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  • Cocaine is a powerful stimulant drug often associated with increased sex drive and sexual performance. As early as the 1900s, it was used in elixirs and drinks as a social lubricant and aphrodisiac. 

    Although cocaine appears to have positive effects on sex drive, long-term use can lead to erectile dysfunction and other adverse effects. Lowered inhibitions from cocaine use can also lead to unsafe sex and sexually transmitted infections. 

    Effects Of Cocaine On Sex

    Cocaine increases dopamine levels in the reward centers of the brain, which causes its euphoric effects. The reward center is also responsible for sexual pleasure, which can feel enhanced when you use stimulants. 

    Effects of cocaine on sex may include:

    • increased energy
    • prolonged sexual intercourse
    • increased sexual desire
    • increased intensity of orgasm
    • sexual assertiveness
    • increased sensitivity to touch, sight, and sound

    Along with these effects, cocaine may also increase heart rate, blood pressure, and body temperature. Heavy use can cause heart attacks, cardiac arrest, and other health related issues. 

    Sex & Cocaine

    Euphoria and increased sensitivity to touch contribute to enhanced sexual desire. However, it’s possible the drug’s effects are not the only reason why sexual desire is increased. 

    Environment may also play a role because cocaine is often used in social situations where sex is already expected.

    Heavy cocaine use can cause a decreased sensitivity to pleasurable activities and an increased sensitivity to stress. The euphoric high can turn into anxiety, paranoia, and irritability. These changes in the brain play a role in sex drive and performance.

    Adverse effects of cocaine on sex include:

    • decreased sexual desire
    • problems achieving orgasm
    • loss of control 
    • decreased sensitivity
    • premature ejaculation

    Erectile Dysfunction

    Erectile dysfunction is the inability to get or maintain an erection. An erection requires proper blood flow, which can be affected by heavy drug use. 

    During an erection, the penis becomes rigid as it fills with blood. Cocaine interferes with this because it constricts blood vessels, causing blood flow to slow or stop.  

    A study published in the Journal of Drug Issues shows 57.4 percent of 228 cocaine users experienced erectile dysfunction. The study excluded anyone who used heavy amounts of alcohol or opiates, which can also affect sex drive and erectile dysfunction.

    Other effects on sexual performance include:

    • premature ejaculation
    • losing control during sex
    • decreased sexual desire
    • decreased sensation 


    Priapism is a painful condition that causes an erection that can last for hours, even after sexual stimulation has stopped. It is often caused by constriction of the blood vessels, which is a common side effect of cocaine. 


    In males, heavy cocaine use is associated with lower sperm count and motility. However, co-occurring opiate and alcohol abuse also be a risk factor for fertility issues. 

    After long-term use, decreased blood flow results in a loss of oxygen and important nutrients to the cells. Studies on rats have shown this is related to testicular cell apoptosis, also known as programmed cell death. 

    Effects Of Cocaine On Female Sex Drive

    Long-term substance abuse can have adverse effects on female sexual health as well. Prolonged sexual activity can lead to vaginal inflammation. Many females also experience problems with lubrication, which can contribute to inflammation.  


    Cocaine is known as a social drug that enhances experiences and creates a positive sense of well-being. However, large amounts of cocaine can cause unexpected violence, anxiety, and aggression. 

    When your senses are heightened from cocaine, you may be more likely to engage in aggressive sexual behaviors. 

    Sexually Transmitted Infections (STIs)

    When you abuse cocaine heavily, you are less likely to use a condom or ask your partner questions about their sexual history. Unprotected sex increases your risk of pregnancy and sexually transmitted diseases. 

    According to the National Institute on Drug Abuse (NIH), cocaine interferes with immune cell function and may increase the risk of HIV infection. Human immunodeficiency virus (HIV) is a disease that affects your immune system, making it more difficult to fight infections. 

    Other STIs include:

    • genital herpes
    • gonorrhea
    • syphilis 
    • chlamydia 

    If you have had unsafe sex, you can seek condoms and testing at a health clinic or doctor’s office. 

    How To Prevent Adverse Sexual Health Effects

    The best way to prevent erectile dysfunction and other adverse effects is to stop using cocaine. If you think you may be addicted, a detox can help you safely withdraw from cocaine. 

    Following detox, it is highly beneficial to consider a drug rehab or outpatient program to address cravings, behaviors, and any underlying mental health issues. 

    If you or a loved one is seeking information about treatment programs offered at Ark Behavioral Health, please contact us today. 

    Written by Ark Behavioral Health Editorial Team
    ©2024 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.
    Medically Reviewed by
    Kimberly Langdon M.D.
    on June 17, 2022
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