This week’s mailbag question addresses a number of questions we’ve received about sexual dysfunction. Rather than try to tackle each one individually, I reached out to Dr. Jordan Tishler, an M.D. from Harvard who does great work in the field of sex and cannabis. He generously offered his wisdom and recommendations for using cannabis to help with sexual dysfunction.
One thing to keep in mind is that Dr. Tishler’s work is deeply informed by science, and at this point in human history, science is still heavily gendered and heteronormative, focusing mainly on cisgender men and women in research.
What are the most common sexual dysfunctions that you see in your practice?
“These break down a little differently for males and females. For the men, the issues revolve around low libido or early finish (premature ejaculation – although that term is not commonly used any longer). It may surprise you but men report low libido as their most common issue — 30% of men, compared to 20% for erectile dysfunction and 20% for early finish.”
“For women, the problems are low libido and difficulty achieving satisfactory intimacy (often associated with difficulty achieving adequate quality and frequency of orgasm).”
What sexual issues are most positively impacted/treated by the use of cannabis?
“The interesting bit is that, for both men and women, all of these problems respond well to cannabis therapy! In men, the success is a bit more tricky as the dose must be controlled more accurately. Too much and the whole thing gets shut down. I always say, it’s difficult to maintain an erection, etc., when your head is orbiting Jupiter.”
How do you determine an appropriate therapeutic dose or method of imbibing for a given condition? Can you give an example?
“Dosing is very personal, and depends on a number of factors, including whether the patient has used cannabis recently (tolerance). Again, for the men, lower is better. For the women it doesn’t matter as much (although too much can be no fun at all). I’m a big fan of inhalation as a method. I say inhalation, not smoking, as smoking just isn’t very good for you, so use a vape. Sharing a vape can be a really wonderful part of the foreplay, and you’re also less likely to burn down your bedroom when things heat up.”
“Topicals are very “in” at the moment for sex with cannabis. I’m less sold on this as it takes a while to kick in (who wants to wait?) and also only really affects the genitals. Since most of [our sexuality] occurs ‘above the neck,’ topical cannabis misses the really important sexual organ, the brain.”
Any general advice for using cannabis to treat sexual dysfunction?
“Consent, low dosing (especially in men), use protection, support each others’ needs, and have fun.”
Dr. Tishler’s pragmatic approach to sex and cannabis is a welcome addition to this relatively nascent field of study. As more states legalize recreational cannabis (go vote!), hopefully there will be opportunities for more inclusive studies to look at the many facets of cannabis-enhanced sex.
Here are two great books if you want to learn more about science, sex, and society:
- Come As You Are: The Surprising New Science That Will Transform Your Sex Life, by sex researcher Dr. Emily Nagoski. It’s arguably one of the most important books on women’s sexuality in our generation.
- Sex Outside the Lines: Authentic Sexuality in a Sexually Dysfunctional Culture, by sex therapist Dr. Chris Donaghue.
Dr. Tishler is a leading expert in the field of medical cannabis therapeutics. As an emergency physician, he has treated countless alcoholics and drug users. His observation that he had never seen a cannabis overdose led him to delve deeply into the science of cannabis safety and treatment. After years of research and learning, Dr. Tishler brings his knowledge, reason, and caring to patients at Inhale Medical Consulting, and through his advocacy work at the local and national levels. He graduated from both Harvard University and then Harvard Medical School (affectionately known together as Preparation H), trained in internal medicine at the esteemed Brigham and Women’s Hospital, and has spent many years working with the underserved, particularly our veterans. He is a frequent speaker and author on a variety of topics related to the medical applications of cannabis, and he helps establish best practices for bringing new cannabis products to market. He is also a Massachusetts spokesperson for Doctors for Cannabis Regulation (DFCR).