Erectile Dysfunction Associated with Psychoactive Substances

Abstract

Psychoactive substances are believed to be aphrodisiac; but in reality they have deleterious effects on all the aspects of sexual function. The purpose of this article is to review and summarize the available scientific literature on the impact of psychoactive substances, including alcohol, tobacco and illicit drugs on erectile dysfunction (ED) in men. Almost all of them have been reported to be associated with ED. These substances may exert their inhibitory effect on erection through their effects on central neurotransmitter pathways (serotogenic, adrenergic or dopaminergic). Besides, some also may exhibit vasoconstricting properties (cocaine), impair endothelium function (nicotine) or suppress the release of luteinizing hormone from the pituitary, resulting in hypogonadism (morphine) to induce ED. The relationship between ED and psychoactive substances is attributed not only to pharmacological effects, but also to psychological and social reactions to substance dependence. Whether withdrawal from the substances could restore erectile function remains unknown. However, human and animal studies demonstrated that the effects of neurological damage from chronic substance abuse are long-lasting. This information of sexual consequence of the substances will be of great general interest and may serve as a powerful tool to healthcare providers.

Adaptation, Equivalence, and Validation of the Changes in Sexual Functioning Questionnaire-Drugs in a Sample of Drug-Dependent Men

“…Worse sexual functioning was observed even in drug-dependent men with about one year of abstinence (see Table 1). Moreover, drug-dependent participants showed worse sexual functioning, similarly to the findings of Bang-Ping (2009), Palha and Esteves (2002, 2008. Although the direct physiological effects derived from substance use may disappear after 3 weeks, the conditioning caused by associating sexual practice and sexual problems may not disappear so quickly.…”

“…These beneficial effects sometimes lead individuals to start to consume a given substance (La Pera et al, 2008), but they are short-lived. An increase in the dose or time of consumption leads to problems in sexual functioning (Aguilar De Arcos et al, 2008;Avila Escribano, Pérez Madruga, Olazabal Ulacia, & López Fidalgo, 2004;Bang-Ping, 2008, 2009Johnson, Phelps, & Cottler, 2004;Peugh & Belenko, 2001;Rosen, 1991;Smith, 2007).…”

Standardization and Normalization of the Changes in the Sexual Functioning Questionnaire in Male Addicts and a Comparing Male Addict's Sexual Functioning with Normal People

“…The results showed that the sexual functioning was significantly different in addicts and healthy individuals. These results are consistent with the results of previous studies [8,[10][11][12][13][15][16][17]. A reason for this could be the impact of drugs on the factors involved in sexual functioning, among which the most important ones include psychological, neurological, hormonal, and arterial factors.…”

“…Duration of drug use also have direct effects on the degree of dysfunction. Drug use impairs the movement of cilia and bronchi, and it can similarly impair the movement of sperms and cause Infertility [8,[10][11][12][13][15][16][17]19]. Another reason for the impact of drug use on sexual desire is that after using some drugs, an amount of dopamine is released in the brain that is 2 to 10 times higher than the amount of dopamine released during the natural feeling of pleasure.…”

“…Therefore, they try to experience the benefits again, but there are often opposite effects, and drug tolerance and a decline in physical functioning begin to appear [10]. Finally, the increase in the amount and duration of drug use, leads to sexual dysfunction [8,[11][12][13][14][15][16][17]. Other researchers have also found relationships between changes in sexual functioning and use of medications; these changes occur both in psychological and physiological areas, leading to sexual dysfunction or changes in sexual functioning [10].…”