OPEN Foundation

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Casey Horner; Unsplash

BETTER SEX BEYOND THE TRIP: ENHANCED SEXUAL FUNCTIONING MONTHS AFTER A PSYCHEDELIC EXPERIENCE​

“This study shines yet more light on the far-reaching effects of psychedelics on an array of psychological functioning”

Dr David Erritzoe, Clinical Director of the Centre for Psychedelic Research

Introduction

What substances come to your mind if you think about sexual enhancement? Viagra? Alcohol? Amphetamines? Maybe over-the-counter natural products like Gingo Bilboa? 

Many psychonauts and plenty of anecdotes describe that altered states of consciousness – induced by psychedelics, such as psilocybin (the active component of magic mushroom), LSD, or  5-meo DMT – can foster an intimate, novel and magical sexual experience. But is there also evidence for positive effects on sexual functioning that outlast the drug experience and carry over into the sober, everyday life?

In the recent Nature publication, first author Tommaso Barba – who was recently a guest speaker at OPEN foundation – together with a research group from Imperial College London, suggest that psychedelics may enhance sexual functioning for up to 6 months after a trip! Tommaso believes that “this is the first scientific study to explore the effects of psychedelics on sexual functioning”.  Importantly, the researchers emphasize that their study does not cover “drug-sex” (sex during a trip), but rather captures the long-term effects of psychedelic experiences and psychedelic-assisted therapy that outlasts their pharmacological effect by far. In other words, the aim was to explore and understand differences in sexual functioning weeks and months after one experienced a psychedelic trip.

‘As I sit silent, away from you, you come into my mind. Caressing me gently with your limitless body. Stroking my heart with soft sand, holding my hand. Unwinding my mind, intertwining to the divine, into the forest we slip, deep, dark, unknown guided by light, you gently lead me to the unfolding lotus. Kissing me with blue petals of love. 

– EROWID experience report of an LSD user with her partner 

Who were the participants?

The research group combined responses of almost 300 participants derived from two different studies. The first study recruited participants who already planned to explore psychedelics (such as ayahuasca, 5 meo DMT, psilocybin or LSD) recreationally or in a ceremony. Via an online survey, 261 people answered questions before their psychedelic experience, then four weeks and six months after. 

The second study reflects answers from 59 participants who were part of a clinical depression trial led by Professor Robin Carhart-Harris and aimed to assess the differences in efficacy between the antidepressant drug escitalopram (an SSRI) and psilocybin (the active component in magic mushrooms).

What results are indicated by the study?

Results of the study demonstrate sexual improvements for up to 6 months after the study! Improvements cover various dimensions of sexual functioning, such as the pleasure of sex, sexual arousal, attraction to their partner, acceptance of their own physical appearance, interpersonal communication, and a sense of spirituality related to sex. Neither of the two studies noted a change in the perceived importance of sex.

While both psilocybin and escitalopram decreased depressive symptoms equally well, the present study demonstrates that, compared to the psilocybin group, the antidepressant escitalopram is not related to sexual improvements, but rather worsening. Furthermore, half of the patients in the escitalopram group reported sexual dysfunction, compared to only 13% in the psilocybin group. This is huge because it highlights an important difference between the two substances and can indicate further research directions and hint at novel therapeutic applications.

How do the researchers explain these long-lasting effects of psychedelics on sexual functioning?

The most commonly reported lasting positive effects of psychedelic experiences usually involve higher openness (how curious you are to explore new experiences), connectedness (with yourself and to others), and elevated mindfulness (how present and aware you are in and of the current moment).

openness

An open state of mind after psychedelics may explain why participants reported exploring new sexual experiences more often after experiencing a trip. This in turn has been shown to increase perceived sexual functioning. The authors write that it is beneficial to maintain “a mindful and open state of mind for attaining a satisfactory sexual performance”.

connectedness

There is no question that psychedelics can produce lasting perceptions of connectedness. Feeling more connected psychologically, emotionally or physically to yourself or others enhances interpersonal intimacy and fosters a sense of comfort that ultimately improves the sexual experience.

mindfulness

Experiencing the moment, tuning in to one’s senses and being aware of one’s surroundings are all positive outcomes of higher mindfulness. Not only meditation but also psychedelics can increase mindfulness for a long time after a trip. Researchers suggest that mindfulness is important for one’s sexual performance and the satisfaction of the sexual experience.

brain changes

Brain researchers and psychologists suggest that psychedelic-assisted therapy may help patients relieve certain mental barriers and overthinking patterns by lowering the activity of certain brain networks that are involved in excessive self-directed attention. This is especially useful for people who suffer from excessive overthinking and rumination – as observed in depression.

spirituality

You may wonder what spirituality has to do with sexual performance. Spirituality almost functions as a combination of all the abovementioned factors. Spiritual individuals – and psychedelic users – often experience the “transcendence of the ego”. This shift away from self-centeredness can reduce performance pressure and self-consciousness during sexual activity, allowing for a more natural and fulfilling experience. Additionally, spirituality often brings about greater mindfulness, a willingness to embrace new experiences, and an elevated sense of well-being.

Why are these findings so important?

As the first author Tommaso Barba explains “On the surface, this type of research may seem ‘quirky’, but the psychological aspects of sexual function – including how we think about our bodies, our attraction to our partners, and our ability to connect to people intimately – are all important to psychological wellbeing in sexually active adults”. The relevance of healthy sexual functioning goes way beyond the satisfaction, pleasure and arousal one experiences before, during and after sex. Couple therapists often stress the importance of both sexual performance and the perception of one’s sex life, underscoring their pivotal role in nurturing a healthy and fulfilling relationship. 

Often psychiatric disorders are accompanied by reoccurring issues with sexual functioning. For example, individuals with depression often report anhedonia (the loss of experiencing pleasure), lower self-esteem, and struggle to accept and be satisfied with their physical appearance. These psychological constructs are central to healthy sexual functioning – psychologically and physically. Some therapists even suggest that impaired sexual functioning may be a central risk factor for some individuals to develop a behavioural disorder, such as depression or anxiety.

Patients who are treated with antidepressants often complain about sexual dysfunction. The results from this study may help to identify sub-populations that may benefit more from a psychedelic intervention. For example, sexually active individuals who suffer from depression with comorbid sexual dysfunction (or vice versa!) may benefit more from a psychedelic-assisted intervention compared to antidepressants (SSRIs). 

What are some pitfalls of these findings?

While all of these results are very exciting and illuminate the variety of positive effects psychedelics may induce, it is extremely important to maintain a critical mindset. Therefore, the following lines will reflect some of the pitfalls of the study and explain why we need more research to confirm and apply these findings.  

Even though the study integrated two different study groups (naturalistic users and participants in a clinical trial), the participants’ demographic background primarily reflects white, well-educated and heterosexual people. Secondly, the measurement of sexual dysfunction relied on self-report, which means that the improvements are derived from subjective opinions. Adding to that, the study did not include the evaluation of the sexual functioning of the (sexual) partners – hence, solely relying on one side self-report.

Conclusion

In conclusion, the study sheds light on the potential long-lasting benefits of psychedelics on sexual functioning, extending beyond the immediate drug experience. Despite being preliminary and not free of limitations, the findings underscore the importance of exploring holistic approaches to mental health and well-being, acknowledging the interconnectedness of psychological, emotional, and physical aspects of human experience. Moreover, they raise intriguing possibilities for therapeutic interventions targeting sexual dysfunction, particularly in populations where conventional treatments may fall short. However, it’s crucial to recognize the limitations of the study, such as the narrow demographic focus and reliance on self-reported data, highlighting the need for further research with more diverse populations and rigorous methodologies. Overall, this research contributes valuable insights into the complex interplay between psychedelics, mental health, and sexual well-being, paving the way for future exploration and innovation in this ever-evolving field.

By Simon Jost 


30 April - Q&A with Rick Strassman

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