Yes, long-term cocaine use can cause erectile dysfunction (ED) as a side effect.

Cocaine causes ED through vasoconstriction or narrowing of the blood vessels. Over time, the tissues of the penis receive less oxygen and nutrients because the cells are not getting as much blood.

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.

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 use of cocaine 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. Cocaine 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 Sexual Side Effects From 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.

If you or someone you know uses cocaine, the best way to prevent permanent sexual damage is to stop using cocaine.

Key Points: Cocaine and ED

Keep the following key points in mind when considering how cocaine and ED are related:

  • Cocaine increases sexual pleasure at first by increasing dopamine
  • Dopamine is a chemical signal that increases feelings of pleasure
  • Over time, cocaine causes unwanted sexual side effects
  • Cocaine cuts off blood flow to the penis by causing vasoconstriction
  • A healthy erection requires good blood flow and relaxes muscles in the penis
  • Cocaine and other substances can cause permanent sexual side effects

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

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a 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 provider.