Cannabis use and male sexuality in a Tunisian sample: A case-control study

Cannabis is widely used for various reasons, including its effects on sexuality. It has significant short- and long-term health consequences. However, its impact on sexual health remains uncertain. This study assesses sexual function in Tunisian cannabis users compared to non-users.

We conducted a cross-sectional, descriptive, and analytical case-control study at the Tunisian Association for the Fight Against Sexually Transmitted Diseases and AIDS. We used the Cannabis Abuse Screening Test (CAST) and the International Index of Erectile Function (IIEF-15) to evaluate cannabis dependence and male sexual function.

The study included 30 male cannabis users matched with 30 control subjects from the general population. The median total CAST score was 24, indicating a severe level of dependence. All users reported trying cannabis at least once before sexual activity. The average IIEF-15 score among users was 63.07±4.32, and daily cannabis users had a significantly lower IIEF-15 total score (P=0.01). Compared to the control group, the mean total IIEF-15 score (P=0.001), as well as the mean scores in the domains of erection (P=0.001), orgasm (P=0.001), desire (P=0.006), and satisfaction (P=0.001), were significantly higher in the group of cannabis users.

This study highlights the controversial effects of cannabis on sexuality. However, the cross-sectional design limits the ability to establish a causal relationship between cannabis use and sexual dysfunction. Therefore, further research, particularly longitudinal studies, is needed along with increased awareness among healthcare professionals to ensure careful assessment of sexual function and to optimize patient management.