Cannabis, CBD and ED: what the research shows
The short answer
The research is mixed. A 2019 review of five small studies found higher odds of ED in men who smoked cannabis, but a large clinic study and a 2024 genetic study found no clear link. No clinical trial shows CBD or hemp oil treats ED, and the FDA has not approved any CBD product for ED.
In short: cannabis is now legal in many places, and CBD and hemp oil products are sold almost everywhere, so it is fair to ask what either one has to do with erections. The honest answer is that the research is thin and points in different directions. This page sets out what the published studies found about cannabis use and erectile dysfunction (ED), why they disagree, what is and is not known about stopping, and what the U.S. Food and Drug Administration (FDA) says about CBD products, including whether any of them is approved for ED.
Can daily cannabis use affect erections?
It might, but the studies disagree and none of them can show cause and effect. The first systematic review and meta-analysis on the question, published in 2019, pooled five case-control studies with 3,395 men, 1,035 of whom smoked cannabis. About 69% of the cannabis users had ED, compared with about 35% of the men who did not use it, and the users had almost four times the odds of ED, an odds ratio of 3.83 (Pizzol et al., Am J Mens Health 2019). The authors flagged that result as uncertain: the studies varied a great deal from one another, and the range of likely results crossed the point of no difference. Their conclusion was that “future longitudinal research is needed to confirm/refute this” (Pizzol et al., 2019).
Newer studies have not settled it. A 2021 study of 7,809 men seen at one academic andrology clinic found that, once other factors were accounted for, cannabis use was not associated with scores on a standard erection questionnaire or with testosterone levels (Shiff et al., Can Urol Assoc J 2021). A 2024 study that used genetic data from large biobanks in place of self-reported habits found no evidence of a causal link between cannabis use, or cannabis use disorder, and ED (Zhang et al., Int J Impot Res). Pointing the other way, a 2026 online survey of 549 sexual minority men in the United States found that men who used marijuana had 1.83 times the odds of reporting ED (Otieno et al., J Cannabis Res 2026).
| Study | Who was studied | What it found | Main limit |
|---|---|---|---|
| Pizzol et al., 2019 (meta-analysis) | 3,395 men in 5 case-control studies | ED more common in men who smoked cannabis (odds ratio 3.83) | Few, small studies that varied widely |
| Shiff et al., 2021 (clinic cohort) | 7,809 men at one andrology clinic | No link with erection questionnaire scores after adjustment | One clinic, men seen for fertility care |
| Zhang et al., 2024 (genetic study) | Large genetic datasets, including the UK Biobank | No evidence that cannabis use causes ED or changes sex hormones | Uses genetic stand-ins, not measured use |
| Otieno et al., 2026 (survey) | 549 sexual minority men, online survey | Higher odds of self-reported ED in marijuana users (odds ratio 1.83) | One-time survey, cannot show which came first |
| Allen and Walter, 2018 (meta-analysis) | 89 studies of lifestyle factors and sexual health | Too little research to draw conclusions about cannabis | Low statistical power for cannabis |
Why do the cannabis and ED studies disagree?
Mostly because the studies are few, small and built in ways that cannot separate cause from coincidence. The 2019 meta-analysis included only case-control studies, and its authors note these “could be affected by reverse causality”, meaning men with ED may simply have been more likely to use cannabis (Pizzol et al., 2019). A larger 2018 meta-analysis of 89 studies on lifestyle and sexual health found clear patterns for cigarette smoking, alcohol and physical activity, but said there was insufficient research to draw conclusions about cannabis as a risk factor (Allen and Walter, J Sex Med 2018). The clinic study drew only on men attending a fertility clinic, and its authors say this may limit how far the results apply to other men (Shiff et al., 2021). Few of the studies measured how often men used cannabis, how strong it was or how they took it, which is the detail a man asking about daily use most wants. Our guide to how to read ED evidence explains why these study types carry different weight.
How could cannabis affect erections?
Researchers have proposed a few possible paths, but none has been proven in people. The 2019 review points to the body’s own cannabinoid system: receptors for these compounds sit in a part of the brain that helps regulate erections and in the erectile tissue of the penis itself (Pizzol et al., 2019). The heart and blood vessels are another possible route. The National Institute on Drug Abuse (NIDA) says cannabis can raise heart rate and blood pressure right after use, and that some research links long-term use with a higher risk of stroke, heart attack and heart rhythm problems, though “more research is needed” to know whether cannabis is the direct cause (NIDA, Cannabis (Marijuana)). The NIH lists “using recreational and illicit drugs” among the lifestyle behaviors that may contribute to ED, alongside smoking cigarettes and drinking too much alcohol (NIDDK, Symptoms & Causes of ED). Smoking cannabis also means inhaling smoke, which NIDA says contains many of the same toxins and irritants as tobacco smoke (NIDA); our page on smoking and ED covers what is known about tobacco.
What happens after quitting cannabis?
No study we found measured erections in men after they stopped using cannabis, so there is no evidence either way on whether ED improves, worsens or stays the same after quitting. What is documented is withdrawal. NIDA says a person may have withdrawal symptoms after stopping or sharply cutting back heavy or long-term use, and cites one study estimating that 12.1% of people who use cannabis frequently experience withdrawal. The symptoms it lists include irritability, feeling nervous or anxious, restlessness, depression, trouble sleeping and strange dreams (NIDA). Erection changes are not on that list. Separately, the NIH names mental or emotional issues, such as anxiety and depression, among the things that can lead to ED (NIDDK, Symptoms & Causes), so a rough stretch after stopping is worth mentioning to a clinician rather than reading as a sign of lasting harm. NIDA adds that behavioral treatments such as cognitive behavioral therapy can help people with cannabis use disorder, and that no medicine is FDA-approved for it (NIDA).
Does CBD or hemp oil help ED?
There is no clinical trial evidence that CBD (cannabidiol) or hemp oil treats ED. We found no published trial in men that tested CBD as an ED treatment, and the FDA says CBD products sold in stores and online, other than one prescription drug, have not been evaluated for whether they work, what the right amount is, how they interact with other medicines or whether they have dangerous side effects (FDA, Regulation of Cannabis and Cannabis-Derived Products). “Hemp oil” is also a loose label. The FDA says hemp seeds do not naturally contain THC or CBD, and that hemp seed oil cleared as a food ingredient contains only trace amounts the seeds may pick up during harvesting and processing, which is different from a CBD extract (FDA).
The FDA also lists known risks of CBD. It can cause liver injury, it can change how other medicines work, and it can cause sleepiness, diarrhea, reduced appetite and irritability. In animal studies, CBD caused male reproductive harm, including smaller testes, impaired sperm development and lower testosterone; the FDA says it is not yet clear what this means for men (FDA, What You Need to Know About Products Containing Cannabis or CBD). A 2020 review of 32 studies in men, laboratory animals and cells concluded that CBD has negative effects on the male reproductive system, while noting that knowledge is still limited and more research is needed (Carvalho et al., J Appl Toxicol 2020). None of that shows CBD causes ED, but it is not a reason to expect CBD to help. Our comparison of natural remedies and medication for ED covers the other non-prescription options and what their evidence looks like.
Are CBD products approved for ED?
No. The FDA has not approved cannabis for any disease or condition, and the only FDA-approved CBD drug is Epidiolex, a prescription medicine for seizures linked to three specific conditions. The agency says there are no other FDA-approved drug products that contain CBD (FDA, Regulation of Cannabis and Cannabis-Derived Products).
Status: Not FDA-approved for ED in the US (applies to cannabis and all CBD products). Source: FDA, FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD), checked 2026-10-17.
The FDA has also concluded that THC and CBD products cannot legally be sold as dietary supplements, and it has sent warning letters to companies marketing CBD products to treat diseases (FDA, Regulation of Cannabis and Cannabis-Derived Products). In its own testing, many CBD products did not contain the amount of CBD they claimed, and the agency is investigating reports of contaminants such as pesticides, heavy metals and THC. The FDA warns that unproven claims can lead people to put off proper diagnosis and treatment (FDA, What You Need to Know). Products sold for “male enhancement” carry a separate risk of hidden drug ingredients, which our page on FDA tainted supplement warnings tracks.
Does cannabis use mean it caused my ED?
Not necessarily, and the current research cannot answer that for any one man. ED has many possible causes. The NIH lists diabetes, heart and blood vessel disease, hormone problems, nerve conditions, many common medicines, emotional issues and several lifestyle behaviors (NIDDK, Symptoms & Causes). The cannabis studies above describe groups of men, and the best of them disagree, so a link in a study is not a diagnosis. The useful step is a checkup that looks at the whole picture. Our overview of lifestyle and ED covers the habits with the strongest evidence, such as exercise and not smoking tobacco.
When to talk to a clinician
Tell your clinician how often you use cannabis or CBD and in what form, along with every medicine and supplement you take, since the FDA says CBD can change how other medicines work. Bring up any erection changes, especially if they came on with other symptoms. If you find it hard to cut back on cannabis, ask about help; NIDA says behavioral treatments can work. Our guide on when to see a doctor about ED covers what that visit usually involves.
The bottom line
Whether cannabis affects erections is still an open question. One 2019 review of small studies found ED was more common in men who smoked cannabis, while a large clinic study and a 2024 genetic study found no clear link, and no study has tracked what happens to erections after quitting. CBD and hemp oil have no clinical trial evidence for ED, CBD carries real risks the FDA has flagged, and no CBD product is FDA-approved for ED. A clinician who knows your full history is the right person to sort out what is behind your own symptoms.
Sources
Every clinical statement on this page traces to a primary or government source:
- Pizzol D, et al. Relationship Between Cannabis Use and Erectile Dysfunction: A Systematic Review and Meta-Analysis (American Journal of Men’s Health, 2019): five case-control studies, 3,395 men; ED in 69.1% of cannabis users vs 34.7% of controls; odds ratio 3.83 with high heterogeneity and a prediction interval crossing 1; possible receptor pathways; reverse causality as a limitation.
- Shiff B, et al. The impact of cannabis use on male sexual function: A 10-year, single-center experience (Canadian Urological Association Journal, 2021) (full text): 7,809 men at one andrology clinic; on multivariate analysis cannabis use was not associated with SHIM score or testosterone; cohort limited to men seen for fertility care.
- Zhang Y, et al. The impact of cannabis use on erectile dysfunction and sex hormones: a Mendelian randomization analysis (International Journal of Impotence Research, published online 2024): no evidence of a causal relationship between genetically predicted cannabis use or cannabis use disorder and ED or sex hormone levels.
- Otieno M, et al. Association between marijuana use and erectile dysfunction in a sample of sexual minority men: a cross-sectional analysis (Journal of Cannabis Research, 2026): 549 men in an online survey; adjusted odds ratio 1.83 for self-reported ED in marijuana users.
- Allen MS, Walter EE. Health-Related Lifestyle Factors and Sexual Dysfunction: A Meta-Analysis of Population-Based Research (Journal of Sexual Medicine, 2018): 89 studies; insufficient research to draw conclusions on cannabis as a risk factor for ED.
- Carvalho RK, et al. The effects of cannabidiol on male reproductive system: A literature review (Journal of Applied Toxicology, 2020): 32 studies in men, monkeys, rodents and sea urchins, in vivo and in vitro; CBD associated with negative effects on the male reproductive system; more research needed.
- National Institute on Drug Abuse, Cannabis (Marijuana): heart rate and blood pressure effects, long-term cardiovascular associations, cannabis smoke, withdrawal symptoms and the 12.1% estimate, behavioral treatment, and no FDA-approved medicine for cannabis use disorder.
- FDA, FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD) (content current as of July 16, 2024): no approval of cannabis for any condition; Epidiolex as the only approved CBD drug; unapproved CBD products not evaluated for effect, dose, interactions or safety; THC and CBD excluded from dietary supplements; warning letters to firms marketing CBD to treat diseases; hemp seed oil and trace THC and CBD.
- FDA, What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD: liver injury, drug interactions, side effects, male reproductive toxicity in animal studies, inaccurate CBD content and contaminants, and the risk of delaying care.
- NIH NIDDK, Symptoms & Causes of Erectile Dysfunction (last reviewed October 2024): using recreational and illicit drugs among the lifestyle behaviors that may contribute to ED, and the other diseases, medicines and emotional issues that can lead to ED.
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