Does cocaine cause sexual side effects? Some people use cocaine with sex to enhance the pleasure, but long-term use can cause permanent damage.

Men who combine cocaine and sex may experience unwanted side effects in the bedroom. But does cocaine directly cause erectile dysfunction (ED)? The truth is, yes, long-term cocaine use can cause ED as a side effect. Even worse, these symptoms can be irreversible.

Illegal Drugs like cocaine cause ED through vasoconstriction or narrowing of the blood vessels. Vasoconstriction is when blood vessels (arteries or veins) tighten. The body does this naturally for many reasons. For example, if you are cold, the capillaries in your hands and feet might constrict to save heat. Over time, the tissues of the penis receive less oxygen and nutrients because the cells are not getting as much blood.

Article at a Glance:

  • Cocaine increases sexual pleasure at first by increasing dopamine (a chemical signal that increases feelings of pleasure)
  • A healthy erection requires good blood flow and relaxes muscles in the penis
  • Cocaine cuts off blood flow to the penis by causing vasoconstriction
  • Over time, drug abuse can cause unwanted sexual side effects that can be permanent

Short-Term Effects of Cocaine on ED

Cocaine works by increasing levels of neurotransmitters in different body cells. Neurotransmitters are chemicals that brain cells (neurons) use to send messages to one another.

When cocaine enters the bloodstream, it increases the levels of dopamine, epinephrine, and norepinephrine. Dopamine is the neurotransmitter most responsible for pleasure and it plays a role in sexual pleasure as well.

When someone first uses cocaine, they experience positive sexual side effects, at first. People using stimulants like cocaine report the following:

  • Feelings of more control during sex
  • Increased duration of sex
  • Increased quality of sexual pleasure
  • More pleasurable orgasms

Such positive side effects are why some people continue to use cocaine to supplement their sexual experiences. The positive side effects happen because of the extra dopamine present when someone uses cocaine.

The positive effects of cocaine start to diminish over time and as tolerance develops to the positive sexual side effects. 

Long-Term Effects of Cocaine on ED

Over time, a person must use more cocaine to achieve the same effects, if they can achieve them at all. Long-term cocaine use can cause the following sexual side effects:

  • Decreased blood flow to the penis
  • Decreased libido, or sex drive
  • Loss of feelings of control during sex
  • Loss of sensation during sex
  • Premature ejaculation

Damage caused by cocaine is slow and hard to notice. Cocaine causes erectile dysfunction over time because of vasoconstriction. The drug causes the body’s blood vessels to tighten and deliver less blood and oxygen to different cells in the body. 

A healthy erection depends on the ability of the penile blood vessels to relax. During an erection, the soft tissue of the penis fills with blood. Cocaine prevents this relaxation by tightening and constricting the blood vessels.

In addition to decreasing blood flow to the penis, cocaine also blunts the brain’s ability to respond to sexual stimulation. Prolonged high levels of dopamine will cause neurons to become less sensitive to sexual stimulation. Therefore, sexual stimulation while sober will not cause the same levels of arousal as it used to before cocaine use began.

Can the Sexual Side Effects of Cocaine Be Reversed?

Damage from cocaine and other substance abuse seems to be permanent. A recent study examined 905 men to observe the long-term effects of drug abuse on sexual functioning. The substance dependant group included 549 men, and the other 356 were controls. The men in the control group did not use drugs, and the researchers compared their sexual functioning against the men in the substance use group.

Men in the substance dependence group showed impaired sexual functioning that lasted even after they stopped using the drug. When the researchers examined the men two weeks after abstinence (stopped using the drug entirely), their sexual functioning stayed decreased. The men were surveyed again after one year, and they still had poorer sexual functioning than the control group.

Drug or cocaine use causes permanent sexual side effects if it goes on too long. The best way to prevent permanent sexual damage is to stop using cocaine. If you or someone you know needs treatment for substance abuse, contact The Recovery Village to speak with a representative about how treatment can help. Begin your healthier future by calling today.

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Editor – Thomas Christiansen
With over a decade of content experience, Tom produces and edits research articles, news and blog posts produced for Advanced Recovery Systems. Read more
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Medically Reviewed By – Dr. Conor Sheehy, PharmD, BCPS, CACP
Dr. Sheehy completed his BS in Molecular Biology at the University of Idaho and went on to complete his Doctor of Pharmacy (PharmD) at the University of Washington in Seattle. Read more

Dolatshahi, Behrouz. A Qualitative Study of the Relationship […]ance Abusers. International Journal of High Risk Behaviors and Addiction, 2016. Accessed May 20, 2019.

Vallejo-Medina, Pablo, and Juan Carlos Sierra. Effect of Drug Use and Influence of Abst[…]tisite Study. The Journal of Sexual Medicine, 2013. Accessed May 20, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.