Drug Use and Sex: Women

This entry was posted in Addicts, Blog and tagged , , on by .

Dr. David Fawcett

While there is a rich literature on sexualized drug use among men, notably men who have sex with men, there is far less research concerning women. Much of the literature on sexualized drug use among women has been with sex workers. Studies of female sex workers along the Mexico-US border found sexualized drug use rates ranging from 14 to 63 percent.[i] A study of 198 sex workers in Canada reported that 59 percent had shared drugs with clients in the preceding six months, and that sexualized drug use was associated with inconsistent condom use, verbal harassment, physical assault, and sexual assault.[ii]

Importantly, it is well-documented that women respond differently to drugs. While cannabis is popular among all sexes in a sexual context, females use less marijuana than men. Research indicates that cannabis impairs spatial memory more often in females, while men experience a greater marijuana-induced high, and perhaps this is a factor.[iii] Women may also be more susceptible to the stimulating effects of amphetamines due to a sensitivity linked to estrogen.[iv]

Alcohol also impacts women differently than men. For the most part, this is related to the fact that men tend to have more muscle tissue while women tend to have more fatty tissue—usually gynoid fat in their breasts and hips. Because alcohol is water soluble, it is diffused out of the bloodstream into muscle tissue, which is water soluble, but not fat tissue, which is not water soluble. As a result, alcohol tends to remain in the bloodstreams of women at higher levels for longer periods of time. So, if a man and a woman weigh the same and drink the same amount of alcohol, the woman will probably have a higher blood alcohol content and be more impacted by it for a longer period of time.

Notably, alcohol consumption can impact both a woman’s desire for and ability to enjoy sex.[v] Often, with female sexual desire a drink or two is likely to increase libido. This may be linked to a decrease in sexual inhibitions, or it may be something of a self-fulfilling prophecy where females expect to be sexual in drinking settings and act accordingly. With heavier drinking, however, especially if a woman reaches the point of intoxication, the impact on sexual desire is less predictable. Many women find their sexual desire suppressed, while others continue to experience higher levels of desire.

In general, alcohol consumption in women:

  • Decreases blood flow to the extremities, including the genitals.
  • Depresses the central nervous system.

The two issues may impact not only libido but a woman’s ability to naturally lubricate for sex, to reach orgasm, and to fully enjoy an orgasm. However, these effects are more sporadic with women than with men. Basically, research shows that for many women alcohol consumption is associated with taking longer to reach orgasm and a decreased intensity of orgasm, but the opposite occurs for plenty of other women.[vi] Similarly, opioids decrease sexual performance in women. One study indicated that both men and women receiving opioid treatment for pain experienced a loss of libido, and that a woman’s sexual functioning was slightly more affected than that of men.[vii]

REFERENCES

[i] Ong, J. J., Xiong, M., Tucker, J. D., Wang, Y., Smith, M. K., Tang, W., … & Wang, C. (2021). Sexualized drug use among female sex workers from eight cities in China: A Cross-sectional Study. Archives of Sexual Behavior, 1-10.

[ii] Shannon, K., Kerr, T., Bright, V., Gibson, K., & Tyndall, M. W. (2008). Drug sharing with clients as a risk marker for increased violence and sexual and drug-related harms among survival sex workers. AIDS care, 20(2), 228-234.

[iii] Pope, H. G., Jacobs, A., Mialet, J. P., Yurgelun-Todd, D., & Gruber, S. (1997). Evidence for a sex-specific residual effect of cannabis on visuospatial memory. Psychotherapy and psychosomatics, 66(4), 179-184.

[iv] Evans, S. M., & Foltin, R. W. (2006). Exogenous progesterone attenuates the subjective effects of smoked cocaine in women, but not in men. Neuropsychopharmacology, 31(3), 659-674.

[v] Crowe, L. C., & George, W. H. (1989). Alcohol and human sexuality: review and integration. Psychological Bulletin, 105(3), 374.

[vi] Beckman, L. J., & Ackerman, K. T. (2002). Women, alcohol, and sexuality. In Recent developments in alcoholism (pp. 267-285). Springer, Boston, MA.

[vii] Abs, R., Verhelst, J., Maeyaert, J., Van Buyten, J. P., Opsomer, F., Adriaensen, H., … & Van Acker, K. (2000). Endocrine consequences of long-term intrathecal administration of opioids. The Journal of Clinical Endocrinology & Metabolism, 85(6), 2215-2222.