J male mice were fed a normal chow diet (NCD) or high-fat diet (HFD) daily and treated with or without either MJ or THC extract for 2 months. After euthanization, mouse penises were isolated and processed for immunohistochemical studies to determine: (i) smooth muscle cell to collagen content, (ii) myofibroblast proliferation, and (iii) anti-oxidative activity. Main Outcome Measures Quantitative assessment of immunohistochemical markers of fibrosis and oxidative stress within the corpora cavernosa of mice fed a high-fat diet in combination with either oral marijuana (MJ) or Δ-9-tetrahydrocannabinol extract (THC). Results The combination of HFD with MJ resulted in: (i) a decrease in the smooth/collagen ratio in the corpora cavernosa, (ii) an increase in alpha-smooth muscle actin expression in the tunica albuginea compatible with myofibroblast proliferation, and (iii) a decrease in heme oxygenase 1 expression indicating an increase in oxidative stress. Significant histological changes were not observed in the HFD + THC group. Conclusions HFD combined with oral MJ extract led to structural alterations in erectile tissue that are associated with accelerated corporal fibrosis. However, the addition of THC to the diet did not exacerbate histological changes within the corpora. Further studies are warranted to elucidate the discrepant effects between MJ and THC in order to optimize the therapeutic potential of cannabis and minimize its adverse effects on penile health. S Nguyen, M Mangubat, S Eleswarapu, et al. The Combination of High-Fat Diet and Oral Marijuana Promotes the Development of Fibrosis in the Mouse Corpora Cavernosa. Sex Med 2021;XX:XXX–XXX
... 8 In addition, it seems that cannabis may impair erectile function in animal and in vitro studies. 9 In a community survey evaluating the sexual dysfunction and drug abuse, painful sex and inhibited orgasm were associated with marijuana use. 10 However, most studies are focusing on evaluating sexual dysfunctions in drug abusers, and no data are available about screening drug abuse in patients with sexual dysfunction especially PE. Therefore, this cross-sectional study was designed to assess the pattern of drug abuse in patients with lifelong PE; in addition, to identify the relationship between drug abuse and PE severity and to evaluate the impact of drug abuse on the hormonal profile in PE patients. ...
Article
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Introduction: Most studies investigate sexual dysfunction in drug abusers; however, there are no data available about the pattern of drug abuse in patients with lifelong premature ejaculation (PE). Aim: To assess the pattern of drug abuse in patients with lifelong PE and to evaluate its potential effect on their hormonal profile. Methods: A cross-sectional study included patients with lifelong PE (n = 76) with no prescribed medications for 1 month and age-matched control without PE (n = 48). Participants were evaluated by history, examination, Arabic index of PE, and hormonal profile. A urine sample was screened by dipstick kits for the following drug abuse tramadol, opiate, tetrahydrocannabinol (cannabis), amphetamine, barbiturate, cocaine, and benzodiazepines. Positive results were confirmed with a immunoassay drug analyzer. Main outcome measures: The outcomes of this study are positive and negative drug abuse and hormonal profile changes. Results: Control patients and patients with PE showed median (interquartile range) of age 43 (33-46.8) and 38.5 (31-45) years, respectively. Drug abuse testing results showed significantly high positive drug abuse in patients with PE, 26 of 76 (34.2%), in comparison with control, 9 of 48 (19.1%) (P = .05). The most commonly abused drug was tetrahydrocannabinol in control, 3 of 9 (33.3%), and tramadol, 12 of 26 (46.2%), in patients with PE. Control patients and patients with PE with positive drug abuse had significantly higher smoking percent (P < .0001) and higher positive drug abuse history (P < .0001). However, there was no relationship between drug abuse and PE severity, and there were no significant changes in their hormonal profile. Conclusions: Drug abuse is high among patients with lifelong PE in Upper Egypt, with tramadol being the comment drug. Drug abuse is common among smokers. However, no hormonal disturbance could be shown in drug abuse patients. Drug abuse might be considered in the evaluation of patients with PE. Mohammed SA, Abdelhamed A, El Sayed RM. Evaluation of Drug Abuse in Patients With Lifelong Premature Ejaculation: A Cross-Sectional Study. Sex Med 2020;XX:XXX-XXX.
... including increased sensitivity, sexual satisfaction, and orgasm strength, involve altered perception of the sexual encounter and activation of cannabinoid receptors in the central nervous system. 21 Indeed, a study of noncopulating male rats demonstrated that pharmacologic activation of the central nervous system's endocannabinoid network resulted in sexual behavior in 50% of the population. 22 In humans, a study using functional magnetic resonance imaging revealed that cannabis intoxication modulates the response of the right nucleus accumbens to visual erotic stimuli. ...
Article
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Introduction: Cannabis is the most commonly used drug in the United States; however, the effects of cannabis use on male sexual function are poorly understood. Aim: To characterize the contemporary landscape of cannabis use and to assess the associations between male sexual function and the frequency of use, the primary method of consumption, or cannabis chemovar (tetrahydrocannabinol or cannabidiol) among current users. Methods: We surveyed adults who visited a single cannabis dispensary for baseline demographic information, medical history, cannabis use habits, and sexual function as assessed by the International Index of Erectile Function (IIEF). An IIEF-5 < 21 was considered erectile dysfunction. Main outcome measures: The main outcome measure of the study was male sexual function via the IIEF domain scores. Results: A total of 325 men completed the survey with a mean age of 46.7 years. 71.1% of the men were Caucasian and 52.6% were married. 13 men (4%) were never users; 29 men (8.9%) used 1-2 times/week; 51 men (15.7%) used 3-5 times/week, and 232 men (71.4%) used 6+ times/week. The average IIEF-5 score was 22.3 with 19.4% of the men having erectile dysfunction. In univariate analysis, men using cannabis more frequently had a higher overall IIEF (65.36 vs 60.52, P = .001), erectile domain (27.32 vs 25.74, P = .03), orgasm domain (9.08 vs 8.12, P < .001), intercourse satisfaction domain (12.42 vs 11.31, P = .006), and overall satisfaction domain (8.11 vs 7.05, P = .002). In multivariable analysis, compared to men who used cannabis 0 times/week, those who used 6 times/week had an increased overall IIEF (69.08 vs 64.64, P-value adjusted = 0.02), intercourse satisfaction domain (P-value adjusted = 0.04), and overall satisfaction domain (P-value adjusted = 0.02). The primary method of consumption (eg, smoking, edibles, etc.) and cannabinoid composition (eg, cannabidiol vs tetrahydrocannabinol dominant) were not associated with sexual function. Conclusion: We report an association between the increased frequency of cannabis use and increased male sexual function. However, while the increased frequency of use was statistically significant with regard to the IIEF scores, the clinical significance of this is likely low, and selection bias may limit the generalizability of these findings. The method of consumption and cannabis chemovar were not associated with sexual function. Bhambhvani HP, Kasman AM, Wilson-King G, et al. A Survey Exploring the Relationship Between Cannabis Use Characteristics and Sexual Function in Men. J Sex Med 2020;8:436-445.
... About 60% to 95% of people in Africa use aphrodisiacs as traditional complementary medicine especially for primary health care needs (Miller, 1985;van Andel, Mitchell, et al., 2012;WHO, 2003;WHO, 2019) that are sex related (Mataure et al., 2002). Today across the world, medications such as Viagra and Cialis and drugs/illicit medicines 1 /herbs such as tramadol, cannabis, cocaine, and opiates are among some of the substances used (Shamloul & Bella, 2011). ...
Article
Indigenous peoples’ knowledge of and expertise in herbal remedies is not new. Although studies have emphasized use of herbal medicine in Africa, it remains unclear how gender impacts the uptake of herbal remedies as aphrodisiac-therapeutic types. Using qualitative data from urban Ghana, this article examines how cultural expectations of male sexuality in intimate heterosexual relationships influence the marketing and patronage of local aphrodisiacs, that is, herbal bitters in the West African context. Analysis reveals links with how men talk about notions of manhood and experiences of herbal bitters, including issues related to insecurities about hegemonic masculine ideals and women’s power. Although dominant masculinity has been associated with practices that allow men’s control over women, it also functions to harm men’s sexuality. Harm reduction requires behavioral modification and sexual and reproductive health and rights education program via media advocacy. A call to scale-up research, policy development, and implementation in regard to the production, advertisements, and patronage of local aphrodisiacs especially in countries in Africa where the phenomenon has risen to problematic levels is sine qua non to this approach.
... Women with diabetes mellitus may face decreased sexual desire, inability to reach orgasm, and difficulty in obtaining vaginal lubrication; however, studies could not find any correlation of sexual functioning in women with duration of diabetes, age, or insulin use. 21 Cerebrovascular accidents or stroke: A stroke may cause dysfunction in the autonomic system which may lead to poststroke sexual dysfunction. It is estimated that about 20% to 75% of people having stroke have sexual dysfunction. ...
Article
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There is a substantial increase in the total geriatric population worldwide. This change in demography calls for a greater, deeper, and thorough understanding of elderly and age-related issues. Even though sexuality is a basic and vital driving force, human sexuality, especially elderly sexuality, is frequently misunderstood. Many myths and misconceptions regarding elderly sexuality exist which need attention. Contrary to the popular belief, studies reveal that sexual life continues to be an important aspect in later life and is often viewed by elderly as an expression of love, passion, affection, admiration, and loyalty. Various factors play a role in elderly sexuality including that of bio-psycho-social factors, changes in the body, presence of comorbid conditions along with sexual disorders. Sexual disorders, if present, should be treated and addressed adequately.
... This may lead to lower semen volume and sperm motility and morphological alterations [7]. On the other hand, cannabis, although it raises sexual desire, may hamper erectile function [8]. In fact, cannabis interferes with endothelial nitric oxide release, leading to vascular alterations in the absence of other risk factors [9]. ...
Article
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Recent epidemiological studies suggest an increase of sexual and reproductive chronic diseases caused by problematic behaviours acquired during peri-pubertal age. The aims of our study were: (i) to investigate awareness of sexual transmitted infections (STIs) among adolescents; (ii) to describe the close relationship between possibly incorrect lifestyles during adolescence and reproductive and sexual disturbances during adulthood. The “Amico-Andrologo” survey is a permanent nationwide surveillance program supported by the Italian Ministry of Health. We administered a validated structured interview to investigate the lifestyle of adolescents and their knowledge of STIs. We selected a cohort of 360 male high-school students aged ≥18 years old. In this cohort, 150 (41.5%) were smokers while 59 (19.7%) smoked more than 10 cigarettes/day; 25 (9.3%) declared a consumption ≥6 drinks/weekend; and 65 (19.7%) were habitual cannabis consumers (at least twice/week). Among the sample of students selected, the main sources of sexual disease information were the internet and friends. The perceived level of knowledge on STIs was the same between students that used contraceptive methods and students that did not. The present results demonstrate that adolescents in Calabria do not receive appropriate information about risky health behaviours. Therefore, there is a necessity for specific educational programs to increase awareness of dangerous behaviours during the transitional age that is relevant for a safe sexual and reproductive adult life.
... Few studies outlined the beneficial effects of cannabis in enhancing erectile function while others contradict the result. [54] Crohn's disease and ulcerative colitis are two major chronic disorders of gastrointestinal tract forms of inflammatory bowel diseases (IBD). Anandamide and 2-arachidonoylglycerol are endogenous bioactive lipids that bind to and activate the cannabinoid receptors, and together with the enzymes responsible for their biosynthesis and degradation [fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL)] constitute the endocannabinoid system (ECS). ...
Article
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Bhanga (Cannabis sativa L.),Cannabinaceae family, an annual herbaceous plant, has been used since millennia as a source of medicine, industrial fibre, seed oil, food,recreation, religious and spiritual moods. This fast-growing plant has recently seen a resurgence of interest because of its wide applications. Ayurveda, the science of life, describing many of the formulation about the pharmaco-clinical application of Bhanga but many of these formulations are not in practice today. Indeed; it is a treasure trove of multi-variant Guna (qualities) and Karma (actions), making it a broad spectrum drug. In this review, the rich spectrum of cannabis is being discussed by putting a special emphasis on the formulations containing cannabis either as a major or a minor ingredient. Available 41 Rasagranthas and 26 Chikitsagrantha and other Ayurvedic treatises were referred with respect to Bhanga’s Adhikara (main indication), Kalpana (dosage forms), Anupana (vehicle), Aushadha Sevana Kala (time and period of administration),Pathya- Apathya(do’s and dont’s),Prayojyanaga (parts used), Karma (action), specific uses and instructions of the formulations. It is observed that, there are 210 formulations which contain Bhanga, out of which 193 are recommended for internal administration and 17 for external applications. Among the formulations indicated for internal administration, 102 contain Bhanga as one of the major ingredient, whereas in 91 formulations, it’s a minor ingredient. Nine formulations of external application are having Bhanga as major ingredient and 8 as minor ingredient.The review represents formulations being indicatedof 45 differentRoga- Adhikara, 22 Kalpana,18 Pathya- Apathya, five different parts used, 49 Karma (action) and few benefits and instruction to be followed during administration of formulations containing Bhanga. Keywords: Ayurveda, Bhanga, Cannabis sativa, Kalpana, Anupana, Matra, Shodhana
... Few studies outlined the beneficial effects of cannabis in enhancing erectile function while others contradict the result. [54] Crohn's disease and ulcerative colitis are two major chronic disorders of gastrointestinal tract forms of inflammatory bowel diseases (IBD). Anandamide and 2-arachidonoylglycerol are endogenous bioactive lipids that bind to and activate the cannabinoid receptors, and together with the enzymes responsible for their biosynthesis and degradation [fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL)] constitute the endocannabinoid system (ECS). ...
Article
Full-text available
Bhanga (Cannabis sativa L.),Cannabinaceae family, an annual herbaceous plant, has been used since millennia as a source of medicine, industrial fibre, seed oil, food,recreation, religious and spiritual moods. This fast-growing plant has recently seen a resurgence of interest because of its wide applications. Ayurveda, the science of life, describing many of the formulation about the pharmaco-clinical application of Bhanga but many of these formulations are not in practice today. Indeed; it is a treasure trove of multi-variant Guna (qualities) and Karma (actions), making it a broad spectrum drug. In this review, the rich spectrum of cannabis is being discussed by putting a special emphasis on the formulations containing cannabis either as a major or a minor ingredient. Available 41 Rasagranthas and 26 Chikitsagrantha and other Ayurvedic treatises were referred with respect to Bhanga's Adhikara (main indication), Kalpana (dosage forms), Anupana (vehicle), Aushadha Sevana Kala (time and period of administration),Pathya-Apathya(do's and dont's),Prayojyanaga (parts used), Karma (action), specific uses and instructions of the formulations. It is observed that, there are 210 formulations which contain Bhanga, out of which 193 are recommended for internal administration and 17 for external applications. Among the formulations indicated for internal administration, 102 contain Bhanga as one of the major ingredient, whereas in 91 formulations, it's a minor ingredient. Nine formulations of external application are having Bhanga as major ingredient and 8 as minor ingredient.The review represents formulations being indicatedof 45 differentRoga-Adhikara, 22 Kalpana,18 Pathya-Apathya, five different parts used, 49 Karma (action) and few benefits and instruction to be followed during administration of formulations containing Bhanga.
... La consommation de cannabis peut entraîner une diminution de la libido chez les hommes et les femmes 15 . Chez les hommes, et particulièrement chez les jeunes, le cannabis est à l'origine de dysfonctions érectiles 22 . Les conducteurs sous l'influence du cannabis ont 1,8 fois plus de risque d'être responsables d'un accident mortel que les conducteurs négatifs. ...
Article
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Contexte. La consommation de cannabis chez les 15-34 ans a dépassé les consommations de tabac et d’alcool en France. Les effets délétères à court et à long termes de la consommation de cannabis sont nombreux et connus. L’outil de repérage CAST et l’intervention brève pour la prise en charge des consommations modérées sont largement encouragés. Pourtant, les MG interrogent peu leurs patients sur leur consommation de cannabis. Objectifs. Aider les MG à comprendre pourquoi il est nécessaire de réaliser un repérage de la consommation de cannabis notamment auprès des plus jeunes. Fournir aux généralistes des informations pour construire leur repérage et leur intervention auprès de leurs patients consommateurs. Méthode. Revue narrative de littérature réalisée à partir des bases de données PubMed et Cochrane, des sites nationaux sanitaires et gouvernementaux de lutte contre les addictions, et des recommandations et législations de plusieurs pays. Résultats. Le médecin généraliste a plusieurs outils à sa disposition pour bien connaître les produits consommés à base de cannabis, et donc aborder la question avec ses patients en étant avisé. Les risques aigus et chroniques de la consommation de cannabis, qu’ils soient biomédicaux ou psychosomatiques, sont maintenant bien établis. Le message est sans équivoque pour l’adolescence : la consommation de cannabis provoque des dommages neuro-cérébraux et donc des répercussions neuro-psychiatriques aiguës et chroniques irréversibles. Le médecin généraliste peut s’appuyer sur ces données pour informer chaque patient sur ses risques de manière personnalisée. Les observations dans différents pays ne permettent pas actuellement de se positionner sur les effets du système législatif sur la consommation. Le médecin, comme pour la consommation d’alcool ou de cigarettes, doit adopter une posture d’expert de santé et faire abstraction de ses représentations et du débat sociétal sur la manière d’aborder ce produit. Conclusion. Les généralistes doivent rechercher la consommation de cannabis, notamment chez les jeunes patients, de manière systématique, quel que soit leur motif de consultation initial. L’évaluation en termes de quantité mais surtout de répercussions sur la vie somatique et psychosociale dictera leur conduite à tenir : intervention brève ou orientation vers une consultation spécialisée.
Article
The association between drugs of abuse and sexual function is thought to be prehistoric. In our era, science has shed some light on the roles of different neurotransmitters on sexual function. Objective This systematic review aims to summarize the role of drugs of abuse on human sexuality. Methods A systematic review was undertaken, according to PRISMA guidelines, for PubMed indexed English articles between 2008 and 2020. Results The use of addictive substances is associated with poorer relationship functioning. Additionally, they can be both a trigger and a maintaining factor for sexual dysfunction by affecting any or all phases of sexual response models. These substances include alcohol, tobacco, cannabis, opioids, cocaine, amphetamines, and party drugs. Failure to address drug-induced sexual problems and dysfunctions or their treatment may induce relapses or represent the loss of a precious therapeutic opportunity. Conclusion Health care providers should be aware of the relationship between drugs of abuse and sexual function, and use the permission, limited information, specific suggestions, intensive therapy model. We believe addiction professionals should have skills on clinical sexology, and conversely, clinical sexologists should have training in addictions. L’association faite entre les drogues illicites et le fonctionnement sexuel est perçu comme étant archaïque. De nos jours, la science a apportée une certaine lumière sur les rôles des différents neurotransmetteurs dans le fonctionnement sexuel. Objectifs Cette revue systématique vise à résumer le rôle des drogues illicites sur la sexualité humaine. Méthodes Une revue systématique a été entreprise, conformément aux directives PRISMA, pour les articles en anglais indexés PubMed entre 2008 et 2020. Résultats La consommation de substances addictives est associée à un fonctionnement relationnel inférieur. De plus, ils peuvent être à la fois un déclencheur et un facteur de maintien de la dysfonction sexuelle en affectant une ou toutes les phases des modèles de réponse sexuelle. Ces substances comprennent l’alcool, le tabac, le cannabis, les opioïdes, la cocaïne, les amphétamines et les drogues festives (party drugs). Ne pas s’attaquer aux problèmes et dysfonctionnements sexuels induits par ces drogues ou à leur traitement peut provoquer des rechutes ou représenter la perte d’une précieuse opportunité thérapeutique. Conclusions Les pourvoyeurs de soins de santé devraient être conscients de la relation entre les drogues et le fonctionnement sexuel, et utiliser le modèle PLISSIT. Nous pensons que les professionnels de l’addiction devraient avoir des compétences en sexologie clinique et, à l’inverse, les sexologues cliniciens devraient avoir une formation en addiction.
Article
Introduction Substance abuse has become a worldwide health problem, leading to numerous consequences such as social problems among family members, abnormal behavior, adverse health effects, and psychological problems as well as economic consequences. Objectives We sought to assess the relationship between substance abuse and male sexual health. Methods A search was carried out in the following databases: PubMed, MeSH (Medical Subject Headings), Science Direct, Scopus, Cochrane Library, EMBASE, CINAHL, Academic Search Complete, and the Egyptian Knowledge Bank. The following keywords were used to assess the outcomes for relevant associations: illicit drugs, addiction, substance abuse, sexual health, erectile dysfunction, ejaculatory disorders, impotence, orgasm disorders, and sexual performance. Results The initial literature search identified a total of 148 articles in all searched databases. After removal of duplicate studies and application of inclusion/exclusion criteria, 75 reported studies were retained for review, including 38 case-control studies and 37 cross-sectional studies. These articles were classified into the following categories according to the type of abused substance addressed: cannabis/marihuana, 16 articles; opioids, 13 articles; heroin, 11 articles; cocaine, 5 articles; tramadol, 6 articles; ketamine, 2 articles; ecstasy, 4 articles; amphetamine, 2 articles; khat, 7 articles; androgen anabolic steroids, 2 articles; and polydrugs, 7 articles. Most of these recruited articles demonstrated a negative impact of the addressed substance on male sexual health, with variable levels. Conclusion Substance abuse has negative impacts on male sexual health that should be addressed. More studies conducted with proper methodological and statistical approaches, including logistic regression analysis, are needed to predict the effects of specific substances, considering the rapidly growing effects of non–substance-use disorders on male sexual health.
Article
Background and aims: Sexual dysfunction is often associated with substance use disorders. This study aimed to synthesize Indian literature on sexual dysfunction among patients with substance use disorders. Materials and methods: Electronic search engines were used to identify studies of the last 20 years that reported sexual dysfunction with different substance use disorders. Information was extracted using a predefined template. Quality appraisal of the included studies was carried out using Joanna Briggs Institute checklist. Results: Twenty-seven relevant papers were identified that pertained to 24 distinct studies. Most of them were in patients with alcohol dependence, and fewer were in patients with opioid dependence. The study designs were primarily single-group cross-sectional, though many case-control, cross-sectional studies were also identified. The proportion of participants with sexual dysfunction ranged from 22.2% to 76% for studies related to alcohol dependence and 40% to 90% for studies pertaining to opioid dependence. Varied types of sexual dysfunctions were identified, including poor satisfaction, lack of desire, premature ejaculation, and erectile dysfunction. Efforts to address bias and confounders were not reported in most studies. Conclusion: Sexual dysfunction affects a substantial proportion of patients with substance use disorders. Clinicians can make an effort to ascertain and address sexual dysfunction in their routine clinical practice while dealing with patients with substance use disorders.
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Introduction International studies have suggested that social disruptions caused by the COVID-19 pandemic have led to sexual dysfunction, but the impact on males in the United States is less defined. Aim To examine changes in male sexual function during the COVID-19 pandemic and to evaluate associated demographic variables. Methods Pre-pandemic survey data was collected between October 20, 2019 and March 1, 2020 on adult males in the United States. Follow-up survey data collected for comparison during the COVID-19 pandemic between August 1, 2020 and October 10, 2020 included International Index of Erectile Function (IIEF) scores, Patient Health Questionnaire for Depression and Anxiety with 4 items (PHQ-4) scores, and questions regarding sexual frequency. Questions were also asked about mask-wearing habits, job loss, relationship changes, and proximity to individuals who tested positive for COVID-19. Main Outcome Measures Differences in pre-pandemic and pandemic male sexual function assessed by self-reported IIEF domain scores and sexual frequency Results 76 men completed both pre-pandemic and pandemic surveys with a mean age of 48.3 years. Overall, there were no differences in either overall IIEF score or any subdomain score when comparing men's pre-pandemic and pandemic survey data. There was an increase in sexual frequency during the pandemic with 45% of men reporting sex ten or more times per month during the pandemic compared to only 25% of men prior to the pandemic (p=0.03). Among the subgroup of 36 men who reported a decrease in IIEF, the decrease was an average of 3.97, and significantly associated with higher PHQ-4 depression subscale scores (1.78 versus 1.03, p=0.02). Conclusions The COVID-19 pandemic is associated with increased sexual frequency and no change in overall sexual function in males in the United States. Interventions intended to promote male sexual health during the COVID-19 pandemic should include a focus on mental health.
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Purpose of Review Benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) is a disease complex with enormous societal burden and yet the pathogenesis of LUTS/BPH is poorly understood. We set out to review the literature on the relationship between depression, marijuana usage, and erectile dysfunction (ED) to LUTS/BPH. Recent Findings LUTS/BPH has independent associations with depression as well as with ED. In each case, the causality and mechanistic relationship is unknown. The impact of marijuana, as it increasingly pervades the general population, on the disease complex of LUTS/BPH is not well studied but recent results support short-term benefit and long-term caution. Summary Depression, a form of central nervous dysfunction, and ED, which is likely mediated via endothelial dysfunction, are independently associated with LUTS/BPH. The presence of cannabinoid receptors in urologic organs, coupled with recent population studies, supports a modulatory effect of marijuana on voiding although an enormous knowledge gap remains.
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Alcohol and other drugs have actions in limbic-hypothalamic hedonic motivational pathways that subserve basic biological functions including sexual behaviors. They may also have a range of other physiological and psychological effects on sexual function. Psychoactive drugs are often used to facilitate or enhance sexual behaviors, but they can also cause sexual dysfunction. Their use can be associated with risky or harmful sexual behaviors. Pharmacotherapies commonly used in addiction treatment, including opioid pharmacotherapies, sedative/hypnotics, antidepressants, and antipsychotics, can negatively affect sexual function, with implications for treatment adherence and effectiveness. Further, common psychological and physical comorbidities in people with substance use disorders may cause sexual dysfunction. An understanding of these issues can help clinicians working in the field of addiction better to appreciate motivations for continuing or reducing drug use, can inform motivational and harm reduction interventions, and can improve understanding of issues around treatment adherence. While there are challenges for clinicians in speaking about sexuality with their patients, this may be an important part of comprehensive assessment and treatment planning. The clinical benefits of addressing these issues, ranging from reducing sexual risk behavior to improving the quality of life of people receiving pharmacotherapies, can be substantial.
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Palliative care is a specialized medical care that focuses on quality of life for patients with serious illnesses. In the realm of palliative care and symptom management, there is growing interest in the role for cannabis-based medicine. There is some evidence to support the use of cannabinoids for the palliation of some symptoms and quality of life issues. Most notably, research supports the efficacy of cannabinoids for the treatment of chemotherapy-induced nausea and vomiting, though the evidence for phytocannabinoids is lacking. Moreover, cannabis use in the treatment of neuropathic pain is supported by several small high-quality studies. There is great interest in cannabis-based medicine to aid in the management of other symptoms such as anorexia, cachexia, insomnia, fatigue, anxiety, and delirium, among others that are prevalent in palliative care patients. Though there are limited studies for these various applications of cannabis, the data is not conclusive, and patients’ treatment goals must be carefully considered prior to the administration of medical cannabis. Further research is needed to better understand the possible benefits of medical cannabis as well as the safety, side effects, and drug interactions.
Article
The use of cannabis use is likely to increase as regulations on its consumption are diminishing throughout the world. Coinciding with an increase in the use of cannabis is an observation that semen quality appears to be declining in developed countries, and couples are delaying conception more often than previous generations. Therefore, it is important to study the effects of cannabis on male reproductive potential in order to better counsel infertile couples and men of reproductive age. In this mini-review, we highlight the known effects of cannabis on clinical markers of male fertility potential and review the role of the endocannabinoid system as it pertains to sex hormone and sperm production, as well as sperm function. Overall, current evidence is contradictory regarding the effects of cannabis on male reproductive hormone production. However, most studies associate cannabis use with lower sperm concentrations, suggesting a negative impact on fertility potential.
Article
Background: Erectile dysfunction (ED) is a common condition that may affect men of all ages; in 1999, a Process of Care Model was developed to provide clinicians with recommendations regarding the evaluation and management of ED. Aim: To reflect the evolution of the study of ED since 1999, this update to the process of care model presents health care providers with a tool kit to facilitate patient interactions, comprehensive evaluation, and counseling for ED. Methods: A cross-disciplinary panel of international experts met to propose updates to the 1999 process of care model from a global perspective. The updated model was designed to be evidence-based, data-driven, and accessible to a wide range of health care providers. Outcomes: This article summarizes the resulting discussion of the expert meeting and focuses on ED evaluation. The management of ED is discussed in an article by Muhall et al (J Sex Med 2018;15:XXX-XXX). Results: A comprehensive approach to the evaluation of ED is warranted because ED may involve both psychological and organic components. The updated process of care model for evaluation was divided into core and optional components and now focuses on the combination of first-line pharmacotherapy and counseling in consideration of patient sexual dynamics. Clinical implications: Patient evaluation for ED should encompass a variety of aspects, including medical history, sexual history, physical examination, psychological evaluation, laboratory testing, and possibly adjunctive testing. Strengths & limitations: This update draws on author expertise and experience to provide multi-faceted guidance for the evaluation of ED in a modern context. Although a limited number of contributors provided input on the update, these experts represent diverse fields that encounter patients with ED. Additionally, no meta-analyses were performed to further support the ED evaluation guidelines presented. Conclusion: Comprehensive evaluation of ED affords health care providers an opportunity to address medical, psychological/psycho-social, and sexual issues associated with ED, with the ultimate goal being effective management and possibly resolution of ED. While some or all techniques described in the updated model may be needed for each patient, evaluation should in all cases be thorough. Mulhall JP, Giraldi A, Hackett G, et al. The 2018 Revision to the Process of Care Model for Evaluation of Erectile Dysfunction. J Sex Med 2018;XX:XXX-XXX.
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Erectile dysfunction (ED), the inability to attain or maintain a sufficient penile erection for satisfactory sexual intercourse, is a major health issue predicted to affect 322 million people worldwide by year 2025. This chapter reviews well-known risk factors of ED including aging, vasculopathy, neuropathy, neurologic diseases, psychogenic problems, metabolic and endocrine dysregulation, and medications. Commonly consumed toxins such as tobacco, alcohol, and marijuana are also discussed as are environmental factors implicated in ED ranging from chemicals used in agriculture (pesticides and DDT), industrial chemicals, lead, bisphenol A, and 4,4'-diaminostilbene-2,2'-disulfonic acid to arsenic. Although how these compounds cause ED is unclear, this chapter reviews the available research and current theories on how they are thought to be endocrine disrupters with antiandrogenic or estrogenic properties and neurotoxins. The chapter concludes with a discussion of what are believed to be natural solutions for sexual dysfunction (aphrodisiacs) including commonly used cooking ingredients such as honey and potentially lethal plant derivatives such as yohimbine.
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The past decade has been witness to dramatic advances in drug therapy for erectile dysfunction. Multiple therapeutic targets along the physiologic pathway essential for normal erection have been exploited. While phosphodiesterase inhibitors are the “poster child” for this therapeutic field, are well tolerated oral therapies other delivery pathways and agents exist that hold great promise as well. A multitude of intracavernosal agents have been studied with varying success, including vasoactive and gene-based approaches. Topical and intraurethral therapies are also available with merits and limitations of their own. The future is bright, armed with an enhanced understanding of erectile physiology, new targets and approaches for therapies are being developed.
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Chronic neurological disease can have a tremendous impact on a woman’s health, self-image, and consequently on self-esteem [1]. One of the most important areas that could be impaired after the onset of a neurological disease is sexual function.
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Sex is a key function of human beings. Its physical, emotional, psychological, and social aspects permeate into many parts of our lives. Therefore, it is a major contributor to “Quality of life” (QoL). This chapter covers defining and measuring sexual QoL, and then details sex and QoL in nonclinical populations covering a variety of demographic groups. A detailed review follows for QoL in clinical populations of medical/surgical, psychiatric disorders, and sexual disorders before and after treatment. The chapter concludes with a discussion of ways to enhance QoL by detailing interventions to improve QoL in general and in sex in particular.
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Sexual dysfunction is a very common problem that affects many women in their lifetime. Female sexual dysfunction is a complex multifactor phenomenon that covers a range of sexual problems including sexual desire, sexual arousal, orgasm, or sexual pain disorders. Each one has distinct symptoms that are negatively regulated by drug abuse (i.e., cocaine and heroin, but also antidepressants), tobacco, and alcohol; however, some drugs have been found to make sexual problems worse, others milder. The pharmacological mechanisms associated to female sexual disorders promoted by drugs are unfortunately only partially elucidated. Moreover, the levels of several physiological neurotransmitters, as serotonin or dopamine, or vascular factors, as nitric oxide, seem to contribute to female sexual disorders and are modulated by drugs as antidepressants or by toxic compounds as tobacco. In addition, women have pharmacokinetic and pharmacodynamic characteristics that are different from men and that increase drug side effects respect to men. Further studies are thus necessary to better understanding the impact of alcohol and drug abuse on female sexual dysfunction.
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Bhavana (impregnation) and Swedana (boiling) are the processes used in Ayurvedic pharmacy for preparation of formulations containing the drugs of metallic, mineral and poisonous origin to make them safe and potent for internal administration. Drugs of herbal origins are primely used for the Bhavana process. Bhanga (Cannabis sativa Linn.) a drug with great medicinal potency has been highlighted for its Deepana (digestive stimulant), Pachana (digestive), Ruchya (Taste promoter), Madakari (intoxicant), Vyavayi (short acting), Grahi (withholds secretions), Medhya (memory booster), Rasayana (adapto-immuno-neuro-endocrino-modulator) activities were used as a processing media in many formulations. In 19th century, it is included in narcotic group of plants and its use, as a drug, has been restricted. In 21st century again, the drug is gaining attraction from scientific communities due to its wide pharmacological properties. However, there is no collective information available at a glance regarding the use of Bhanga in various processing techniques of classical formulations. Hence, it is the need of the time to present the comprehensive information on cannabis, as quoted in classical texts with probable research co-relation, so as to bring the drug again in to limelight. The present review aims to compile all the information about the use of cannabis as an activity potentiator so that it can be further practically utilized in pharmaceutics and clinics with legal permissions. A thorough review, from available 41 Rasagranthas (text related to Indian alchemy) and 26 classical texts was carried out to compile the information about formulations where Bhanga is used as process media. The review shows that; Bhanga has been used, as a pharmaceutical processing agent, in 157 formulations being indicated in 40 different disease conditions. Among them, in 154 formulations, it is used as Bhavana media and in 3 formulations as a Swedana media. The present observation could help the future researchers to explore the drug for therapeutic utilities
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Multiple drugs are frequently assumed to induce sexual dysfunction as an unwanted side effect. In this chapter we review the known mechanisms of sexual function and how the drugs hypothesized to cause sexual dysfunction are thought to interrupt these pathways. The management of drug-induced sexual dysfunction for physicians can be challenging; here we discuss several management strategies for the treatment of drug-induced sexual dysfunction.
Research
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This research monograph is a peer-reviewed summary of the scientific evidence on the uses and harms of cannabis and cannabinoids for medical purposes.
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Corporal smooth muscle relaxation is mediated mainly but not completely by nitric oxide. Endocannabinoids modulate the various neurotransmitter systems. In the present study, a possible role of endocannabinoids on non-nitrergic nonadrenergic noncholinergic (NANC)-mediated relaxations was investigated. In precontracted tissues, control electrical field stimulation (EFS)-induced NANC relaxation responses were obtained using varying frequencies of stimulation in the presence of L-arginine methyl ester (L-NAME), guanethidine, and atropine. To investigate the effects of cannabinoids on EFS-evoked non-nitrergic NANC relaxation responses, a similar experimental procedure was applied in the presence of cannabinoid receptor antagonists AM251 or AM630; vanilloid receptor antagonist capsazepine; or cannabinoid receptor agonists anandamide, arachidonyl-2-chloroethylamide (ACEA), or JHW015. Effects of cannabinoid receptor antagonists and agonists on EFS-evoked non-nitrergic NANC relaxation responses. L-NAME abolished EFS-induced relaxation responses at lower frequencies (2-4 Hz) and inhibited the relaxation responses at higher frequencies (8-32 Hz). AM251 and AM630 either together or separately inhibited, whereas anandamide, ACEA, and JHW015 enhanced non-nitrergic NANC relaxation responses. Anandamide did not alter EFS-induced non-nitrergic NANC relaxations in the presence of AM251 and AM630. Capsazepine enhanced non-nitrergic NANC relaxation responses. These results suggest that non-nitrergic NANC relaxations may be mediated partially by cannabinoid-like neuronal factors acting at both cannabinoid CB(1) and cannabinoid CB(2) receptors.
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Cannabis use can both increase and reduce anxiety in humans. The neurophysiological substrates of these effects are unknown. To investigate the effects of 2 main psychoactive constituents of Cannabis sativa (Delta9-tetrahydrocannabinol [Delta9-THC] and cannabidiol [CBD]) on regional brain function during emotional processing. Subjects were studied on 3 separate occasions using an event-related functional magnetic resonance imaging paradigm while viewing faces that implicitly elicited different levels of anxiety. Each scanning session was preceded by the ingestion of either 10 mg of Delta9-THC, 600 mg of CBD, or a placebo in a double-blind, randomized, placebo-controlled design. Fifteen healthy, English-native, right-handed men who had used cannabis 15 times or less in their life. Regional brain activation (blood oxygenation level-dependent response), electrodermal activity (skin conductance response [SCR]), and objective and subjective ratings of anxiety. Delta9-Tetrahydrocannabinol increased anxiety, as well as levels of intoxication, sedation, and psychotic symptoms, whereas there was a trend for a reduction in anxiety following administration of CBD. The number of SCR fluctuations during the processing of intensely fearful faces increased following administration of Delta9-THC but decreased following administration of CBD. Cannabidiol attenuated the blood oxygenation level-dependent signal in the amygdala and the anterior and posterior cingulate cortex while subjects were processing intensely fearful faces, and its suppression of the amygdalar and anterior cingulate responses was correlated with the concurrent reduction in SCR fluctuations. Delta9-Tetrahydrocannabinol mainly modulated activation in frontal and parietal areas. Delta9-Tetrahydrocannabinol and CBD had clearly distinct effects on the neural, electrodermal, and symptomatic response to fearful faces. The effects of CBD on activation in limbic and paralimbic regions may contribute to its ability to reduce autonomic arousal and subjective anxiety, whereas the anxiogenic effects of Delta9-THC may be related to effects in other brain regions.
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Aim of the study was to evaluate whether endothelial dysfunction is a marker of erectile dysfunction (ED) in recreational drug abuse. Sixty-four non-consecutive men complaining of ED from at least 3 months were included. All patients underwent detailed history about recreational drug abuse and were then submitted to dynamic penile duplex ultrasound (PDU). According to pharmaco-stimulated peak systolic velocity (PSV) cutoff at 35 cm s(-1), patients were divided into two groups: organic (O; n=30) and non-organic (NO; n=34) ED. All subjects and 7 healthy age-matched subjects as controls, underwent veno-occlusive plethysmography (VOP) for the evaluation of endothelium-dependent dilatation of brachial arteries. Blood pressure, total and free testosterone, prolactin, estradiol, low-density lipoprotein and high-density lipoprotein cholesterol were also evaluated; patients were classified with regard to insulin resistance through the HOMA-IR index. Cannabis smoking was more frequent in O-ED vs NO-ED (78% vs 3%, P<0.001) in the absence of any concomitant risk factor or comorbidity for ED. VOP studies revealed impaired endothelium-dependent vasodilatation in O-ED but not in NO-ED and controls (12+/-6 vs 32+/-4 and 34+/-5 ml min(-1), respectively; P=0.003). Overall patients showed a direct relationship between HOMA-IR and PSV (r(2)=0.47, P<0.0001), which was maintained in men with organic ED (r(2)=0.62, P<0.0001). In cannabis consumers, a direct relationship between HOMA-IR and VOP was also found (r(2)=0.74, P<0.0001). Receiver-operating characteristic (ROC) curve analysis revealed that VOP values below 17.22 ml min(-1) were suggestive for vasculogenic ED. We conclude that early endothelial damage may be induced by chronic cannabis use (and endocannabinoid system activation); insulin resistance may be the hallmark of early endothelial dysfunction and may concur to determine vascular ED in the absence of obesity. Further studies are warranted to establish a direct relationship between cannabis abuse, onset of insulin resistance and development of vascular ED.
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Marijuana and many of its constituent cannabinoids influence the central nervous system (CNS) in a complex and dose-dependent manner. Although CNS depression and analgesia are well documented effects of the cannabinoids, the mechanisms responsible for these and other cannabinoid-induced effects are not so far known. The hydrophobic nature of these substances has suggested that cannabinoids resemble anaesthetic agents in their action, that is, they nonspecifically disrupt cellular membranes. Recent evidence, however, has supported a mechanism involving a G protein-coupled receptor found in brain and neural cell lines, and which inhibits adenylate cyclase activity in a dose-dependent, stereoselective and pertussis toxin-sensitive manner. Also, the receptor is more responsive to psychoactive cannabinoids than to non-psychoactive cannabinoids. Here we report the cloning and expression of a complementary DNA that encodes a G protein-coupled receptor with all of these properties. Its messenger RNA is found in cell lines and regions of the brain that have cannabinoid receptors. These findings suggest that this protein is involved in cannabinoid-induced CNS effects (including alterations in mood and cognition) experienced by users of marijuana.
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The major active ingredient of marijuana, delta 9-tetrahydrocannabinol (delta 9-THC), has been used as a psychoactive agent for thousands of years. Marijuana, and delta 9-THC, also exert a wide range of other effects including analgesia, anti-inflammation, immunosuppression, anticonvulsion, alleviation of intraocular pressure in glaucoma, and attenuation of vomiting. The clinical application of cannabinoids has, however, been limited by their psychoactive effects, and this has led to interest in the biochemical bases of their action. Progress stemmed initially from the synthesis of potent derivatives of delta 9-THC, and more recently from the cloning of a gene encoding a G-protein-coupled receptor for cannabinoids. This receptor is expressed in the brain but not in the periphery, except for a low level in testes. It has been proposed that the nonpsychoactive effects of cannabinoids are either mediated centrally or through direct interaction with other, non-receptor proteins. Here we report the cloning of a receptor for cannabinoids that is not expressed in the brain but rather in macrophages in the marginal zone of spleen.
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This study examines the prevalence of DSM-III sexual dysfunctions and their association with comorbid drug and alcohol use in a community epidemiologic sample. The data for these analyses are based on the Epidemiological Catchment Area Project, a multistage probability study of the incidence and prevalence of psychiatric disorders in the general population conducted in 1981-83. Only the sample of 3,004 adult community residents in the St. Louis area was queried on DSM-III sexual dysfunctions of inhibited orgasm, functional dyspareunia (painful sex), inhibited sexual excitement (i.e., lack of erection/arousal), and inhibited sexual desire. There was a prevalence rate of 11% for inhibited orgasm, 13% for painful sex, 5% for inhibited sexual excitement, 7% for inhibited sexual desire, and 26% for any of these sexual dysfunctions (14% for men and 33% for women). The prevalence of qualifying lifetime substance use among the population was 37%, with males meeting more drug and alcohol use criteria than females. After controlling for demographics, health status variables, and psychiatric comorbidity (depression disorder, generalized anxiety disorder, antisocial personality disorder, and residual disorders), inhibited orgasm was associated with marijuana and alcohol use. Painful sex was associated with illicit drug use and marijuana use. Inhibited sexual excitement was more likely among illicit drug users. Inhibited sexual desire was not associated with drug or alcohol use.
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Cannabinoids (CBs) exert untoward effects on reproduction by reducing LH secretion and suppressing gonadal function. Recent evidence suggests these effects are due primarily to hypothalamic dysfunction; however, the mechanism is obscure. Using immortalized hypothalamic GnRH neurons, we find these cells produce and secrete at least two different endocannabinoids. After release, 2-arachidonyl monoacylglycerol and anandamide are rapidly transported into GnRH neurons and are degraded to other lipids by fatty-acid amide hydrolase. The immortalized GnRH neurons also possess CB1 and CB2 receptors that are coupled to Gi/Go proteins whose activation leads to inhibition of GnRH secretion. In perifusion experiments, CBs block pulsatile release of GnRH. When a CB receptor agonist is delivered into the third ventricle of adult female mice, estrous cycles are prolonged by at least 2 d. Although in situ hybridization experiments suggest either that GnRH neurons in vivo do not possess CB1 receptors or that they are very low, transcripts are localized in close proximity to these neurons. Inasmuch as GnRH neurons in vivo possess G protein receptors that are coupled to phospholipase C and increased intracellular Ca2+, these same neurons should also be able to synthesize endocannabinoids. These lipids, in turn, could bind to CB receptors on neighboring cells, and perhaps GnRH neurons, to exert feedback control over GnRH function. This network could serve as a novel mechanism for regulating GnRH secretion where reproductive functions as diverse as the onset of puberty, timing of ovulation, duration of lactational infertility, and initiation/persistence of menopause may be affected.
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We recently showed that central injections of alpha-melanocyte-stimulating hormone (alpha-MSH) inhibits oxytocin cells and reduces peripheral release of oxytocin, but induces oxytocin release from dendrites. Dendritic oxytocin release can be triggered by agents that mobilize intracellular calcium. Oxytocin, like alpha-MSH, mobilizes intracellular calcium stores in oxytocin cells and triggers presynaptic inhibition of afferent inputs that is mediated by cannabinoids. We hypothesized that this mechanism might underlie the inhibitory effects of alpha-MSH. To test this, we recorded extracellularly from identified oxytocin and vasopressin cells in the anesthetized rat supraoptic nucleus (SON). Retrodialysis of a CB1 cannabinoid receptor antagonist to the SON blocked the inhibitory effects of intracerebroventricular injections of alpha-MSH on the spontaneous activity of oxytocin cells. We then monitored synaptically mediated responses of SON cells to stimulation of the organum vasculosum of the lamina terminalis (OVLT); this evoked a mixed response comprising an inhibitory component mediated by GABA and an excitatory component mediated by glutamate, as identified by the effects of bicuculline and 6-cyano-7-nitroquinoxaline-2,3-dione applied to the SON by retrodialysis. Application of CB1 receptor agonists to the SON attenuated the excitatory effects of OVLT stimulation in both oxytocin and vasopressin cells, whereas alpha-MSH attenuated the responses of oxytocin cells only. Thus alpha-MSH can act as a "switch"; it triggers oxytocin release centrally, but at the same time through initiating endocannabinoid production in oxytocin cells inhibits their electrical activity and hence, peripheral secretion.
Article
Oral doses of extracts of marihuana were found to induce a greater concentration on the present and a foreshortening of the span of awareness into the future. Although there were individual differences in emotional reactions, the greater concentration on the present was associated, in general, with euphoric moods.
Article
Previous scientific research indicates that there are no true aphrodisiacs; that is, there are no pharmacological substances that enhance sex drive or directly increase sexual frequency or other sexual performance variables. However, if the definition of aphrodisiac is expanded to include an enhanced subjective pleasure of sexual experience, this conclusion may be unwarranted. Current knowledge of certain pharmacological agents (marijuana, central nervous system stimulants, and methylenedioxyamphetamine) is examined with this redefinition in mind and reveals positive theoretical potentials for research on sex and drug interactions.
Article
Introduction: Data concerning the physiology of desire, arousal, and orgasm in women are limited because of ethical constraints. Aim. To gain knowledge of physiology of female sexual function through animal models. Methods: To provide state-of-the-art knowledge concerning female sexual function in animal models, representing the opinions of seven experts from five countries developed in a consensus process over a 2-year period. Main outcome measure: Expert opinion was based on the grading of evidence-based medical literature, widespread internal committee discussion, public presentation, and debate. Results: Sexual desire may be considered as the presence of desire for, and fantasy about, sexual activity. Desire in animals can be inferred from certain appetitive behaviors that occur during copulation and from certain unconditioned copulatory measures. Proceptive behaviors are dependent in part on estrogen, progesterone, and drugs that bind to D1 dopamine receptors, adrenergic receptors, oxytocin receptors, opioid receptors, or gamma-amino butyric acid receptors. Peripheral arousal states are dependent on regulation of genital smooth muscle tone. Multiple neurotransmitters/mediators are involved including adrenergic, and nonadrenergic, noncholinergic agents such as vasoactive intestinal polypeptide, nitric oxide, neuropeptide Y, calcitonin gene-related peptide, and substance P. Sex steroid hormones, estrogens and androgens, are critical for structure and function of genital tissues including modulation of genital blood flow, lubrication, neurotransmitter function, smooth muscle contractility, mucification, and sex steroid receptor expression in genital tissues. Orgasm may be investigated by urethrogenital (UG) reflex, in which genital stimulation results in rhythmic contractions of striated perineal muscles and contractions of vagina, anus, and uterine smooth muscle. The UG reflex is generated by a multisegmental spinal pattern generator involving the coordination of sympathetic, parasympathetic, and somatic efferents innervating the genital organs. Serotonin and dopamine may modulate UG reflex activity. Conclusions: More research is needed in animal models in the physiology of female sexual function.
Article
The putative role of the endocannabinoid system and the effects of cannabis use in male and female sexual functioning are summarized. The influence of cannabis intake on sexual behavior and arousability appear to be dose-dependent in both men and women, although women are far more consistent in reporting facilitatory effects. Furthermore, evidence from nonhuman species indicate somewhat more beneficial than debilitating effects of cannabinoids on female sexual proceptivity and receptivity while suggesting predominantly detrimental effects on male sexual motivation and erectile functioning. Data from human and nonhuman species converge on the ephemeral nature of THC-induced testosterone decline. However, it is clear that cannabinoid-induced inhibition of male sexual behavior is independent of concurrent declines in testosterone levels. Investigations also reveal a suppression of gonadotropin release by cannabinoids across various species. Historical milestones and promising future directions in the area of cannabinoid and sexuality research are also outlined in this review.
Article
Cannabis is the most commonly used illicit substance worldwide. Despite this, its impact on sexual health is largely unknown. The aim of this article is to examine the association between cannabis use and a range of sexual health outcomes. The main outcome measures include the number of sexual partners in the past year, condom use at most recent vaginal or anal intercourse, diagnosis with a sexually transmissible infection in the previous year, and the occurrence of sexual problems. Method used in this article includes a computer-assisted telephone survey of 8,656 Australians aged 16-64 years resident in Australian households with a fixed telephone line. Of the 8,650 who answered the questions about cannabis use, 754 (8.7%) reported cannabis use in the previous year with 126 (1.5%) reporting daily use, 126 reported (1.5%) weekly use, and 502 (5.8%) reported use less often than weekly. After adjusting for demographic factors, daily cannabis use compared with no use was associated with an increased likelihood of reporting two or more sexual partners in the previous year in both men (adjusted odds ratio 2.08, 95% confidence interval 1.11-3.89; P = 0.02) and women (2.58, 1.08-6.18; P = 0.03). Daily cannabis use was associated with reporting a diagnosis of a sexually transmissible infection in women but not men (7.19, 1.28-40.31; P = 0.02 and 1.45, 0.17-12.42; P = 0.74, respectively). Frequency of cannabis use was unrelated to sexual problems in women but daily use vs. no use was associated with increased reporting among men of an inability to reach orgasm (3.94, 1.71-9.07; P < 0.01), reaching orgasm too quickly (2.68, 1.41-5.08; P < 0.01), and too slowly (2.05, 1.02-4.12; P = 0.04). Frequent cannabis use is associated with higher numbers of sexual partners for both men and women, and difficulties in men's ability to orgasm as desired.
Article
Anandamide, a proposed endogenous cannabinoid (CB) agonist, has been shown to enhance neurogenic responses in vitro of the rat corpus cavernosal tissue (CC). However, no information is available on the distribution of CB-receptors or effects by anandamide in CC from primates or humans. To characterize the distribution of CB-receptor isoforms in the human and primate CC and to investigate the effects of anandamide on isolated CC preparations. CC tissue was excised from the crura penis of six rhesus monkeys and five patients. Expression and distribution of CB1 and CB2 receptors were characterized with Western blot analyses and immunohistochemical investigations. The effects of anandamide on isolated CC preparations were analyzed during pharmacologic and nerve-mediated activation of primate tissue in aerated organ baths. The expression and localization of CB1 and CB2 receptors in the primate CC and effects of anandamide on nerve-mediated relaxations and pharmacologically evoked contractions. Western blot experiments revealed CB1 and CB2 receptors at expected band weights. Within and between strands of CC smooth muscle, CB1 and CB2 immunoreactivity (IR) was found in nerve fibers that also expressed IR for nitric oxide synthase (NOS) or transient receptor potential V1 (TRPV1). Neither CB1-IR nor CB2-IR nerves were colocalized with calcitonin-gene-related peptide (CGRP)-containing or tyrosine hydroxylase-containing nerves. No differences were observed between primate and human CC sections. Anandamide (10(-9) to 10(-4) M) had no contractile effects on CC smooth muscle, no relaxant effects on precontracted preparations, and no effect on phenylephrine-induced contractions. However, anandamide (10muM) inhibited electrically evoked smooth-muscle relaxations (34-48%; p</=0.05). CB1 and CB2 receptors are located on NOS-containing nerves in primate and human CC tissue. In contrast to findings in rats, anandamide antagonized nerve-mediated relaxations of the primate CC, suggesting important species differences for CB-mediated functions. The results also suggest a peripheral mechanism for cannabis-related sexual dysfunction.
Article
Despite the rapidly changing scene of cannabis drug usage, it is becoming more frequent among university students; however, the majority of users (41.8%) are still uneducated. A high school education had been attained by 34.57% of this majority, while the remaining 29.5% were university students. Adverse reactions were more common in the uneducated group. Again, a different situation exists in the United States, where many marihuana users are educated youth from college campuses. With regard to occupation, persons in lower income groups were more susceptible to adverse reactions. This finding, again, contrasts with marijuana users in the United States and other Western countries, where users are mostly from the middle classes. The individuals studied were apparently healthy persons with little or no apparent personality problems and no history of mental disorder or neurosis. An invariable element was their history of drug use. The symptoms and the effects were so similar and uniform that they suggest that, simply, a definite effect follows a definite cause. The effects were mostly of a mental nature that simulated toxic psychosis. There were no other common factors beyond the use of the drug. This eliminated the possibility that the adverse toxic reactions observed were caused by other factors. Thus, cannabis may precipitate latent psychiatric disorders, may aggravate preexisting psychiatric problems, or may have both effects.
Article
To investigate possible effects of chronic marijuana use on reproductive and stress hormones, we assayed testosterone, luteinizing hormone, follicle stimulating hormone, prolactin, and cortisol in 93 men and 56 women with a mean (+/- S.E.) age of 23.5 +/- 0.4 years. Hormone values were compared among groups of subjects stratified according to frequency of marijuana use (frequent, moderate and infrequent; N = 27, 18, and 30, respectively) and non-using controls (N = 74). Chronic marijuana use showed no significant effect on hormone concentrations in either men or women.
Article
Four healthy male subjects smoked two marijuana cigarettes or one marijuana cigarette and one placebo cigarette, or two placebo cigarettes on separate days in a random order crossover design. Each marijuana cigarette contained 2.8% delta-9-tetrahydrocannabinol (THC). Plasma hormones and THC were measured before and after each smoking session. Plasma LH was significantly depressed and cortisol was significantly elevated after smoking marijuana. Nonsignificant depressions of prolactin, FSH, testosterone and free testosterone and elevation of GH also occurred. Concurrent measures of subjective effects via subscales of the Addiction Research Center Inventory, Single Dose Questionnaire and a Visual Analog Scale were generally elevated. Significant impairment on a psychomotor performance task paralleled elevations in subjective effects, hormone effects and peak THC determinations. Although all the hormone effects were within normal basal ranges, interactions between these systems, and their effects on behavior cannot be discounted.
Article
To test the relation between chronic marihuana use and testosterone levels, we studied 27 men, 21 to 26 years of age. Plasma testosterone was measured daily before, during, and after a 21-day period of marihuana use. The mean pre-use testosterone level of 12 casual users (who smoked an average of 54 marihuana cigarettes during the 21-day use period) was 988±93 ng per 100 ml (±S.E.M.), and that of 15 heavy users, who smoked an average of 119 cigarettes, was 1115±69 ng per 100 ml. No statistically significant changes in plasma testosterone levels were observed during and after the smoking period as compared with the pre-smoking base-line levels. These data do not corroborate an association between chronic marihuana use and decreased plasma testosterone. (N Engl J Med 291:1051–1055, 1974)
Article
Twenty heterosexual men 18 to 28 years of age who used marihuana at least four days a week for a minimum of six months without use of other drugs during that interval were studied. Mean (± S.E.M.) plasma testosterone — 416 ± 34 ng per 100 ml — was significantly lower in this group than that in the control-group mean — 742 ± 29 ng per 100 ml — for age-matched men who had never used marihuana. Decreased testosterone was dose related. Abstention from marihuana use and stimulation with human chorionic gonadotropin during continued marihuana use produced marked increases in testosterone. Measurements of liver function, circulating gonadotropins, prolactin, Cortisol and thyroxine were within normal limits. Six of 17 men (35 per cent) showed oligospermia, and two men were impotent. The data suggest that chronic intensive use of marihuana may produce alterations in male reproductive physiology through central (hypothalamic or pituitary) action. (N Engl J Med 290:872–874, 1974)
Article
As a guide to future experiments, the chief experiential effects of marijuana have been elucidated with the help of a detailed questionnaire given to seasoned marijuana users whose experiences, it seems, are almost entirely pleasant.
Article
Marihuana usage is associated with a life-style that involves earlier and more frequent sexual activity. Marihuana usage does not affect human male testosterone levels significantly, but does adversely affect sperm production. Animal studies have not found consistent changes in weights of male sexual organs but have corroborated the adverse effects of cannabinoid compounds on sperm production. The biological significances of these effects on sperm production are unclear, however, since there is no evidence that human marihuana users or male animals given cannabinoid compounds are less fertile or are at risk for dominant lethal mutations. Cannabinoid compounds reliably inhibit ovulation in animals and are associated with depressed luteinizing hormone (LH) levels in both female and male animals. The decreased LH levels appear to be due to both hypothalamic and ovarian sites of action. Treatment with cannabinoid compounds is also associated with lower testosterone levels in male and lower prolactin levels in female animals. Effects on progesterone levels are inconclusive. Cannabinoid compounds do not possess estrogenic activity. Despite some consistencies in the data in virtually every study conducted with animals, there has been a basic confounding between direct drug action and secondary effects resulting from drug-induced decreases in food and water consumption and attendant weight loss. Almost all of the adverse effects of cannabinoid exposure on reproductive organs can be attributed to these secondary effects.
Article
The evidence from this study indicates that marijuana, when it affects sexual experience, affects it in a positive way. The most uniformly reported effects were general ones: feelings of sexual pleasure and satisfaction, feelings of emotional closeness and intimacy, and a general concurrence that marijauna has mild aphrodisiac properties. While a significant majority of the users agreed that marijuana is consistently an aphrodisiac, or at least under some circumstances, it is apparent that only the most frequent users often seek out the use of this substance specifically for its sexually stimulating qualities. For the others, their use of marijuana is more likely to be coincidental to their sexual behavior. While marijuana does appear to be a drug of choice for the users where sexual activity is concerned, the effects are mild, positive and facilitating, but not compelling.
Article
At the present level of ignorance about sexuality and cannabis, what rational position can be adopted? First, it must be recognized that even without cannabis, current involvement in sex-related activities may well have been called "promiscuous" by a preceding generation or two. The general loosening of morality, the erosion of family, church and other authoritarian controls, The Pill, antibiotics and other recent developments have contributed to current casual attitudes. Although one may not perceive it, counterculture beliefs have had their impact on the dominant culture. Marijuana has some enhancing effect upon sexual proceedings for some individuals. It may be sexually evocative and gratifying. Nonspecific factors play an important role in this matter. Opposite effects also occur, and an endocrinologic basis for actual diminution of drives and potency may exist. The final paradox is that cannabis' employment for sexual arousal is predominantly an activity of young adults. The older age groups most in need of sexual support and assistance are less frequently involved in its use. It is unclear why this dichotomy between need and utilization exists.
Article
To develop a brief, reliable, self-administered measure of erectile function that is cross-culturally valid and psychometrically sound, with the sensitivity and specificity for detecting treatment-related changes in patients with erectile dysfunction. Relevant domains of sexual function across various cultures were identified via a literature search of existing questionnaires and interviews of male patients with erectile dysfunction and of their partners. An initial questionnaire was administered to patients with erectile dysfunction, with results reviewed by an international panel of experts. Following linguistic validation in 10 languages, the final 15-item questionnaire, the international index of Erectile Function (IIEF), was examined for sensitivity, specificity, reliability (internal consistency and test-retest repeatability), and construct (concurrent, convergent, and discriminant) validity. A principal components analysis identified five factors (that is, erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction) with eigenvalues greater than 1.0. A high degree of internal consistency was observed for each of the five domains and for the total scale (Cronbach's alpha values of 0.73 and higher and 0.91 and higher, respectively) in the populations studied. Test-retest repeatability correlation coefficients for the five domain scores were highly significant. The IIEF demonstrated adequate construct validity, and all five domains showed a high degree of sensitivity and specificity to the effects of treatment. Significant (P values = 0.0001) changes between baseline and post-treatment scores were observed across all five domains in the treatment responder cohort, but not in the treatment nonresponder cohort. The IIEF addresses the relevant domains of male sexual function (that is, erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction), is psychometrically sound, and has been linguistically validated in 10 languages. This questionnaire is readily self-administered in research or clinical settings. The IIEF demonstrates the sensitivity and specificity for detecting treatment-related changes in patients with erectile dysfunction.
Article
The purpose of this study was to identify brain sites that contribute to the delta(9)-tetrahydrocannabinol (delta(9)-THC)-induced impairment of spatial memory in rats. Rats were tested in the eight-arm radial maze after microinjections of delta(9)-THC into one of 14 different brain regions. The bilateral microinjection of delta(9)-THC (20 microg/side) impaired spatial memory when injected into the dorsal hippocampus (DH), ventral hippocampus (VH) or dorsomedial thalamus nucleus (DMT). However, rats treated with delta(9)-THC into DMT produced preseverative behavior which has not been observed by systemic administration of delta(9)-THC. On the other hand, spatial memory was unaffected by microinjections of delta(9)-THC into the other 11 areas examined: frontal (FC) and frontoparietal (FPC) cortex, central (ACE) and basolateral (ABL) amygdaloid nucleus, medial caudate putamen (CPM), lateral hypothalamus (LH), mammillary body (MB), basal forebrain (BF), medial septal nucleus (SEP) and dorsal (DR) and median (MR) raphe nucleus. These results suggest that DH and VH may be important brain sites for the delta(9)-THC-induced impairment of spatial memory.
Article
The effect of cannabinoid CB1 receptor agonists and antagonists on penile erection was studied in male rats when injected into the paraventricular nucleus of the hypothalamus. The CB1 receptor antagonist SR 141716A [N-(piperidin-1-yl)-5-(4-chlorophenyl)-4-methyl-1H-pyrazole-3-carboxyamide] (0.5-5 microg) induced penile erection in a dose-dependent manner. The minimal effective dose was 1 microg, while the maximal response was found with 5 microg of the compound. In contrast, the CB1 receptor agonists WIN 55,212-2 [4,5-dihydro-2-methyl-4(4-morpholinylmethyl)-1-(1-naphthalenyl-carbonyl)-6H-pyrrolo[3,2,1-I,j]quinolin-6-one] (0.5-5 microg) and CP 55,940 [1alpha,2beta-(R)-5alpha]-5-(1,1-dimethylheptyl)-2-[5-hydroxy-2-(3-hydroxy-propyl)cyclohexyl]phenol (0.5-5 microg) were ineffective at all the doses tested. Nevertheless, both compounds reduced the enhancing effect of SR 141716A on penile erection when given into the paraventricular nucleus at the above doses before SR 141716A. The pro-erectile effect of SR 141716A was also reduced by the non-competitive NMDA receptor antagonist dizolcipine (MK-801) (0.2 microg) and by the NO synthase inhibitor NG-nitro-l-arginine methylester (L-NAME) (20 microg) but not by the dopamine receptor antagonist cis-flupenthixol (10 microg) or the oxytocin receptor antagonist d(CH2)5Tyr(Me)2-Orn8-vasotocin (0.1 microg), when given into the paraventricular nucleus. In spite of its inability to prevent the pro-erectile effect of SR 141716A when given in the paraventricular nucleus, d(CH2)5Tyr(Me)2-Orn8-vasotocin) (1 microg) reduced almost completely SR 141716A-induced penile erection when given into the lateral ventricles. The present results show that cannabinoid CB1 receptors present in the paraventricular nucleus may influence erectile function and sexual activity by modulating paraventricular oxytocinergic neurons mediating erectile function.
Article
The paraventricular nucleus of the hypothalamus is an integration centre between the central and peripheral autonomic nervous systems. It is involved in numerous functions from feeding, metabolic balance, blood pressure and heart rate, to erectile function and sexual behaviour. In particular, a group of oxytocinergic neurons originating in this nucleus and projecting to extra-hypothalamic brain areas (e.g., hippocampus, medulla oblongata and spinal cord) control penile erection in male rats. Activation of these neurons by dopamine and its agonists, excitatory amino acids (N-methyl-D-aspartic acid) or oxytocin itself, or by electrical stimulation leads to penile erection, while their inhibition by gamma-amino-butyric acid (GABA) and its agonists or by opioid peptides and opiate-like drugs inhibits this sexual response. The activation of these neurons is secondary to the activation of nitric oxide synthase, which produces nitric oxide. Nitric oxide in turn causes, by a mechanism that is as yet unidentified, the release of oxytocin in extra-hypothalamic brain areas. Other compounds recently identified that facilitate penile erection by activating central oxytocinergic neurons are peptide analogues of hexarelin, a growth hormone releasing peptide, pro-VGF-derived peptides, endogenous peptides that may be released by neuronal nerve endings impinging on oxytocinergic cell bodies, SR 141716A, a cannabinoid CB1 receptor antagonist, and, less convincingly, adrenocorticotropin-melanocyte-stimulating hormone (ACTH-MSH)-related peptides. Paraventricular oxytocinergic neurons and similar mechanisms are also involved in penile erection occurring in physiological contexts, namely noncontact erections that occur in male rats in the presence of an inaccessible receptive female, and during copulation. These findings show that the paraventricular nucleus of the hypothalamus plays an important role in the control of erectile function and sexual activity. As the male rat is a model of sexual behaviour and penile physiology, which has largely increased in the last years our knowledge of peripheral and central mechanisms controlling erectile function (drugs that induce penile erection in male rats usually do so also in man), the above results may have great significance in terms of a human perspective for the treatment of erectile dysfunction.
Article
The cannabinoid CB1 receptor antagonist SR141716A (0.5, 1 and 2 microg) induces penile erection when injected into the paraventricular nucleus of male rats. The pro-erectile effect of SR 141716A occurs concomitantly with an increase in the concentration of NO2- and NO3- in the paraventricular dialysate obtained by means of intracerebral microdialysis. Both penile erection and NO2- increase induced by SR 141716A were reduced by the prior injection into the PVN of the cannabinoid CB1 agonists WIN 55,212-2 (5 microg) or HU 210 (5 microg), given into the paraventricular nucleus at doses unable to induce penile erection or to modify NO2- concentration. SR 141716A responses were also reduced by nitro-L-arginine methylester (20 microg), a non-selective NO synthase inhibitor, S-methyl-L-thiocitrulline (20 microg), a selective neuronal NO synthase inhibitor, the excitatory amino acid NMDA receptor antagonist dizocilpine ((+)MK 801) (1 microg), or the GABAA receptor agonist muscimol (0.2 microg) injected into the PVN 15 min before SR 141716A. In contrast, the inducible NO synthase inhibitor L-N(6)-(1-iminoethyl)lysine (20 microg), the GABAB receptor agonist baclofen (0.2 microg), the mixed dopamine receptor antagonist cis-flupenthixol (10 microg), and the oxytocin receptor antagonist d(CH2)5Tyr(Me)-Orn8 -vasotocin (1 microg), were ineffective. Despite its inability to reduce penile erection and NO2- increase induced by SR 141716A when injected into the PVN, d(CH2)5Tyr(Me)-Orn8 -vasotocin (1 microg) reduced almost completely penile erection without reducing paraventricular NO2- increase when injected into the lateral ventricles 15 min before SR 141716A. The present results show that SR 141716 induces penile erection by a mechanism (possibly activation of excitatory amino acid neurotransmission), which causes the activation of neuronal NO synthase in paraventricular oxytocinergic neurons mediating penile erection.
Article
Marijuana and its psychoactive constituents induce a multitude of effects on brain function. These include deficits in memory formation, but care needs to be exercised since many human studies are flawed by multiple drug abuse, small sample sizes, sample selection and sensitivity of psychological tests for subtle differences. The most robust finding with respect to memory is a deficit in working and short-term memory. This requires intact hippocampus and prefrontal cortex, two brain regions richly expressing CB1 receptors. Animal studies, which enable a more controlled drug regime and more constant behavioural testing, have confirmed human results and suggest, with respect to hippocampus, that exogenous cannabinoid treatment selectively affects encoding processes. This may be different in other brain areas, for instance the amygdala, where a predominant involvement in memory consolidation and forgetting has been firmly established. While cannabinoid receptor agonists impair memory formation, antagonists reverse these deficits or act as memory enhancers. These results are in good agreement with data obtained from electrophysiological recordings, which reveal reduction in neural plasticity following cannabinoid treatment, and increased plasticity following antagonist exposure. The mixed receptor properties of the pharmacological tool, however, make it difficult to define the exact role of any CB1 receptor population in memory processes with any certainty. This makes it all the more important that behavioural studies use selective administration of drugs to specific brain areas, rather than global administration to whole animals. The emerging role of the endogenous cannabinoid system in the hippocampus may be to facilitate the induction of long-term potentiation/the encoding of information. Administration of exogenous selective CB1 agonists may therefore disrupt hippocampus-dependent learning and memory by 'increasing the noise', rather than 'decreasing the signal' at potentiated inputs.
Article
The purpose of this study was to investigate the effect of the endogenous cannabinoid anandamide on the nonadrenergic noncholinergic (NANC) relaxant responses to electrical field stimulation in isolated rat corpus cavernosum. The corporal strips were mounted under tension in a standard oxygenated organ bath with guanethidine sulfate (5 microM) and atropine (1 microM) (to produce adrenergic and cholinergic blockade). The strips were precontracted with phenylephrine hydrochloride (7.5 microM) and electrical field stimulation was applied at different frequencies to obtain NANC-mediated relaxation. The expression of CB1, CB2 and vanilloid receptor proteins within the rat corpus cavernosum was evaluated using western blot analysis. The results showed that the relaxant responses to electrical stimulation were significantly enhanced in the presence of anandamide at 1 and 3 microM. The potentiating effect of anandamide (1 microM) on relaxation responses was significantly attenuated by either the selective cannabinoid CB1 receptor antagonist N-(piperidin-1-yl)-5-(4-iodophenyl)-1-(2, 4-dichlorophenyl)-4-methyl-1H-pyrazole-3-carboxamide (AM251; 1 microM) or the vanilloid receptor antagonist capsazepine (3 microM), but not by the selective cannabinoid CB2 receptor antagonist 6-iodo-2-methyl-1-[2-(4-morpholinyl) ethyl]-1H-indol-3-yl (4-methoxyphenyl)methanone (AM630; 1 microM). Neither of these antagonists had influence on relaxation responses. Indomethacin (20 microM) had no effect on NANC-mediated relaxation in the presence or absence of anandamide (1 microM). Preincubation with Nw-Nitro-L-Arginine Methyl Ester (L-NAME; 1 microM) significantly inhibited the relaxation responses in the presence or absence of 1 microM anandamide. Although at 30 nM, L-NAME did not cause a significant inhibition of relaxant responses individually, it significantly inhibited the potentiating effect of anandamide (1 microM) on relaxation responses. Anandamide (1 microM) had no influence on concentration-dependent relaxant responses to sodium nitroprusside (10 nM-1 mM), a nitric oxide (NO) donor. The western blotting of corporal tissues demonstrated the existence of both vanilloid and CB1 receptors in corporal strips. In conclusion, our results showed that anandamide has a potentiating effect on NANC-mediated relaxation of rat corpus cavernosum through both CB1 and vanilloid receptors and the NO-mediated component of the NANC relaxant responses to electrical stimulation is involved in this enhancement.
Article
[N-(piperidin-1-yl)-5-(4-chlorophenyl)-4-methyl-1H-pyrazole-3-carboxyamide] (SR 141716A), a selective cannabinoid CB1 receptor antagonist, injected into the paraventricular nucleus of the hypothalamus (PVN) of male rats, induces penile erection. This effect is mediated by the release of glutamic acid, which in turn activates central oxytocinergic neurons mediating penile erection. Double immunofluorescence studies with selective antibodies against CB1 receptors, glutamic acid transporters (vesicular glutamate transporters 1 and 2 (VGlut1 and VGlut2), glutamic acid decarboxylase-67 (GAD67) and oxytocin itself, have shown that CB1 receptors in the PVN are located mainly in GABAergic terminals and fibers surrounding oxytocinergic cell bodies. As GABAergic synapses in the PVN impinge directly on oxytocinergic neurons or on excitatory glutamatergic synapses, which also impinge on oxytocinergic neurons, these results suggest that the blockade of CB1 receptors decreases GABA release in the PVN, increasing in turn glutamatergic neurotransmission to activate oxytocinergic neurons mediating penile erection. Autoradiography studies with [(3)H](-)-CP 55,940 show that chronic treatment with SR 141716A for 15 days twice daily (1 mg/kg i.p.) significantly increases the density of CB1 receptors in the PVN. This increase occurs concomitantly with an almost twofold increase in the pro-erectile effect of SR 141716A injected into the PVN as compared with control rats. The present findings confirm that PVN CB1 receptors, localized mainly in GABAergic synapses that control in an inhibitory fashion excitatory synapses, exert an inhibitory control on penile erection, demonstrating for the first time that chronic blockade of CB1 receptors by SR 141716A increases the density of these receptors in the PVN. This increase is related to an enhanced pro-erectile effect of SR 141716A, which is still present 3 days after the end of the chronic treatment.
Article
Intact endogenous cannabinoid signaling is involved in several aspects of drug addiction. Most importantly, endocannabinoids exert pronounced influence on primary rewarding effects of abused drugs, including exogenous cannabis itself, through the regulation of drug-induced increase in bursting activity of dopaminergic neurons in the ventral tegmental area (VTA). Previous electrophysiological studies have proposed that these dopaminergic neurons may release endocannabinoids in an activity-dependent manner to regulate their various synaptic inputs; however, the underlying molecular and anatomical substrates have so far been elusive. To facilitate understanding of the neurobiological mechanisms involving endocannabinoid signaling in drug addiction, we carried out detailed analysis of the molecular architecture of the endocannabinoid system in the VTA. In situ hybridization for sn-1-diacylglycerol lipase-alpha (DGL-alpha), the biosynthetic enzyme of the most abundant endocannabinoid, 2-arachidonoylglycerol (2-AG), revealed that DGL-alpha was expressed at moderate to high levels by most neurons of the VTA. Immunostaining for DGL-alpha resulted in a widespread punctate pattern at the light microscopic level, whereas high-resolution electron microscopic analysis demonstrated that this pattern is due to accumulation of the enzyme adjacent to postsynaptic specializations of several distinct morphological types of glutamatergic and GABAergic synapses. These axon terminal types carried presynaptic CB(1) cannabinoid receptors on the opposite side of DGL-alpha-containing synapses and double immunostaining confirmed that DGL-alpha is present on the plasma membrane of both tyrosine hydroxylase (TH)-positive (dopaminergic) and TH-negative dendrites. These findings indicate that retrograde synaptic signaling mediated by 2-AG via CB(1) may influence the drug-reward circuitry at multiple types of synapses in the VTA.
Article
Systemic administration of direct cannabinoid CB1 receptor agonists and inhibitors of the hydrolytic enzyme fatty acid amide hydrolase have been shown to elicit antidepressant effects. Moreover, the endocannabinoid system in the hippocampus is sensitive to both chronic stress and antidepressant administration, suggesting a potential role of this system in emotional changes associated with these regimens. The aim of this study was to determine if cannabinoid CB1 receptors in the hippocampus modulate emotionality in rats as assessed via the forced swim test. Male Sprague-Dawley rats were bilaterally implanted with cannulae directed at the dentate gyrus of the dorsal hippocampus and subsequently received three infusions of either the cannabinoid CB1 receptor agonist HU-210 (1 and 2.5 microg), the fatty acid amide hydrolase inhibitor URB597 (0.5 and 1 microg), the cannabinoid CB1 receptor antagonist AM251 (1 and 2.5 microg), or vehicle (dimethyl sulfoxide) and were assessed in the forced swim test. Infusion of both doses of HU-210 resulted in a dramatic reduction in immobility and increase in swimming behaviour, indicative of an antidepressant response, which was partially reversed by coadministration of AM251. No effect of URB597 administration or any effect following the administration of AM251 alone was, however, observed. These data indicate that activation of CB1 receptors in the dentate gyrus of the hippocampus results in an antidepressant-like response. Collectively, these data highlight the potential importance of changes in the hippocampal endocannabinoid system following stress or antidepressant treatment with respect to the manifestation and/or treatment of depression.
Independent Drug Monitoring Unit. Types of Cannabis Available in the United Kingdom (UK)
  • M J Atha