The Correlation of Women's Sexual Health and Marijuana Use
Condition: Women's Sexual Health
MeSH terms: Marijuana Use
Study type: Observational

Summary: 
      This study is attempting to determine whether there is any effect (worsening or improvement
      of sexual function) after marijuana consumption. Both users and non users of marijuana will
      be given the opportunity to participate by completing a questionnaire.
    

Detailed description: 
      Marijuana is the most commonly used illicit drug (19.8 million past-month users) according to
      the 2013 National Survey on Drug Use and Health (NSDUH).

      There is a current movement towards the legalization of marijuana in various states and there
      are numerous claims of potential uses in medicine.

      The internet is rich with nonscientific, non-evidence based information regarding the effects
      of marijuana on the sex lives of women. However, surprisingly little scientific research has
      been done on it.

      Cannabis use and sexual function Endocannabinoids, which are structurally similar to cannabis
      (marijuana) help regulate a number of motivated behaviors and emotional states, including
      sexual function. There are a variety of ways that cannabinoids interact with the hormones and
      neurotransmitters that affect sexual behavior. This interaction has not been clearly
      elucidated but studies in rats have helped to clarify the relationship between cannabinoids
      and the hormones and neurotransmitters that affect sexual behavior.

      In male rats, administration of tetrahydrocannabinol (THC, the psychoactive compound in
      marijuana) reduced sexual motivation. In female rats, the relationship between THC and sexual
      behavior is less clear. found that giving female rats a low dose of THC increased their
      receptivity to copulation. However a high dose interfered with receptivity, also found that
      THC stimulated receptivity and increased proceptivity ("courting behavior") in female
      hamsters.

      Lopez et al found that in rats, giving a cannabinoid receptor blocker, increased sexual
      motivation during the estrous cycle. They then found that ovariectomized rats given a
      cannabinoid receptor agonist, had reduced sexual motivation. When exogenous estrogen and
      progesterone were given, this effect was attenuated.

      The exact mechanism by which THC affects sexual function in women is unknown. It is known
      that THC and the hypothalamic-pituitary-gonadal (HPG) axis, which controls the sex hormones,
      interact with eachother. Acute administration of THC has been shown to inhibit LH and PRL
      secretion from the anterior pituitary in males and females. In females, high dose of THC can
      interfere with estrous and menstrual cycle timing and can delay or prevent ovulation.
      Cannabinoids inhibit or interfere with activity of the HPG axis and reduce secretion of
      several hormones which tend to have an inhibitory impact on sexual behavior.

      It is known that dopamine is a key prosexual modulator in normal excitatory female sexual
      function. It is also known that the major effects of THC in the central nervous system are
      mediated by cannabinoid receptors. These receptors have been shown to enhance dopamine
      (Lazenka et al, 2015), which may be another pathway by which marijuana affects sexual
      function.

      Human studies are limited. Questioned regular male and female marijuana users about their
      opinions regarding changes in the sexual experience when using marijuana. They found that
      when marijuana affects the sexual experience, it affects it positively. Marijuana did appear
      to increase desire mildly and enhances the quality of orgasm.

      There are several links between THC and hormonal and neurotransmitter pathways that play a
      role in sexual function and dysfunction, providing a theoretical way that THC may alter
      sexual functioning. These links need to be more clearly studied and elucidated.
    

Observational model: Ecologic or Community
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Patient participants will be asked upon check-in at their ob/gyn office whether they would
        like to participate in the questionnaire study. Patients will be asked to complete their
        questionnaire in the exam room of the ob/gyn practice. Patients who choose to voluntarily
        participate in the study, will be instructed to place their anonymous questionnaire in a
        provided blank envelope and seal it as to ensure confidentiality, then return their
        completed questionnaire to the front desk and place the sealed envelope in a lock box
        themselves.