(267) Ecstasy' - Accurate or Deceptive Name? A Systematic Review of MDMA Effects on the Male Sexual Response Cycle

Abstract Introduction 3,4-Methylenedioxymethamphetamine (MDMA, ‘Ecstasy’ or ‘Molly’) is a synthetic psychostimulant and entactogenic drug of abuse that augments feelings pleasure, increases energy, distorts sensory perception. MDMA serotonin, dopamine, norepinephrine neurotransmission within the mesolimbic reward pathway, which impacts human sexual function. While dopamine implicated as facilitator arousal orgasm, serotonin associated with inhibitory effects. Unlike most psychostimulants function primarily via increased dopaminergic neurotransmission, generates approximately equivalent simultaneous in both serotonin. In alignment its central neurochemical impact, reported to enhance while impairing other domains, such erectile function, ejaculation. Objective To evaluate effects on different domains male response cycle. Methods We conducted systematic review various response. PubMed, Embase, MEDLINE were queried, results screened using Preferred Reporting Items for Systematic Reviews Meta-Analyses (PRISMA) guidelines. Six search terms, including “MDMA” “ecstasy” combination “desire,” “orgasm,” “pleasure,” “libido,” “erection,” “ejaculation” utilized. Inclusion criteria were: was used by study subjects, outcomes at least 1 domain cycle reported, manuscript written English published between January 2000 June 2022. Case reports studies did not examine excluded. Results identified total 90 studies, 8 met inclusion exclusion criteria. Seven evaluated desire and/or arousal, 5 erection, 3 2 The average age participants 25 years. Primary outcome measures highly variable largely qualitative; however, common included Sexual Arousal Desire Inventory (SADI) International Index Erectile Function (IIEF) score. Two double-blind, crossover trials relative placebo (methylphenidate, modafinil) mixed conclusions. One no effect compared less than methylphenidate, methylphenidate modafinil. remaining interview-based, 6 evaluating arousal. Sixty percent interview-based desire, 40% effect. Of impairment, effects, “fear erection impairment.” All orgasm difficulty achieving but intensity pleasure if achieved. Conclusions This demonstrates there are few high-quality investigating distinct response, our findings suggest enhances intensifies males despite potential impairments ejaculatory Given MDMA's illicit unregulated nature, these should be interpreted caution users must consider adverse drug-related behavioral health Disclosure Any authors act consultant, employee shareholder an industry for: Abbvie, Coloplast