Relationship Between Cannabis Use and Erectile Dysfunction: A Systematic Review and Meta-Analysis.

Globally, there is increasing usage and legalization of cannabis. In addition to its reported therapeutic effects, cannabis has several health risks which are not clearly defined. Erectile dysfunction (ED) is the most common male sexual disorder and there are plausible mechanisms linking cannabis use to ED. No attempt has been made to collate the literature on this topic. The aim of this review was to summarize the prevalence and risk of ED in cannabis users compared to controls. A systematic review of major databases from inception to January 1, 2019, without language restriction, was undertaken to identify studies investigating cannabis use and presence of ED. The analysis compared the prevalence of ED in cannabis users versus controls. Consequently, the odds ratio (OR) with 95% confidence intervals (CI) was calculated, applying a random-effect model. Five case-control studies were included with data from 3,395 healthy men, 1,035 using cannabis (smoking) and 2,360 nonusers. The overall prevalence of ED in cannabis users was 69.1% (95% CI: 38.0-89.1), whilst the correspondent figure in controls was 34.7% (95% CI: 20.3-52.7). The OR of ED in cannabis users was almost four times that of controls (OR = 3.83; 95% CI: 1.30-11.28; p = .02), even if characterized by high heterogeneity (I2 = 90%) and the prediction intervals overlapped 1.00 (95% CI: 0.35-7.26). Data suggest that ED is twice as high in cannabis users compared to controls. Future longitudinal research is needed to confirm/refute this and explore if a dose-response relationship between cannabis and ED may be evident.

American journal of men's health. 0000 Jan [Epub]

Damiano Pizzol, Jacopo Demurtas, Brendon Stubbs, Pinar Soysal, Corina Mason, Ahmet Turan Isik, Marco Solmi, Lee Smith, Nicola Veronese

Italian Agency for Development Cooperation, Jerusalem, Israel., Primary Care Department Azienda USL Toscana Sud Est, Grosseto, Italy., Physiotherapy Department, South London and Maudsley NHS Foundation Trust, UK., Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey., Department of Health Psychology, University of Aberdeen, UK., Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey., Department of Neurosciences, University of Padova, Italy., The Cambridge Centre for Sport & Exercise Sciences, Anglia Ruskin University, Cambridge, UK., National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy.