Cocaine and Sex

Estimated reading time: 26 minute(s)

Cocaine addiction can impose multiple adverse effects on health. The side effects profile associated with this drug use can range from minor physical symptoms to organ failure, financial losses, and professional deterioration. While these side effects are well-acknowledged and known, most people using cocaine fail to realize a crucial aspect of health this drug can affect: sexual health.

Cocaine and sexual health share an inverse relationship, i.e., the more you abuse cocaine, the poorer your sexual health will likely become. With these sexual effects, many relationships begin to fail, favoring negative mental health outcomes. Hence, raising awareness about the potential relationship between cocaine and sex drive, libido, and other aspects of sexual health is imperative so that you can easily ask for help when needed.

Does Cocaine Affect Sex? Positive Effects of the Party Drug on Sexual Health

Surprisingly, many people use cocaine because it favors their sexual health and performance. In particular, using this drug can lead to the following three effects, which in turn, make sex on cocaine more pleasurable:

  • Heightened awareness
  • Boosted sensory stimulation
  • Euphoria

Additionally, some people also feel more confident and energetic while they are on this drug. With the temporary increase in sex drive secondary to cocaine use, a user is more likely to be involved in sexual activity. [1] Other people believe that their sexual activity lasts longer when they are on cocaine, in addition to reporting more intense orgasms.

While there is some element of truth to the experiences mentioned above, it is imperative to understand that the positive effects of cocaine on sex wear off very quickly and are often replaced by negative ones.

Cocaine and Sex: The Negative Consequences

As mentioned above, people who engage in sexual activity following cocaine use may initially feel the positive effects. However, these effects may become adverse and negative fairly soon. In general, cocaine has the potential to affect the following aspects of sexual health:

Cocaine and Sex Drive

Cocaine is a central nervous system stimulant that triggers the release of epinephrine, dopamine, and norepinephrine. These neurotransmitters reach the pleasure centers of the brain and cause euphoria. These euphoric effects initially enhance sexual pleasure by:

  • Increasing energy
  • Prolonging sexual intercourse
  • Increasing sexual assertiveness
  • Enhancing the intensity of orgasms

However, as the cocaine levels in the blood begin to drop, the positive effects quickly wear off. Moreover, people who have been abusing cocaine for a long time may ultimately experience a decrease in their sexual drive through the following side effects:

  • Decreasing sexual desire
  • Causing premature ejaculation
  • Decreasing sensitivity
  • Contributing to a loss of control

Cocaine and Unsafe Sexual Activity

Many people use cocaine to boost their sexual experiences; however, this effect is not always achievable. According to experts, cocaine can increase impulsivity, negatively affect decision-making, and lower inhibitions. As a result, people using it may be at risk of the following:

  • Frequent engagement in risk-taking behaviors, such as unprotected sex [2]
  • Contracting a sexually transmitted infection or STI
  • Engaging in more dangerous situations
  • A high risk of unwanted pregnancies
  • A higher number of sexual partners

Cocaine and Sexual Dysfunction

Taking cocaine, especially over a long duration of time, can negatively affect sexual performance and function through the following issues:

  • Premature ejaculation
  • Decreased lubrication
  • Decreased sensation
  • Difficulty having an orgasm
  • Changes to the menstrual cycle
  • Lower sperm count
  • Decreased blood flow to the penis
  • Fertility issues
  • Erectile dysfunction
  • Prolonged erections
  • Increased risk of fallopian tube damage

Cocaine and Risk of Sexual Assault

Drug abuse, especially when it involves cocaine, can put a person at an increased risk of sexual assault. Many who use this drug and engage in sexual activity may not be able to consent due to how this drug alters the brain. Hence, they do certain things they would not normally do. Depending on the circumstances, engaging in sex under the influence of cocaine may also be categorized as sexual assault.

Though sexual assault can negatively affect both men and women, research has noticed gender differences in terms of which of them is affected more. According to studies, females with cocaine use are at a higher risk of experiencing sexual violence than males.

Cocaine and Rough Sex

Cocaine can help relieve pain and numb the body. While many people generally benefit from this effect, it can be particularly dangerous in terms of sexual activity. Under the influence, cocaine users may not realize that they are being too rough due to the painkilling effect of the drug. This rough sexual activity, in turn, increases the risk of contracting a sexually transmitted infection, especially in the following situations:

  • There is no condom, or it breaks
  • There is the presence of other bodily fluids
  • If any of the delicate membranes tear

Cocaine and Orgasm

It is a common notion that cocaine aids orgasms, and many believe that using it heightens them while prolonging their duration. While this effect is somewhat accurate during the initial use, orgasms on cocaine can eventually become harder. Moreover, cocaine use is commonly linked to sexual dysfunction, such as erectile dysfunction, which makes achieving orgasms more difficult.

Cocaine and Sexually Transmitted Diseases

The risk of picking up a sexually transmitted disease (STD), such as HIV,  is particularly high as people engage in substance use due to many reasons. [3] First, many people prefer injecting cocaine into their veins using needles. These needles, if shared, can be a potential source of STDs as they spread through blood. Moreover, the use of cocaine can also cause poor judgment, which may force a person to engage in unprotected sex. Sometimes, infidelity may occur, which leads to engagement in sexual activity with a carrier of an STD.

Cocaine and Irreparable Relationships

Many people who rely on cocaine to improve their sexual performance end up developing an addiction to it. This addiction can lead to adverse effects on romantic relationships due to many reasons, such as infidelity. Regardless of the reason for a breakup, losing a relationship is always tough and may exert severe mental stress on a user, making them more prone to cocaine use. This cycle can continue for as long as a person seeks help.

Cocaine and Sex: Negative Effects on Women

Women who prefer engaging in sexual activities under the influence of cocaine are at a heightened risk for STIs, unwanted pregnancies, and unsafe sex. In certain cases, cocaine use may also induce infertility in female users. Cocaine use is also known to change a female’s menstrual cycle and may also interrupt their ovulation while damaging their fallopian tubes. Consequently, it may become difficult for them to conceive.

Even when long-term cocaine user stops abusing the drug, they may continue to experience permanent damage to their hormones. These permanent problems may lead to prolonged problems with conception. In addition to pregnancy-related issues, females using cocaine are also at risk of the following issues:

  • Seizures
  • Premature birth
  • Migraines
  • Placental abruption

Miscarriages and stillbirths are more frequent to occur at a higher rate in women who abuse cocaine during conception. If both partners in a relationship are cocaine abusers, infertility can happen in both simultaneously, making conception more difficult.

Overcoming Cocaine and Sexual Issues

Unfortunately, drugs can severely affect one’s sex life even when they are in recovery. However, there are certain measures that both men and women can incorporate in daily life to improve their sexual satisfaction and desire during sobriety. These measures may include the use of medications, sex therapy, or a combination of both. Because the effects of cocaine on sex life can affect both partners in a relationship, their combined participation in therapy can lead to better outcomes.

However, remember that before addressing sexual issues related to cocaine use, it is imperative to seek help for cocaine addiction. Abstaining or reducing cocaine is one of the most important steps to address the sexual issues it causes, and people with addiction may not be able to do so without seeking professional help. Fortunately, many rehabs are currently offering help for cocaine abuse management, emphasizing addressing their effects, including sexual side effects.


How does cocaine affect fertility?

Cocaine use in females can directly impact their fertility and reduce it by messing with their ovulation and menstrual cycle. In males, the drug has similar effects as it affects their sperm count.

Can cocaine use cause unwanted pregnancies?

Cocaine can cloud a user’s judgment, making them engage in unprotected sex, which they would not do under normal circumstances. These unprotected sexual encounters can lead to pregnancies. Many females may continue using cocaine without realizing that they are pregnant, putting themselves at risk of the following issues:

  • Miscarriage
  • Preterm birth
  • Birth defects
  • Placental abruptions

These issues can occur regardless of when or how long a female keeps using cocaine during pregnancy.


1 Johnson MW, Herrmann ES, Sweeney MM, LeComte RS, Johnson PS. Cocaine administration dose-dependently increases sexual desire and decreases condom use likelihood: The role of delay and probability discounting in connecting cocaine with HIV. Psychopharmacology. 2017 Feb;234:599-612.

2 Johnson MW, Herrmann ES, Sweeney MM, LeComte RS, Johnson PS. Cocaine administration dose-dependently increases sexual desire and decreases condom use likelihood: The role of delay and probability discounting in connecting cocaine with HIV. Psychopharmacology. 2017 Feb;234:599-612.

3 Hudgins R, McCusker J, Stoddard A. Cocaine use and risky injection and sexual behaviors. Drug and alcohol dependence. 1995 Jan 1;37(1):7-14.

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