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

• Main Authors: Damiano Pizzol PhD, Jacopo Demurtas MD, Brendon Stubbs PhD, Pinar Soysal MD, Corina Mason PhD, Ahmet Turan Isik, Marco Solmi MD, Lee Smith, Nicola Veronese MD
• Format: Article
• Language: English
• Published: SAGE Publishing 2019-12-01
• Series: American Journal of Men's Health
• Online Access: https://doi.org/10.1177/1557988319892464

Globally, there is increasing usage and legalization of cannabis. In addition to its reported therapeutic effects, cannabis has several health risks which are not clearly defined. Erectile dysfunction (ED) is the most common male sexual disorder and there are plausible mechanisms linking cannabis use to ED. No attempt has been made to collate the literature on this topic. The aim of this review was to summarize the prevalence and risk of ED in cannabis users compared to controls. A systematic review of major databases from inception to January 1, 2019, without language restriction, was undertaken to identify studies investigating cannabis use and presence of ED. The analysis compared the prevalence of ED in cannabis users versus controls. Consequently, the odds ratio (OR) with 95% confidence intervals (CI) was calculated, applying a random-effect model. Five case–control studies were included with data from 3,395 healthy men, 1,035 using cannabis (smoking) and 2,360 nonusers. The overall prevalence of ED in cannabis users was 69.1% (95% CI: 38.0–89.1), whilst the correspondent figure in controls was 34.7% (95% CI: 20.3–52.7). The OR of ED in cannabis users was almost four times that of controls (OR = 3.83; 95% CI: 1.30–11.28; p = .02), even if characterized by high heterogeneity ( I 2 = 90%) and the prediction intervals overlapped 1.00 (95% CI: 0.35–7.26). Data suggest that ED is twice as high in cannabis users compared to controls. Future longitudinal research is needed to confirm/refute this and explore if a dose–response relationship between cannabis and ED may be evident.