anonymous on August 26, 2011

To help my depression, I smoked pot…I stopped smoking, but I still can’t get it up. What gives?

I’ve been depressed for about four years, and I’ve been smoking marijuana to help me feel better. Since then, I’ve been having some problems with erectile dysfunction. Now I don't feel pleasure in sex and I don't get hard at all. I quit smoking marijuana about nine months ago, but still can't make my wife happy.

answered by David Sobel, MD, JD on August 26, 2011

Thank you for sharing your concern with us. I’ll do my best to provide you with some helpful information.

First, if you’re not already being treated for depression, please talk with your doctor. Like high blood pressure or heart disease, depression is a serious health condition. And depression may be playing a direct or indirect role in any erectile dysfunction (ED).

Dealing with this combination of problems can be overwhelming…but you’re not alone. One of the most common symptoms of depression is no longer enjoying things that usually give you pleasure: seeing friends, being active…and having sex. And when there’s less pleasure with sex, it can lead to less desire for sex (low libido). So it follows that depression may contribute to ED.

If you’re already taking medication for depression, it’s important to know that a side-effect of some antidepressants is sexual dysfunction. So, again, let your doctor know that you’re having problems. It’s a common issue, and your doctor will want to know about it...there may be a different medications you can take to treat your depression, without the sexual side-effect.

Has your doctor checked your testosterone levels, lately? Men with depression or ED often have low testosterone, which can typically be treated with medication. You’d be surprised how many men think they have depression, only to find out they have low testosterone…and vice versa.

Marijuana use can also lower or “depress” how much testosterone your body makes. While using pot may help you relax or seem to temporarily relieve your depression, some studies show that using pot can make it more difficult to get and keep an erection. Pot (cannabis) can affect receptors in the brain. Anda 2011 study in The Journal of Sexual Medicine indicates there may be similar receptors in the penis. So pot use may have a negative effect on erections in more ways than one.

Lastly, it’s important to stop the cycle of worry. For many men, even a single experience with impotence or losing an erection can undermine confidence and cause anxiety. And the fastest way to lose an erection is to worry about it. So I encourage you to work with your doctor to identify the true cause of your ED, and the best solution for your situation.

Thanks again for writing, and I wish you good luck in resolving your ED.

Related info:

David Sobel, MD, JD

Dr. Sobel is a Colorado-based urologist and Director of the Denver Center for Men’s Health. His areas of expertise include men's sexual health and all areas of urology, including urologic oncology, treatment of benign prostatic hypertrophy, stone disease and incontinence. Dr. Sobel was educated at the University of Michigan Law School and the University of Illinois at Chicago College of Medicine, and completed his residency at the Rush University Medical Center in Chicago, IL.

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