Sex Sex is the trait that determines whether a sexually reproducing animal or plant produces male or female gametes. Male plants and animals produce smaller mobile gametes (spermatozoa, sperm, pollen), while females produce larger ones ( ova, of ...

and drugs date back to ancient humans and have been interlocked throughout human history. Both legal and illegal, the consumption of drugs and their effects on the human body encompasses all aspects of sex, including desire, performance, pleasure, conception, gestation, and

disease A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...

. There are many different types of drugs that are commonly associated with their effects on sex, including alcohol,

cannabis ''Cannabis'' () is a genus of flowering plants in the family Cannabaceae. The number of species within the genus is disputed. Three species may be recognized: '' Cannabis sativa'', '' C. indica'', and '' C. ruderalis''. Alternative ...

cocaine Cocaine (from , from , ultimately from Quechua: ''kúka'') is a central nervous system (CNS) stimulant mainly used recreationally for its euphoric effects. It is primarily obtained from the leaves of two Coca species native to South Ameri ...

MDMA 3,4-Methylenedioxymethamphetamine (MDMA), commonly seen in tablet form (ecstasy) and crystal form (molly or mandy), is a potent empathogen–entactogen with stimulant properties primarily used for recreational purposes. The desire ...

GHB ''gamma''-Hydroxybutyric acid (or γ-hydroxybutyric acid (GHB), also known as 4-hydroxybutanoic acid) is a naturally occurring neurotransmitter and a depressant drug. It is a precursor to GABA, glutamate, and glycine in certain brain areas. ...

amphetamines Substituted amphetamines are a class of compounds based upon the amphetamine structure; it includes all derivative compounds which are formed by replacing, or substituting, one or more hydrogen atoms in the amphetamine core structure with sub ...

opioid Opioids are substances that act on opioid receptors to produce morphine-like effects. Medically they are primarily used for pain relief, including anesthesia. Other medical uses include suppression of diarrhea, replacement therapy for opioid use ...

s, antidepressants, and many others.

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 drug A date rape drug is any drug that incapacitates another person and renders that person vulnerable to sexual assault, including rape. The substances are associated with date rape because of reported incidents of their use in the context of two p ...

s. 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 Prolactin (PRL), also known as lactotropin, is a protein best known for its role in enabling mammals to produce milk. It is influential in over 300 separate processes in various vertebrates, including humans. Prolactin is secreted from the pit ...

, such potent

dopamine receptor Dopamine receptors are a class of G protein-coupled receptors that are prominent in the vertebrate central nervous system (CNS). Dopamine receptors activate different effectors through not only G-protein coupling, but also signaling through diffe ...

agonists as

cabergoline Cabergoline, sold under the brand name Dostinex among others, is a dopaminergic medication used in the treatment of high prolactin levels, prolactinomas, Parkinson's disease, and for other indications. It is taken by mouth. Cabergoline is an e ...

may help achieve multiple

orgasm Orgasm (from Greek , ; "excitement, swelling") or sexual climax is the sudden discharge of accumulated sexual excitement during the sexual response cycle, resulting in rhythmic, involuntary muscular contractions in the pelvic region chara ...

s 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 and effects

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 An aphrodisiac is a substance that increases sexual desire, sexual attraction, sexual pleasure, or sexual behavior. Substances range from a variety of plants, spices, foods, and synthetic chemicals. Natural aphrodisiacs like cannabis or cocai ...

, 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.

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. Alcohol has been shown in human research to have surprising effects on the human libido. While some studies indicates that alcohol improves sexual behavior and desire, 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 all contribute to these controversial 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 apparent 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. Alcohol and sex 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.

Cocaine

Cocaine Cocaine (from , from , ultimately from Quechua: ''kúka'') is a central nervous system (CNS) stimulant mainly used recreationally for its euphoric effects. It is primarily obtained from the leaves of two Coca species native to South Ameri ...

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 females to achieve orgasm.

MDMA

or "ecstasy" originally gained popularity in the 1980s among college students. According to a survey conducted, 10% of college students at a big US institution reported using

, with alcohol and marijuana being the most often used substances.

users report increased enjoyment in physical contact and proximity rather than a sexual experience.

has been shown to impair sexual performance, including erectile dysfunction and delayed orgasm, as well as to suppress sex desire.

2C-B

2C-B 2C-B (4-Bromo-2,5-dimethoxyphenethylamine) is a psychedelic drug of the 2C family. It was first synthesized by Alexander Shulgin in 1974. In Shulgin's book '' PiHKAL'', the dosage range is listed as 12–24 mg. As a recreational drug, 2C-B is so ...

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 5-MeO-MiPT is a psychedelic and hallucinogenic drug, used by some as an entheogen. It has structural and pharmacodynamic properties similar to the drugs 5-MeO-DiPT, DiPT, and MiPT. It is commonly used as a "substitute" for 5-MeO-DiPT because ...

is another psychedelic that some users find to be euphoric and tactile in low to moderate doses of 4-8 milligrams.

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 and cause females to have

breast enlargement Breast enlargement is the enlargement of the breasts. It may occur naturally as in mammoplasia or may occur artificially through active intervention. Many women regard their breasts, which are female secondary sex characteristics, as important to t ...

. 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 MACA or maca can mean: * Maca (plant) Places Geography * Maca District, Peru * Cerro Macá, stratovolcano in the Aisén Region of Chile * Maca River, Romania Outer space * 5228 Máca, a minor planet People * Alain Maca (born 1950), Belgian ...

, 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.

Opioids

Opioid Opioids are substances that act on opioid receptors to produce morphine-like effects. Medically they are primarily used for pain relief, including anesthesia. Other medical uses include suppression of diarrhea, replacement therapy for opioid use ...

s (also known as narcotics) such as

morphine Morphine is a strong opiate that is found naturally in opium, a dark brown resin in poppies (''Papaver somniferum''). It is mainly used as a pain medication, and is also commonly used recreationally, or to make other illicit opioids. T ...

and heroin attach to

opioid receptor Opioid receptors are a group of inhibitory G protein-coupled receptors with opioids as ligands. The endogenous opioids are dynorphins, enkephalins, endorphins, endomorphins and nociceptin. The opioid receptors are ~40% identical to somatostatin ...

s in the brain. These substances have long been known to inhibit sexual behavior. Similar to the effects of psycho-stimulants, both men and women who use heroin report engaging in high-risk sexual practices. Subjects typically report having several sexual partners, using condoms seldom or not at all, and having a high frequency of STI diagnosis. While small doses of heroin may enhance sexual desire and performance, chronic opiate use, including

methadone Methadone, sold under the brand names Dolophine and Methadose among others, is a synthetic opioid agonist used for chronic pain and also for opioid dependence. It is used to treat chronic pain, and it is also used to treat addiction to heroi ...

and

buprenorphine Buprenorphine is an opioid used to treat opioid use disorder, acute pain, and chronic pain. It can be used under the tongue (sublingual), in the cheek (buccal), by injection (intravenous and subcutaneous), as a skin patch (transdermal ...

, synthetic and semi-synthetic opiates prescribed for

opiate addiction Opioid use disorder (OUD) is a substance use disorder characterized by cravings for opioids, continued use despite physical and/or psychological deterioration, increased tolerance with use, and withdrawal symptoms after discontinuing opioids. Op ...

treatment, results in decreased sexual desire, response, and orgasms for both men and women, as well as erectile, ejaculatory dysfunction, and

vaginismus Vaginismus is a condition in which involuntary muscle spasm interferes with vaginal intercourse or other penetration of the vagina. This often results in pain with attempts at sex. Often, it begins when vaginal intercourse is first attempted. ...

Amphetamines

Amphetamines may lead to an increase in

sexual drive Libido (; colloquial: sex drive) is a person's overall sexual drive or desire for sexual activity. Libido is influenced by biological, psychological, and social factors. Biologically, the sex hormones and associated neurotransmitters that act up ...

and delay in orgasm.

Date rape drugs

is any drug that is an

incapacitating agent The term incapacitating agent is defined by the United States Department of Defense as: :"An agent that produces temporary physiological or mental effects, or both, which will render individuals incapable of concerted effort in the performance o ...

which—when administered to another person—incapacitates the person and renders them vulnerable to a

drug-facilitated sexual assault Drug-facilitated sexual assault (DFSA) is a sexual assault (rape or otherwise) carried out on a person after the person has become intoxicated due to being under the influence of any mind-altering substances, such as having consumed alcohol or b ...

(DFSA), including

rape Rape is a type of sexual assault usually involving sexual intercourse or other forms of sexual penetration carried out against a person without their consent. The act may be carried out by physical force, coercion, abuse of authority, or ...

. One of the most common types of DFSA are those in which a victim consumes a recreational drug such as alcohol that was administered surreptitiously. The other most common form of DFSA involves the non-surreptitiously-administered consumption of alcohol. Here, the victims in these cases are drinking voluntarily which then makes them unable to make informed decisions or give consent.

Society and culture

Chemsex

Party and play, or chemsex, is the consumption of drugs to facilitate

sexual activity Human sexual activity, human sexual practice or human sexual behaviour is the manner in which humans experience and express their sexuality. People engage in a variety of sexual acts, ranging from activities done alone (e.g., masturbation) ...

. Sociologically, both terms refer to a subculture of recreational drug users who engage in high-risk sexual activities under the influence of drugs within groups. The term PnP is commonly used by gay men and other

men who have sex with men Men who have sex with men (MSM) are male persons who engage in sexual activity with members of the same sex. The term was created in the 1990s by epidemiologists to study the spread of disease among all men who have sex with men, regardless of ...

(MSM) in North America, while chemsex is more associated with the gay scene in Europe. The drug of choice is typically methamphetamine, known as tina or T, but other drugs are also used, such as

mephedrone Mephedrone, also known as , , and , is a synthetic stimulant drug of the amphetamine and cathinone classes. Slang names include drone, , White Magic, meow meow, bubble, ''txomin'' and yurrpt. It is chemically similar to the cathinone compounds ...

, GBL and alkyl nitrites (known as

poppers Popper is a slang term given broadly to drugs of the chemical class called alkyl nitrites that are inhaled. Most widely sold products include the original isoamyl nitrite or isopentyl nitrite, and isopropyl nitrite. Isobutyl nitrite is al ...

Contraception and abortion

Drug-based contraception has been available since the development of the

contraceptive pill Oral contraceptives, abbreviated OCPs, also known as birth control pills, are medications taken by mouth for the purpose of birth control. Female Two types of female oral contraceptive pill, taken once per day, are widely available: * The combin ...

. As well as their contraceptive effects, contraceptive drugs can also have adverse sexual and reproductive side-effects. Prior to the availability of effective contraceptives, some substances were also used as abortifacients to terminate pregnancy;

medical abortion A medical abortion, also known as medication abortion, occurs when drugs (medication) are used to bring about an abortion. Medical abortions are an alternative to surgical abortions such as vacuum aspiration or dilation and curettage. Medical ...

exists as a modern medical practice.