Can Psychedelic Therapy Help to Improve Sexual Function?

Psychedelics like psilocybin and MDMA may help survivors of sexual trauma. Here’s how psychedelic therapy could help with sexual function.
psychedelic therapy for sexual function
Author: Marie Hasty, RN
By Marie Hasty, RN
January 20, 2023(Updated: April 22, 2024)

Did you know that MDMA was quietly used in couples therapy in the 70’s and 80s? Before its criminalization in 1985, some therapists used it as a tool to bring couples closer. MDMA-assisted therapy and psilocybin-assisted therapy could help people reestablish connection with their partners, and help individuals recover from trauma. Here’s what we know about psychedelic therapy and healing sexual function. 

Psychedelic-assisted therapy is on the rise and could be a core treatment option in the future of mental health care. Psilocybin, MDMA, and ketamine have helped patients with depression, anxiety, PTSD, and more. Additionally, there is some evidence that these substances could be a helpful tool in sex and couples therapy. 

You may have heard of people using psychedelics during sex. We’re not talking about recreational use here. Instead, we’re talking about psychedelic-assisted therapy as a tool to bring couples closer and help individuals heal from sexual trauma in a controlled environment. Psychedelics could be vital in the therapy model of the future. 

Psychedelic Support is at the forefront of evidence-based education in psychedelic medicine. We love exploring evidence, keeping you updated on current events and research, and giving therapists the tools they need to help patients. While there haven’t been many trials exploring psychedelic therapy in relation to sexual function, there is some encouraging evidence in this area. 

Serotonergic psychedelics like psilocybin, LSD, and MDMA activate receptors in the brain linked to sexual desire, dopamine, and testosterone. Researchers are still unsure if these substances can improve mental health challenges, but outcomes in trials have been insightful. 

Psilocybin and MDMA are closest to FDA approval, and we have the most evidence for their benefits. Let’s talk about how the principles of psilocybin- and MDMA-assisted therapy can be applied to sex and couples therapy.

MDMA-Assisted Therapy and Couples Therapy

MDMA spurs intense feelings of closeness to others, openness to experiences, and deep connection. It can cause people to lower their sexual inhibitions, which can be helpful in controlled settings. These qualities prove that MDMA can be a powerful tool for couples trying to regain physical and emotional connection with one another. 

But MDMA therapy doesn’t mean couples simply take MDMA before sex. Practitioners who used it in couples therapy in the 80s advised against sex while on MDMA, because it could confuse people’s boundaries. Instead, therapists used it as a tool to help couples drop down their internal walls to be more emotionally vulnerable with one another. 

MDMA is close to commercialization for treating Post-Traumatic Stress Disorder, and some clinicians are already using it as a tool in couples’ therapy. In our speaker session with Dr. Anne Wagner, we learned how she used MDMA-assisted therapy to help couples and individuals gain connection and overcome past trauma. 

Dr. Wagner uses psychedelic therapy for sexual function to help couples explore trauma and how it impacts their relationship. She says that MDMA “is really well suited to interacting with couples and helping with that creation of safety and the container, but also the feeling of empathy that comes along with that openness and sharing.” 

In couples where one partner is suffering with PTSD, that person can benefit from the openness that MDMA creates. For the other person, MDMA can enhance feelings of empathy and understanding, so they can feel closer to their partner. In Dr. Wagner’s pilot study, MDMA-assisted therapy helped people overcome PTSD symptoms while gaining satisfaction in their relationships. 

There are some encouraging reports of MDMA as treatment for sexual trauma. While on MDMA, people have regained the desire to connect, despite the anxiety resulting from trauma. People are able to confront deep fears without being activated and report having a sense of trusting vulnerability. While these reports are anecdotal in nature, they give us a good direction for how MDMA could help survivors of sexual violence.  

We don’t have large-scale research on MDMA-assisted therapy and sexual function yet, but the experiences of experts like Dr. Wagner are encouraging. Now let’s talk about psilocybin-assisted therapy. 

psychedelic therapy for sexual function

Psilocybin-Assisted Therapy and Sexual Function

Psilocybin-assisted therapy has been shown to improve quality of life in patients with treatment-resistant depression. Sexual dysfunction is a common symptom of depression and antidepressant medications can exacerbate performance anxiety and more. By treating the root cause of depression, psilocybin may, in turn, help people improve their sexual function. 

One of the most difficult side effects of antidepressants is problems with sexual function. Many patients struggle with getting and maintaining arousal and reaching orgasm. This side effect is thought to be caused by a baseline increase in serotonin for people on Selective Serotonin Reuptake Inhibitors (SSRIs). This may lead to irregularities in other hormones we associate with sex, like dopamine and testosterone. 

Encouraging patients to utilize another avenue instead of SSRIs, such as psilocybin, can help people ignite their sex drive and decrease other sexual challenges. Psilocybin works on serotonin receptors, but with a shorter duration. It’s also a partial-agonist, so its effects are short-lived compared to SSRIs. 

These differences mean that psilocybin would not be a replacement for antidepressant therapy, but an alternative for patients who are wanting to taper off medications. More research is needed, but this is one of the ways that psilocybin could improve the lives of patients by helping them reduce or eliminate psychotropic medications. 

Our understanding of psychedelics and their benefits continues to grow as more research comes out. We’re far away from having set standards in psychedelics as a tool for sexual function. Some anecdotal and qualitative research does support psychedelics in this area, so let’s talk about these findings. 

Here is a presentation by Dr. Maloof on social connection and psychedelic medicines for sexual function from our free monthly speaker series.

Do you need CE credit? Learn more here.

Microdosing and Couples’ Therapy

A small qualitative study published earlier this year followed the experience of couples microdosing. Some couples used MDMA, but the study was unclear on what specific substance each couple used. Researchers interviewed four couples, who noted improvements in these key areas:

  • Sexual self-efficacy (a person’s control or confidence in their ability to perform sexually) 
  • Sexual exploration
  • Relationship satisfaction
  • Sexual desire
  • Communication

Along with these improvements, couples also noticed reduced stress and performance anxiety, which improved their experiences of sex overall. While higher doses of MDMA hindered sexual functioning, couples still experienced strong emotional and sensory sensations. These findings are small, but they point to potential use for microdosing in psychedelic therapy for sexual function as a tool to bring couples closer. 

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Safety in Psychedelic Medicine

MDMA is the most famous psychedelic for sexual enhancement. In controlled environments, it can be a tool for growing connection and creating a deep sense of empathy. These feelings could make it especially useful in the group therapy setting, where patients can grow together in a sense of community. But MDMA’s effects can also lead to dangerous situations if it’s taken at the wrong time or with the wrong people. 

If you plan on taking MDMA, or any psychedelic, for healing from sexual trauma or gaining connection, be sure to plan for safety. These substances put people in a state of mind where they’re left vulnerable and can be taken advantage of by others. Sexual assault has happened to people in these situations. Know who you’ll be with during your experience, where you’ll be, and have a plan to stay with those you trust. 

Key Takeaways for the Future of Psychedelics and Sexual Function

We still don’t have much evidence for psychedelics and healing sexual function, but what we do know is encouraging. A collection of positive results from clinician reports, small studies, and anecdotal evidence will hopefully lead to large-scale research further down the line. It’s possible that we won’t know more about these substances’ effects on sexual function until after they’ve gone through commercialization. But our current understanding of these substances and their potential for use in psychedelic therapy for sexual function is growing everyday.

Psychedelic Support is advocating for FDA-approved psychedelic-assisted therapy in controlled settings. When working with licensed therapists and facilitators, patients can go through their psychedelic experience knowing they are safe. Continuing education for therapists will help the collective knowledge grow as more research emerges around sexual function and other illnesses. If you want to stay up-to-date on psychedelic research, subscribe to our newsletter to get updates on articles like this right in your inbox. 

The content provided is for educational and informational purposes only and should be a substitute for medical or other professional advice. Articles are based on personal opinions, research, and experiences of the author(s) and do not necessarily reflect the official policy or position of Psychedelic Support.

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Author: Marie Hasty, RN
Marie Hasty, RN
I'm Marie Hasty - a nurse, medical copywriter, and artist living in Charlotte, North Carolina. I get to use my clinical and academic background to create accurate, readable medical copy. I am passionate about writing informative articles for patients and the community.

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