The impact of cannabis use on male sexual function: A 10-year, single-center experience

Introduction: Despite increasing consumption rates in much of the world, the impact of cannabis use on various components of male sexual function remain poorly established. The purpose of this study was to further evaluate the relationship between cannabis use and reproductive and sexual function using a large patient cohort from a single academic andrology clinic. Methods: This is a historical cohort study from a single academic center andrology clinic. Patients from 2008–2017 were included. Intake questionnaires provided baseline demographic information, as well as data regarding substance use and various sexual function parameters. Subjects were categorized as cannabis users or non-users. Cannabis users and non-users were compared using descriptive statistics and Chi-squared tests, and regression analyses were performed to test for association. Results: A total of 7809 males were included in the study; 993 (12.7%) were cannabis users and 6816 (87.3%) were non-users. Cannabis users had a higher mean Sexual Health Inventory for Men (SHIM) score (21.94.4 vs. 21.24.8, p<0.001) and mean serum total testosterone (13.412.0 nmol/L vs. 12.611.8 nmol/L, p=0.04) than non-users, although they also had a higher rate of positive Androgen Deficiency in the Aging Male (ADAM) scores (52% vs. 46%, p<0.001). Cannabis users also reported higher sexual frequency compared to non-users (8.8 events/month vs. 7.8 events/month, p<0.05). On multivariate analysis, cannabis use was not associated with SHIM score or serum testosterone concentration. Cannabis use was associated with positive ADAM scores. Conclusions: Cannabis use was not associated with clinically significant deleterious effects on male sexual parameters in this cohort.