By Luke Sumpter

Erectile dysfunction, often referred to as ED, affects millions of men across the world. The condition features both physiological and psychological causes, and can greatly impact intimacy, mental health, and confidence. Fortunately, men that experience ED have a variety of interventions available to them. These include pharmaceutical drugs and lifestyle changes.

Now, researchers are exploring cannabidiol (CBD) as a possible aid for the condition.

What Is Erectile Dysfunction? 

ED essentially keeps men from gaining and maintaining an erection long enough to engage in sex. The condition affects some men only for a short period of time, serving as a sign of stress or other psychological problems. However, in others, ED lingers for longer and arises as a symptom of underlying physiological issues.

To understand the mechanism of ED, you need to know what happens in the body to cause an erection in the first place. What we see as a penis, anatomists see as a complex physiological system consisting of three primary parts: the root, body, and glans (tip). The body possesses three cylinders of erectile tissue within. Basically, they’re tubes that fill up with blood to make the penis hard and functional during sex.

Smooth muscle regulates blood flow to the penis. As opposed to skeletal muscle, men can’t voluntarily contract or relax it. Instead, several steps are required[1] to relax these muscles and facilitate sex. Sexual arousal serves as the starting point. After feeling turned on at the sight or thought of your partner, nerve signals start to stimulate the penis.

Impulses from the brain and local nerves cause the smooth muscles to relax, which causes blood to rush into the now open spaces in the tissue. This buildup of blood causes the penis to become erect, hard, and ready for action. However, men that experience ED may fail to maintain this state for long, or fail to get there altogether. Mental or physical factors, or a combination of the two, can disrupt this mechanism at several points[2], including initial arousal and nervous system firing, hormonal signalling, smooth muscle relaxation, and blood flow.

  • Psychological Causes of ED

Anything from excessive stress at work to performance anxiety can disrupt the physiological cascade that fills up the organ with blood. These mental maladies include:

Stress Anxiety Depression
Relationship issues, such as poor communication and arguments
  • Physiological Causes of ED

Even if a man feels psychologically sound, certain underlying health issues can cause sexual dysfunction, including:

Obesity Diabetes
Parkinson’s disease Multiple sclerosis
Sleep disorders High cholesterol
High blood pressure Heart disease
  • Who Does Erectile Dysfunction Affect?

Population studies have managed to identify which groups of men are most susceptible to ED[3]. It turns out that age has a massive influence on the prevalence of the condition. Here are some of the key findings:

  • Approximately 10% of men aged 40–70 experience severe or complete erectile dysfunction
  • Another 25% of men in the same age range experience moderate erectile difficulties
  • Age plays a key role—the chances of moderate to complete ED rise from 22% at age 40 to 49% at age 70
  • Younger men, below the age of 40, experience ED at a prevalence of 5–10%
  • Findings indicate that ED affects quality of life, mood, and interpersonal functioning
  • How Is Erectile Dysfunction Currently Treated?

Doctors approach ED from several different angles depending on the root cause of the patient’s condition.

  • Lifestyle

Doctors may suggest lifestyle changes in cases of ED stemming from health issues such as obesity and diabetes:

Stopping smoking Physical activity
Dietary changes Reducing alcohol consumption
  • Pharmaceuticals

Doctors sometimes prescribe drugs that increase nitric oxide levels in the body. This chemical helps to relax the smooth muscle of the penis and increase blood flow:

Sildenafil (Viagra) Tadalafil
Vardenafil Avanafil
  • Psychological Counselling

Psychological interventions such as counselling can help men overcome stress, performance anxiety, and low self-esteem associated with ED. Types of therapy available for men with the condition include:

  • Cognitive behavioural therapy (CBT): This method helps men understand how certain triggers work to evoke thoughts and feelings that can lead to physical reactions.
  • Psychosexual therapy: This type of talk therapy takes a deep dive into emotional, psychological, and sexual issues that might form the root cause of ED in some men.
  • Sex therapy: This form of counselling allows men to openly discuss sex and sex problems, where therapists often recommend exercises to assist their condition.
  • Surgery and Implants

Some men even opt for surgery and implants to mechanically overcome ED. These procedures include:

  • Penis pumps: Vacuum erection devices that pull blood into the penis
  • Penile implants: The surgical placement of malleable rods into either side of the penis

What Is CBD?

So, where does CBD fit into all of this?

CBD belongs to the cannabinoid chemical class found predominantly within the flowers of cannabis plants. Unlike THC, however, CBD doesn’t produce a psychotropic effect that leads to a high. Instead, it induces a clear-headed effect that helps people feel relaxed and at peace.

As a cannabinoid, CBD influences the endocannabinoid system (ECS)—a large network of receptors and signalling molecules that govern almost every other system in the human body. Because CBD can tap into the ECS, it has the potential to influence a wide range of processes.

Ongoing studies[4] are examining the anti-inflammatory, anti-anxiety, and antioxidant potential of the cannabinoid.

What Is CBD?

CBD for Erectile Dysfunction: What Does the Research Say?

So, can you use CBD oil for erectile dysfunction? It might not surprise you that scientific studies exploring the role of CBD in ED are few and far between. Although no direct research exists in this territory, there are some pieces of evidence from other studies that may serve as clues.

Of particular interest is the use of cannabis for sexual function[5] in the Ayurvedic system of India. Here, practitioners harness the herb in attempts to improve sexual performance and ejaculatory function.

Researchers have also uncovered a potential link between the ECS and ED. A paper published in 2015 displayed an association between habitual cannabis use and ED[6] in young users. The prolonged use of THC may cause issues when it comes to fertility and sexual function, which implicates the ECS in these conditions as well. This raises the question: Could modulating the ECS using CBD also impact ED, perhaps in a positive way?

Research published in 2009 supports this theory. Scientists from the University of Napoli in Italy reported the presence of cannabinoid receptors in the testicles[7] in a paper titled “The Endocannabinoid System: An Ancient Signalling Involved in the Control of Male Fertility”. Although CBD doesn’t directly interface with cannabinoid receptors, it does change the level of our endogenous cannabinoids by inhibiting enzymes that otherwise break them down.

CBD for Erectile Dysfunction: What Does the Research Say?
  • CBD for Performance Anxiety: Is There Hope?

Anxiety plays a big role in inhibiting erections and limiting how long men can sustain them. A few human trials have probed CBD for its anti-anxiety potential. Although none of them explored its role in ED, these findings could be relevant to the development of future treatments.

The journal Frontiers in Psychology published a study that tested the effects of CBD[8] on teenagers with social anxiety disorder (SAD) and avoidant personality disorder in a double-blind study.

Another human trial[9], this time published in the Journal of Psychopharmacology in 2011, used functional neuroimaging to analise the brains of subjects with SAD after receiving either 400mg of CBD or a placebo.

Men that experience performance anxiety often view sex as a high-pressure situation. A 2011 article in the journal Neuropsychopharmacology tested the effects of CBD[10] on patients with social phobia during a simulated public speaking event, finding pretreatment with the cannabinoid to reduce cognitive impairment and the discomfort associated with speech performance. Could these findings translate over to the pressure felt by some men that experience ED?

  • How To Use CBD for Erectile Dysfunction

You might be wondering how to apply CBD oil for erectile dysfunction. In fact, that may not be the best course of action, as very little CBD makes it into the bloodstream this way. Some of the most popular CBD options include:

⇢ Smoking and vaping dried flowers
⇢ Vaping extracts and concentrates
⇢ Edibles, such as gummies, capsules, and oils
⇢ Sublingual oils
⇢ Transdermal patches
⇢ Topicals (low absorption rate)

How To Use CBD for Erectile Dysfunction

Natural Alternative Methods of Approaching Erectile Dysfunction

Exercise, diet, and other lifestyle factors can impact the prevalence and significance of ED. Doctors often recommend lifestyle changes that help to counter underlying conditions and even improve mental status.

  • Aerobic Exercise

Walking, running, cycling, and swimming are all forms of aerobic exercise. The word “aerobic” simply denotes “oxygen”. As well as keeping you generally healthy, randomised controlled trials have found that aerobic exercise may benefit men experiencing arteriogenic ED—a form associated with fatty deposits in the arteries.

Interestingly, aerobic exercise also fires up the ECS. That amazing feeling you experience after a workout, sometimes referred to as the “runner’s high”, most likely stems from an elevation of anandamide[11] (the bliss molecule). CBD also works to boost anandamide levels, which might result in some beneficial crossover.

  • Keep Your Weight Within a Healthy Range

Exercising regularly and cutting down on calories will help you maintain a healthier body weight. Obesity increases the risk of experiencing ED. A 2005 weight loss study[12] showed that 30% of men that took part in the research regained normal sexual function.

  • Don’t Smoke

We could write a long list of the detrimental effects of smoking, but we’ll spare you the time. Instead, take a look at this evidence: A 2015 study found that smoking messes with nitric oxide levels[13] in the body, the key chemical that relaxes the smooth muscles of the penis to increase blood flow.

  • Avoid Drinking Too Much Alcohol

Alcohol can help to relax your nerves before sex, but it can also prevent you from engaging in intercourse altogether. But you don’t need to quit the booze entirely. A 2018 meta-analysis examined the results of 24 studies to see just how alcohol affects sexual function[14]. They found moderate quantities to exhibit a beneficial effect against the risk of ED, whereas regular and high consumption had no effect on the initial risk. Another study, this time published in 2019, found chronic and persistent alcohol use to increase the risk of men developing ED[15].

  • Limit the Amount of Porn You Watch

Not only does viewing porn damage the dopamine reward system[16] in the brain, but it may increase the risk of ED. Research found that 45% of young men[17] experiencing porn addiction have ED. However, many of them only experience the problem during actual sex, not while watching porn.

  • Manage Stress

Stress creates changes in the nervous system and may disrupt how the brain sends signals to the penis during arousal. There are several easy means to reduce stress, including:

⇢ Deep breathing exercises
⇢ Meditation
⇢ Relaxing music
⇢ Biofeedback
⇢ Counselling

  • Keep Your Testosterone Levels in Check

We don’t want to sound alarmist, but men are facing a testosterone crisis. This sex hormone plays a key role in male biology, from maintaining sex drive to increasing muscle and bone mass. Right now, testosterone levels are declining by around 1% per year[18]. There are several variables that come into play, but environmental pollutants that mimic oestrogen, such as BPA[19], share some of the blame.

Testosterone helps to maintain libido. While some men that experience ED have normal testosterone levels, those low in the hormone might start to lose their sex drive[20] and experience the condition. Natural ways of increasing levels of the sex hormone include:

⇢ Exercise and lifting weights
⇢ Sun exposure and supplementing vitamin D
⇢ A healthy sleep schedule
⇢ Minimising stress
⇢ Herbal supplements such as ashwagandha and nettle

Does CBD Cause Any Side Effects?

CBD is generally regarded as safe and well-tolerated. However, the cannabinoid can cause side effects in some people. These include:

⇢ Dry mouth
⇢ Reduced appetite
⇢ Fatigue
⇢ Drowsiness
⇢ Diarrhoea
⇢ Interaction with other medications

CBD Oil for Erectile Dysfunction: We Need More Research

At the end of the day, we need dedicated human trials on the subject. Without testing CBD on patients with ED in a controlled clinical setting, we can’t make an accurate judgement. However, we do know that the cannabinoid has the potential to address some of the causes of the condition. If you’re considering taking CBD for ED, talk to your doctor first. The cannabinoid interacts with some medications, and they will also want to screen you for any other underlying conditions in order to provide the best treatment possible.

External Resources:
  1. How Erections Work, Ejaculation, and Penis Anatomy Image
  2. Pathophysiology of Erectile Dysfunction: Ingenta Connect
  3. Epidemiology of ED » Sexual Medicine » BUMC
  4. Antioxidants | Free Full-Text | Antioxidative and Anti-Inflammatory Properties of Cannabidiol
  5. A Review on Plants Used for Improvement of Sexual Performance and Virility
  6. Marijuana, phytocannabinoids, the endocannabinoid system, and male fertility - PubMed
  7. The Endocannabinoid System: An Ancient Signaling Involved in the Control of Male Fertility
  8. Frontiers | Anxiolytic Effects of Repeated Cannabidiol Treatment in Teenagers With Social Anxiety Disorders | Psychology
  9. Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report - PubMed
  10. Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naïve Social Phobia Patients
  11. A runner’s high depends on cannabinoid receptors in mice | PNAS
  12. Lose weight to lose erectile dysfunction
  13. Effects of cigarette smoking on erectile dysfunction
  14. Alcohol intake and risk of erectile dysfunction: a dose–response meta-analysis of observational studies | International Journal of Impotence Research
  15. Erectile dysfunction and severity of alcohol dependence
  16. Watching pornography rewires the brain to a more juvenile state - Neuroscience News
  17. Does Using Porn Lead to Erectile Dysfunction? | Everyday Health
  18. You're Not The Man Your Father Was
  19. “Bisphenol a: an emerging threat to male fertility” | Reproductive Biology and Endocrinology | Full Text
  20. A logical approach to treating erectile dysfunction - Harvard Health
This content is for educational purposes only. The information provided is derived from research gathered from external sources.

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