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Association Between Habitual Cannabis Use in Young Men and IIEF Sexual Domain Scores
INTRODUCTION AND OBJECTIVES: There is limited data on sexual functioning in young males who habitually use cannabis. Previous studies demonstrate conflicting effects of cannabis use on male libido and erectile function, while a recent study suggests potential damage to penile endothelium. As public policy and societal views on cannabis use evolve, it is vital to define the effect of cannabis use on sexual performance in a young, at-risk population. Therefore, we conducted a multinational survey to investigate the association between drug use, health comorbidities, and sexual functioning on the five domains assessed by the International Index of Erectile Function (IIEF).
METHODS: We administered the IIEF-15 to male subjects in an online community frequented by young cannabis users who reported being sexually active in the past four weeks. Additionally, participants were also asked to self-report comorbidities and drug use. A saturated multivariate linear regression was used to examine association between cannabis use and sexual functioning.
RESULTS: A total of 1265 men participated in this survey. General demographics reported in Table 1. The mean IIEF domain scores for erectile function (EF), orgasmic function (OF), sexual desire (SD), intercourse satisfaction (IS), and overall satisfaction (OS) are greater in cannabis users than non-users as reported in Table 2 and 3. Moreover, current cannabis users show a statistically significant positive correlation in all domain scores versus the number of use-days per year (DOU) (p.95).
CONCLUSIONS: Habitual cannabis use defined by high DOU has a minor, but statistically significant, positive correlation with sexual functioning. YOU positively correlates with domain scores but fails to reach significance due to low-DOU/high-YOU users. Controlled studies that separate the physiological and psychological nuances of cannabis will be needed to assess its impact on sexual health. In the interim, defining cannabis use in men who present in the urological clinic may be insightful.

Table 1: General Demographics

	Never Used Cannabis	Current Cannabis Users	P-value
Number of respondents	280	985
Age: Mean ± SD	24.81 ± 7.78	22.71 ± 5.71	.000
Body Mass Index (BMI): Mean ± SD	26.80 ± 6.46	25.89 ± 6.27	.034
Days of Use per year (DOU)		237.13 ± 121.67
Years of Use (YOU)		5.11 ± 4.67

Table 2: Erectile Function (EF) and Orgasmic Function (OF)

	Never Used Cannabis	Current Cannabis Users	P-value	Standardized Coefficent Beta
Erectile Function (EF): Mean ± SD	24.96 ± 8.24	28.29 ± 3.68	.000
Linear Regression: EF vs YOU		NS	.157
Linear Regression: EF vs DOU		***	.000	AGE:.088 BMI:.066 DM:-.556 HC:-.150 HTN:-.089 DOU:.051
Orgasmic Function (OF): Mean ± SD	7.76 ± 3.32	8.96 ± 1.79	.000
Linear Regression: OF vs YOU		NS	.940
Linear Regression: OF vs DOU		**	.010	AGE:.132 BMI:.078 DM:-.578 HC:-.119 HTN:-.046 DOU:.038

Table 3: Sexual Desire, Intercourse Satisfaction, and Overall Satisfaction

	Never Used Cannabis	Current Cannabis Users	P-value	Standardized Coefficent Beta
Sexual Desire (SD): Mean ± SD	7.02 ± 3.21	8.07 ± 1.85	.000
		NS	.289
		**	.090	AGE:.126 BMI:.116 DM:-.571 HC:NS HTN:NS DOU:.028
Intercourse Satisfaction (IS): Mean ± SD	10.89 ± 4.97	13.25 ± 2.48	.000
Linear Regression: IS vs YOU		*	.038
Linear Regression: IS vs DOU				AGE:NS BMI:.112 DM:-.743 HC:NS HTN:.112 YOU:.020
Overall Satisfaction (OS): Mean ± SD	6.64 ± 3.26	8.07 ± 2.04	.000
Linear Regression: OS vs YOU		NS	.470
Linear Regression: OS vs DOU		*	.028	AGE:NS BMI:NS DM:-.929 HC:NS HTN:NS DOU:.040