Sex and drugs refers to the influence of substances on sexual function and experience. Sex and drugs date back to ancient humans and have been interlocked throughout human history. Sexual performance is known as the execution of the act of sex and the quality of sexual activity. This includes elements such as libido (a person's sexual drive), sexual function (including erection in males and vaginal lubrication in females), sensation (the ability to achieve orgasm). Drugs are termed as any chemical substance that produces a physiological and or psychological change in an organism. Drugs categorized as psychoactive drugs, antihypertensive drugs, antihistamines, cancer treatment, and hormone medication have a significant impact on sexual performance. Various drugs result in different effects, both positive and negative. Negative effects may include low libido, erection issues (in males), vaginal dryness (in females) and anorgasmia. Positive effects usually address these issues, overall enhancing sexual performance and contributing to a more enjoyable sexual experience. It is crucial to know that the impact of drugs on sexual performance varies among individuals, especially among different genders.
Understanding sexual performance Understanding sexual performance involves recognizing various factors that are responsible for a person's combined sexual experience and function. This includes libido, a person's overall sexual desire, and drive; sexual function, which encompasses the male's erectile function and a female's vaginal lubrication; and sensations, which in this context refers to a person's ability to have orgasms and/or ejaculations.
Libido Libido is primarily regulated by the hypothalamus, where sex hormones (testosterone and estrogen), and neurotransmitters (dopamine, oxytocin and serotonin), are the main components that influence sex drive. A decreased libido is predominantly caused by low testosterone in males For females, serotonin acts as a inhibitor for sexual desire as it reduces the ability of stimulatory systems for sexual cues.
Sexual function
Penile erection is a vascular event caused by the innervation of both autonomic (sympathetic and parasympathetic) and somatic nervous systems (sensory and motor). Sensory information is received from the genitals towards these nervous systems, in which neurotransmitters such as serotonin, dopamine, noradrenaline, and adrenaline would be released to control erectile function.
Vaginal dryness refers to the situation when the vagina lacks lubrication which leads to serious pain during sexual intercourse. The production of lubricants in the vagina are highly sensitive to changes in hormones such as estrogen and testosterone, that are also responsible for blood flow. Low estrogen and testosterone circulating in the body contributes to vaginal dryness.
Sensations Orgasms are sensory phenomena that take place in the cerebral cortex with an association with the spinal reflex. Men can achieve orgasm through the penis, and can be categorised to two parts: emission and ejaculation. Neurotransmitters such as serotonin, norepinephrine and dopamine affect ejaculation in males the most. For women, orgasms are induced by stimulation of erotic sites, currently there are no definitive explanations on the chemical triggers for female orgasm.
Disinhibition Drugs are frequently associated with reduced sexual inhibition, both when used voluntarily in social circumstances, and involuntarily, as in the case of some date rape drugs. Because the use of drugs, including alcohol, is commonly presented as an excuse for risky or socially unacceptable behavior, it is necessary to treat the idea of a direct causal relation between drug use and unsafe sex with caution. Drugs may provide a socially acceptable excuse for engaging in sexual behaviors in which people may want to engage but perhaps feel that they should not.
Sexual function Some forms of sexual dysfunction such as erectile dysfunction can be treated with drugs. Because of their effects, erectile dysfunction drugs are sometimes used for recreational purposes. Many drugs, both legal and illegal, some sold online, have side effects that affect the user's sexual function. Many drugs can cause loss of libido as a side effect.
Since a partial cause of the refractory period is the inhibition of dopamine by an orgasm-induced secretion of prolactin, such potent dopamine receptor agonists as cabergoline may help achieve multiple orgasms as well as the retention of sexual arousal for longer periods of time.
Sexual activity, drug use, and risks According to some studies, up to 22.1% of teenagers abused substances during their most recent sexual experience.
Likewise, studies have shown adolescents who regularly abuse substances are more likely to initiate sexual activity at an earlier age, have a more significant number of sexual partners, and engage in unprotected sex more often.
Additionally, substance abuse has been linked to an increased risk of sexually transmitted infection (STI).
Types of drugs that affect sexual performance Drugs on the market provide both benefits and detrimental effects to the person, especially regarding sexual performance, depending on the use and dosage. Drugs are classified into different categories in respect to their functions, including psychoactive drugs, antihypertensive drugs, antihistamines, cancer treatment drugs and hormone medication.
Psychoactive drugs Psychoactive drugs refer to chemical substances that affect an individual's mental processes, such as emotions, cognition, perception, and consciousness. These substances directly impact the central nervous system (CNS), which also has an impact on the neurophysiologic phases of sexual response. Antidepressants are a group of drugs that treat individuals with clinical depression, as well as other mental disorders. This group of drugs have shown to affect sexual functions in both male and females. Alcohol is a group of psychoactive substances where signals of pleasure, rewards are sent to the human brain. It also causes a series of adverse effects on the body, including the brain and the liver, leading to health problems and sexual dysfunction. Antipsychotics are drugs that treat mental disorders such as schizophrenia, and other psychoses. These drugs block certain pathways in humans that contribute to sexual dysfunction, including reduced arousal and sexual desire.
Alcohol
Alcohol inhibits neuronal excitability through acting on gamma-aminobutyric acid (GABA) receptors. Alcohol is often accessible in a number of social situations across many cultures and is frequently connected with uninhibited social activities. However, clinical research has produced mixed results about the effects of alcohol on libido in humans.
Some studies indicate that alcohol improves sexual behavior and desire, but other research indicates that alcohol impairs sexual function. The conditions under which the drinking occurs, laboratory research vs self-report studies from users, as well as the amounts of alcohol consumed, may contribute to these outcomes.
Laboratory studies have demonstrated that while low blood alcohol levels have no effect on or slightly enhance sexual arousal and responsiveness in men, elevated blood alcohol levels result in decreased erectile responsiveness, decreased arousal, and impaired ability to ejaculate. Other laboratory research, on the other hand, found no significant influence of either low or high blood alcohol levels on measures of arousal.
Even with mild alcohol use, women have decreased vaginal flow responses. In contrast, women self-report heightened sexual desire and pleasure when they consume more alcohol and are more likely to engage in sexual activities with someone when intoxicated.
Heavy alcohol intake impairs sexual and reproductive function, erectile, and ejaculatory dysfunction in males, and sexual arousal, interest, and orgasm in women.
Although alcohol may have varying impacts on sexual performance depending on the amount drank, it generally impairs sexual functioning and contributes to increased sexual risk taking.
Antidepressants Psychiatrists and doctors commonly prescribe different types of antidepressants to patients. SSRIs, SNRIs, and NDRIs are the most common types of antidepressants. Each has slightly different effects on sexual functioning, but generally, it has been found that antidepressants can delay/decrease orgasms. Dapoxetine in particular takes advantage of the side effect of delayed orgasm and is approved specifically as a medication for the treatment of premature ejaculation rather than as an antidepressant.
The side effects on sexual functioning can impact mental health and quality of life. However, the decrease in depressive symptoms from antidepressants make it worth the sexual side effects for many people. They can be managed by changing the dose, switching drugs, or taking "antidotes". Maca, a plant that grows in central Peru, aids with sexual dysfunction caused by antidepressant drugs for women. There are specific Maca products that can also increase sexual desire in men.
2C-B 2C-B was first sold commercially in 5 mg pills as a purported aphrodisiac under the trade name "Erox", which was manufactured by the German pharmaceutical company Drittewelle. While being primarily a psychedelic it is also a mild entactogen. 5-MeO-MiPT is another psychedelic that some users find to be euphoric and tactile in low to moderate doses of 4-8 milligrams.
Antihypertensive drugs Antihypertensive drugs are a group of drugs that prevent, control and treat hypertension. Hypertension imposes negative sexual effects on both men and women, where antihypertensive drugs help alleviate erectile dysfunction in men.
Antihistamines Antihistamines are used for relieving symptoms of allergies and hay fever. Antihistamines may cause a drying effect of the mouth, nose and throat but can also cause a drying effect on other parts of the body, such as the vagina, decreasing moisture and lubrication.
Cancer treatment There are a variety of treatment types for cancer, depending on the cancer type. The therapies for treating cancer vary, including hormone therapy, medications that treat pain, depression, nerves and blood vessels. These therapies will affect one's sexual desire and pose possible consequences on sexual response.
Hormone medications Hormone therapy directs its treatment towards hormones in the body, including reproductive hormones. One type is hormonal replacement therapy (HRT), which is used to supply menopausal women that lack estrogen and progesterone, increasing vaginal lubrication. Another type is testosterone replacement therapy, which treats men with hypogonadism and it helps increase libido. On the contractionary, selective estrogen receptor modulators (SERMs) lead to a drop in oestrogen levels that would cause vaginal dryness.
Amphetamines Amphetamines may lead to an increase in sexual drive and delay in orgasm.
Cocaine Cocaine is a potent psycho-stimulant that boosts dopamine levels by inhibiting dopamine transporters. It has been often linked to enhanced libido and risk-taking behavior in humans.
Cocaine has been observed to increase sexual arousal or to trigger spontaneous erections and orgasms.
In contrast, other data has shown that persistent cocaine use impairs sexual desire and the capacity of both men and women to achieve orgasm.
Cannabis
Cannabis is the most commonly used illicit substance. Studies on cannabis and sex have shown that THC has been linked to improved sexual desire and function. Specifically, in one study, 70 percent of users said marijuana was an aphrodisiac, and 81 percent said it improved their sexual pleasure and satisfaction.
Other research has found that long-term marijuana use lowers testosterone levels and other reproductive hormones, causing erectile dysfunction in males.
MDMA