Sex and Ecstasy

How MDMA Affects Sexual Function and Response

Taking ecstasy
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Ecstasy (also called MDMA) is a mind-altering drug with both mild hallucinogenic- and amphetamine-like qualities. On one hand, Ecstasy is associated with a long list of serious negative health consequences, but, as you can tell by its street name, it is also popularly associated with many positive sexual effects.

The fact that there are contradictory reports on the impact of Ecstasy on sex may have to do with the fact that (in animal studies) the effects of Ecstasy seem to be related to the both serotonin and dopamine, which have been implicated in both facilitating (dopamine) and inhibiting (serotonin) sexual desire, arousal, and orgasm.

Always remember that drug effects are rarely simple, and there is no true “wonder drug” that will give you every benefit without any drawback (or vice versa). Also, because sex is more than just a physiological process, drugs may impact your psychological and social experience of sex in unpredictable ways.

Does Ecstasy Make Sex Better?

  • Most people report that the sexual effects of Ecstasy take the focus away from intercourse; many qualitative studies have found that both men and women report heightened feelings of emotional and sensual intensity, without a desire for sexual intercourse.
  • An often-cited study found that 95 percent of males and 100 percent of females reported a moderate to profound increase in sexual desire. The experience was described as “more sensual than usual.”
  • In the same study, 85 percent of men and 53 percent of women reported more intense orgasms (when they were achieved). Eighty percent of women reported enhanced lubrication during sex.
  • One qualitative study found that while the majority of men did not report a desire for sexual intercourse, most women did.
  • Users report that Ecstasy decreases inhibitions, enhances their emotions, and facilitates a boost in self-confidence. These effects can lead to more sexual experimentation (that the individual may have been interested in but uncomfortable to pursue).

    The Bottom Line: Ecstasy does seem to increase subjective satisfaction, desire, and sensitivity. But results vary and it may be that sexual response to Ecstasy has as much to do with our own sexual predispositions as the drugs (e.g. Ecstasy may enhance sex for people who already enjoy it, but may have less of an impact on people who do not get satisfaction from their regular sex life).

    Does Ecstasy Make Sex Worse?

    • For some men (just under half in several studies) Ecstasy makes it difficult or impossible to get an erection.

    • People report delayed orgasm with Ecstasy use. In one study 45 percent of men and women reported Ecstasy inhibited their arousal and/or orgasm

    • Many studies have shown a link between Ecstasy use and risky sex. While risky sex may not feel like a negative at the time, the results (unintended pregnancy, STDs) can be quite negative after the fact.

    • Ecstasy is associated with many serious health effects and its use has been linked to fatalities. Most recently significant memory loss has been associated with the use of Ecstasy. Ecstasy may have unknown long-term negative impacts on sexuality because of the way it affects your body when you are not using the drug.

    The Bottom Line: Ecstasy can result in several negative sex effects, including inability to get an erection, delay in achieving orgasm, and a greater likelihood of engaging in risky sexual behaviors.

    It has been hypothesized that the increased levels of prolactin in the blood during the use of Ecstasy may mimic a post-orgasmic experience, and this may be related to the negative sex effects.


    McElrath, K. “MDMA and Sexual Behavior: Ecstasy Users’ Perceptions About Sexuality and Sexual Risk” Substance Use & Misuse Volume 40, No. 9 (2005): 1461-1477.

    Passie, T., Hartmann, U., Schneider, U., et. al. “Ecstasy (MDMA) Mimics the Post-Orgasmic State: Impairment of Sexual Drive and Function During Acute MDMA-Effects May be Due to Increased Prolactin Secretion.” Medical Hypothesis Volume 64 (2005): 899-903.

    Topp, L., Hando, J., and Dillon, P. “Sexual Behavior of Ecstasy Users in Sydney, Australia” Culture, Health & Sexuality Volume 1, No. 2 (1999): 147-159.

    Zemishlany, Z., Aizenberg, D., & Weizman A.

    “Subjective Effects of MDMA (‘Ecstasy’) on Human Sexual Function.” European Psychiatry Volume 16 (2001): 127–130.