Erectile dysfunction refers to an inability to have and maintain an erection firm enough for sex.

A variety of medical and mental health conditions can trigger erectile dysfunction (ED), as can certain lifestyle choices, including the use of some recreational drugs.

The medical community has not found conclusive evidence that using cannabis, or marijuana, leads to ED.

However, specific effects of the drug may result in ED, and a person who smokes a mixture of marijuana and tobacco may have an increased risk.

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People use cannabis for recreational and medicinal purposes.

According to the National Institute on Drug Abuse (NIDA), in the United States, more than 11 million people between the ages of 18 and 25 used marijuana in 2014.

People in the U.S. are more likely to use marijuana than any other recreational drug.

Marijuana consists of the dried leaves, flowers, seeds, and stems from the hemp plant, Cannabis sativa.

The plant contains a variety of chemicals, including a group called cannabinoids. The best-known of these chemicals is delta-9-tetrahydrocannabinol (THC).

THC has a psychoactive effect, which means that it affects a person's thinking.

The chemical may also have other effects, and some prescription drugs with approval from the U.S. Food and Drug Administration contain synthetic forms of THC.

Marinol and Syndros, for example, are treatments for some types of anorexia. Cesaret, which was developed to treat nausea and vomiting that results from chemotherapy, contains nabilone, which has a similar structure to THC.

A person using marijuana recreationally may smoke it in a pipe, a water pipe, or a hand-rolled cigarette called a joint.

If a person does not want to inhale the smoke, they may use a vaporizer, though these devices are also linked to some health hazards. Others incorporate marijuana into foods, such as brownies or cookies, or brew it as a tea.

Many companies also market marijuana products that can be applied to the skin.

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Cannabis can relax the body, but could it also increase the risk of erectile dysfunction?

While some small studies have suggested that recreational marijuana use may lead to ED, authors of a 2018 meta-analysis concluded that there is not enough evidence to confirm a link.

However, it is possible to identify how certain effects of THC could cause the dysfunction. A person who mixes marijuana with tobacco may have a higher risk.

Smoking tobacco restricts blood flow to the veins and arteries, and a person who smokes cigarettes has an increased risk of developing ED. Smoking marijuana, especially when mixed tobacco, may confer a similar risk.

Cannabinoid receptors are present in the smooth muscle tissue of the penis. For this reason, it is theoretically possible for THC to impair penile function, and this may lead to ED. However, evidence is lacking.

According to NIDA, marijuana can cause a feeling of euphoria, then drowsiness and a slower reaction time.

These effects could lead to a decreased desire for sex.

The Centers for Disease Control and Prevention (CDC) note that marijuana may also affect the circulatory system and lead to increases in blood pressure and heart rate. A person who smokes marijuana is more likely to experience these effects, and both put a person at risk for ED.

There is also some evidence that frequent cannabis use may cause men to have difficulty reaching an orgasm or reaching one in the desired timeframe.

However, at least one study found no significant difference in risk for ED between a group that used cannabis and a control group.

When a person smokes marijuana, THC passes from the lungs into the bloodstream. The bloodstream carries it to the brain and other organs throughout the body.

THC affects the brain's pleasure and reward system. It signals the body to release more dopamine than usual, and the dopamine affects mood and sensation. This is why a person feels "high" after using the drug.

Other short-term effects of using marijuana may include:

  • changed sensory perception
  • euphoria followed by drowsiness and relaxation
  • changes in balance and coordination
  • increased heart rate
  • problems with learning and memory
  • anxiety

Possible long-term effects include:

  • mental health problems
  • frequent respiratory infections and a persistent cough
  • memory impairment

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Scientists are investigating how substances in marijuana might be useful in medication.

Recently, the medical use of marijuana and its components has received a lot of attention.

In June 2018, the FDA approved the use of cannabidiol (CBD) to treat epilepsy that occurs with two rare and severe conditions, Lennox-Gastaut syndrome and Dravet syndrome.

Some compounds within marijuana show promise as treatments for various other conditions. However, much research is still needed before these treatments can be approved.

Even in states where the drug is still banned, many people in the U.S. use marijuana or its derivatives in the hope that it will benefit their health. The risks of doing so are mostly unclear.

Like other drugs, marijuana may interfere with some medicines and alternative treatments, including:

  • Blood thinners: Marijuana may increase the blood-thinning effects of warfarin and some herbs and supplements.
  • Alcohol: Marijuana may amplify the psychotropic and depressant effects.
  • Theophylline: Marijuana may reduce the effects of this treatment on asthma and other respiratory illnesses.Benzodiazepines and barbiturates: Marijuana may increase the depressant effects on the central nervous system.
  • Psychiatric medications: Marijuana may change the effects.
  • Antiretroviral therapy: Marijuana may make some of these drugs less effective.

Other drug interactions may occur, and further research is necessary.

Anyone concerned about the impact of recreational or medicinal use of cannabis or its derivatives should speak with a healthcare professional.

A doctor can provide more detailed information about possible side effects and interactions with medication.

There is not enough evidence to link marijuana use with ED. However, some of the drug's side effects, such as cardiovascular complications, may increase the risk of ED.

Authors of one review found no significant link between cannabis use and ED. They did observe that consuming alcohol and smoking cigarettes increased the risk of ED, while physical activity seemed to reduce this risk.

Anyone concerned about ED may benefit from getting more exercise and avoiding tobacco and alcohol.

A person should only use marijuana in accordance with local laws and while under a doctor's care.