Association between marijuana use and erectile dysfunction in a sample of sexual minority men: a cross-sectional analysis.

Erectile dysfunction (ED) is a condition characterized by difficulty in achieving or maintaining an erection, consequently affecting sexual performance. ED is often a symptom of underlying health conditions such as cardiovascular heart disease and can lead to psychological distress. Previous studies show an association between marijuana use and ED through its potential impact on the endocannabinoid pathways. However, few studies have explored this relationship among sexual minority men (SMM). Considering this knowledge gap, this study aims to assess the association between marijuana use and erectile dysfunction in a sample of SMM in the United States. A secondary analysis of the Men's Body Project (MBP)-a cross-sectional study involving an online survey assessing SMM health outcomes-data was conducted. Multivariable logistic regression and bivariate analyses were used to examine the association between marijuana use and ED. Participants provided demographic information, self-reported ED, erection confidence, erection difficulty, and history of substance use. A total of 549 participants completed the survey (52.1% gay and 47.9% bisexual). The prevalence of ED was higher in bisexual men compared to gay men. Results from the adjusted logistic regression analysis suggested that people who use marijuana had 1.83 times the odds (95% CI: 1.23, 2.74) of reporting erectile dysfunction compared to non-users. Our results suggest a significant association between marijuana use and elevated odds of experiencing erectile dysfunction. These findings highlight the importance of integrating sexual health screening into primary care and considering substance use during sexual health assessments to support early identification and management of ED. Additional research is needed to explore temporal and causal relationships between marijuana use frequency and erectile function.