Cannabis users were four times more likely to have erectile dysfunction in a meta-analysis | Research

The takeaway

A meta-analysis of five studies found that cannabis users had an erectile dysfunction prevalence of 69% compared to 35% in non-users, with nearly four times the odds of ED.

Male cannabis users, urologists, and sexual health researchers.

69% ED prevalence in cannabis users vs. 35% in non-users

What the researchers found

Across 3,395 men (1,035 cannabis users, 2,360 controls), the overall ED prevalence was 69.1% in cannabis users versus 34.7% in controls. The odds ratio for ED in cannabis users was 3.83 (95% CI: 1.30-11.28, p=.02), though heterogeneity was high (I-squared = 90%).

Why it matters

Erectile dysfunction is rarely discussed in the context of cannabis use. This meta-analysis provides the first pooled estimate of this relationship, suggesting a significant association that may be relevant for the many young men who use cannabis.

The numbers in context

5 studies, 3,395 men. ED prevalence: 69.1% in cannabis users vs. 34.7% in controls. OR = 3.83 (95% CI 1.30-11.28, p=.02). I-squared = 90%. Prediction interval: 0.35-7.26.

How the study worked

Systematic review and meta-analysis of major databases through January 2019. Five case-control studies were included. Random-effects model was used to calculate pooled odds ratios.

What this study cannot tell us

Only five case-control studies were available. Heterogeneity was very high (I-squared = 90%), and prediction intervals overlapped 1.00. All studies involved smoked cannabis; other consumption methods were not represented.

How to read the evidence

Moderate: meta-analysis with pooled analysis, but limited to five studies with high heterogeneity.

When this study was published

Published in 2019.

The bigger picture

Cannabis is often perceived as harmless or even beneficial for sexual function. This meta-analysis challenges that perception, though the high heterogeneity and small number of studies mean more research is needed.

Questions still open

Is there a dose-response relationship between cannabis frequency and ED risk? Does the method of consumption matter? Are the effects reversible with cessation?

Common questions

Does cannabis definitely cause erectile dysfunction?

The meta-analysis found a strong association, but the high heterogeneity and small number of studies mean causation is not established. Confounding factors like tobacco co-use may play a role.

Why was heterogeneity so high?

The five studies differed in how they measured cannabis use, defined ED, and selected participants. These differences likely contributed to the wide variation in results across studies.

Read the original research

Relationship Between Cannabis Use and Erectile Dysfunction: A Systematic Review and Meta-Analysis.

American journal of men's health, 13(6), 1557988319892464

View on PubMed ↗Publisher’s paper ↗

Citation

Pizzol, Damiano; Demurtas, Jacopo; Stubbs, Brendon; Soysal, Pinar; Mason, Corina; Isik, Ahmet Turan; Solmi, Marco; Smith, Lee; Veronese, Nicola. (2019). Relationship Between Cannabis Use and Erectile Dysfunction: A Systematic Review and Meta-Analysis.. American journal of men's health, 13(6), 1557988319892464. https://doi.org/10.1177/1557988319892464