Does CBD Help With Premature Ejaculation (performance anxiety)?
Most of our days are spent studying CBD's effects on pretty serious issues:
In our "cluster" of everything anxiety research, some interesting effects and studies have popped up in a less-life threatening situation.
We covered it at a summary level in our CBD and Orgasm article but we're going all in.
It's rare that actual research can show a genuine effect on something so complicated as sexuality from a substance.
There's so much snake oil out there trying to scam men who are anxious on this topic.
Let's get to heart of it.
Look...it's the most common male sexual disorder in the US with 30-70% of men younger than 40 experiencing this issue.
The main medication prescribed has a significant discontinuation rate (more on that below) with the second most common reason being its effectiveness.
It does however, point us in one direction since we know exactly what pathway in the body that it works on.
We're going to look at that in depth:
- New research on brain areas
- Why serotonin affects this pathway
- The powerful effect of anxiety and performance anxiety specifically
- Research on tips shown to actually improve control
Finally, we will investigate what research is showing for CBD and premature ejaculation.
There's impressive results on CBD and a range of anxiety issues.
CBD and public speaking studies are especially relevant since they involve a different but very intense type of performance anxiety in a hypercritical social setting.
What causes premature ejaculation?
Let's set the stage first.
There are two different types of premature ejaculation.
- Lifelong - always present
- Acquired - starts later in life after not having premature ejaculation earlier
This is important.
Both have a strong psychological underpinning but the latter may also have physical causes such as ED, drug side effects, etc.
There's a full list of physical causes here:
Keep in mind that the average length of sexual intercourse in the US is 7.3 minutes.
The link above has an impressive list of general tips for premature ejaculation.
For example, men with lifelong premature ejaculation were able to extend their time to ejaculation significantly with kegels (a type of pelvic floor exercise):
At the end of the treatment, 33 (82.5%) of the 40 patients gained control of their ejaculatory reflex, with a mean IELT of 146.2 s (range: 123.6–152.4 s).
From 40 seconds to 140 seconds in 12 weeks.
That officially puts us over the 60 second severe premature ejaculation diagnosis threshold.
Again, check out the full list here:
One interesting way to look at the two "classes" of erectile dysfunction is by issues that tend to go long with it:
- Low response - e.g., anorgasmia, low libido, erectile dysfunction
- High response - e.g., depression, anxiety, excessive stress
Of particular significance, was social anxiety:
PE was highly associated (p=0.015) with social phobia (SP), with an odds ratio of 2.55. The debut of SP preceded the onset of PE.
That's a huge clue and we're going to see interesting results of CBD on that front.
Check out CBD and social anxiety here.
To put it simply, we have to main "groupings" for erectile dysfunction.
Some people have physical issues (low testerone, low serotonin, vascular issues, drug side effects)
While others may have more of a psychological performance anxiety root.
Yes, this is a simplification but the vast majority of prematureejaculation sufferers will likely fall in these two camps.
Let's move on to where in the body and brain, erectile dysfunction may reside.
Brain areas associated with premature ejaculation
Interestingly, the direct control over ejaculation is actually located in the spinal cord around the lumbar region.
That's the physical switch however.
Interesting research is pointing of course to the brain.
The left inferior frontal gyrus to be exact.
We'll call it the IFG to make it easier.
This is the seat of inhibition or avoiding impulse and action.
The present results indicate that the integrity of left IFG is also critical for successful implementation of inhibitory control over motor responses.
A study looked at people with lifelong premature ejaculation versus a control group with brain scans:
However, LPE patients showed a significantly different correlation pattern between the stop signal reaction time (SSRT) and left inferior frontal gyrus (IFG) activation during successful inhibition, in which a typical negative correlation between SSRT and the activation was completely disappeared in patients.
Let's translate this.
LPE is lifelong premature ejaculation.
The scans showed this area had less connectivity with other key brain areas (dentate nucleus and right frontal pole).
The dentate nucleus is a relay system to the spinal cord and out from there….basically a connector between the brain and body.
The right frontal pole wears many hats:
The frontal lobes are involved in motor function, problem solving, spontaneity, memory, language, initiation, judgement, impulse control, and social and sexual behavior.
So...we have a circuit which connects:
- Motor inhibition (left inferior frontal gyrus) - basically control of bodily actions
- Relay system to the body (dentate nucleus)
- Impulse control and sexual behavior (frontal pole)
Of course, there is more at play but this circuit stood out in the scans.
A pretty impressive overview can be found here based on machine learning analysis of the scans:
Let's now look at a known actor...Serotonin.
Serotonin and premature ejaculation (the depoxetine connection)
We've discussed serotonin quite a bit with our anxiety articles.
Not so much because it's a great lever for anxiety (it's more for depression) but because the biggest class of anxiety medications boost its levels.
They're called SSRI's and you can learn all about CBD versus SSRI's for serotonin here.
We bring serotonin up here because of a side effect of SSRI's...delayed (if not deleted) ejaculation.
This led to them being prescribed for premature ejaculation albeit the participation rate drops off significantly and side effects can be pronounced.
What's the science behind serotonin and premature ejaculation?
Experimental evidence indicates that serotonin (5-HT), throughout brain descending pathways, exerts an inhibitory role on ejaculation.
They've even tied it to a gene that governs serotonin functioning in the brain.
Three types of the gene exist: LL, SL and SS. The study showed that the LL type causes a more rapid ejaculation. On average, men with LL ejaculate twice as quickly as men with SS, and also almost twice as quickly as men with SL.
The net effect of this gene variant is low serotonin activity.
This is important since the 5httlpr gene is tied to everything from emotional resilience (anxiety and depression) to more severe mental illness.
Remember that anxiety, especially social anxiety, is a common factor with premature ejaculation.
Serotonin is a powerful player in brain plasticity and remodeling by the way.
Learn how CBD, mindful meditation, and exercise use this pathway to improve neurogenesis (the brain connectivity we discussed above).
- Exercise boosts all pathways and neurotransmitters.
- Mindful meditation reduces anxiety and actually builds new brain tissue!
We'll get into CBD below.
So put a checkmark next to that as we'll come back to it later with CBD.
It's very exciting!
Speaking of social anxiety…
Premature ejaculation and social anxiety (the public speaking CBD study)
We looked at what may be an underlying cause (Serotonin function) behind both premature ejaculation and social anxiety.
We have an entire article on CBD and social anxiety since it's so interesting.
A big part of premature ejaculation is a kind of performance anxiety aspect to it.
Whether a biological cause initiates it, follow up instances are infused with a fear of the same.
There's a great proxy for premature ejaculation in terms of social anxiety.
It's public speaking!
Public speaking is the single most universal fear (even higher than death).
A few attributes similar to premature ejaculation:
- It sets off a series of involuntary loss of bodily controls
- It's rooted in a fear of rejection, performance failure, and being judged
- It's self-reinforcing: one bout of public speaking fear will make following instances worse
Sounds like something we're discussing above.
This is a great introduction to CBD!
There was a powerful study on the effects of CBD on public speaking anxiety.
We an entire review of it in the above link but the net net:
Pretreatment with CBD significantly reduced anxiety, cognitive impairment and discomfort in their speech performance, and significantly decreased alert in their anticipatory speech.
In the experiment, the effects (both objective and subjective) of performance anxiety from public speaking were virtually identical to the control group!
Again, much like premature ejaculation, the fear of public speaking is nearly out of our control.
The similarities are obvious.
Okay...let's now get to the reason most people started this article...what does research say about CBD and premature ejaculation.
Can CBD help with premature ejaculation
Let's start with hard science (sorry in advance).
Remember the gene variant (a flavor of a particular gene out of many) for serotonin transport that was directly tied to doubling the time to ejaculation?
Doubling the time from one gene.
This speaks to why SSRI's have been shown to delay or obliterate ejaculation (the latter, not being great).
As researchers found:
Experimental evidence indicates that serotonin (5-HT), throughout brain descending pathways, exerts an inhibitory role on ejaculation.
It's not just serotonin levels but the "transport" or processing of it between and within nerves.
Either way, this is pretty well established which is why SSRI's have been prescribed.
That's quite a hammer to swing for premature ejaculation since the side effects can be pretty significant and our brain adjusts for this serotonin with time.
Check our CBD versus SSRI's for serotonin.
What about CBD and serotonin function?
Glad you asked!
In vivo microdialysis revealed that the administration of CBD significantly enhanced serotonin and glutamate levels in vmPFCx in a different manner depending on the emotional state and the duration of the treatment.
The PFC is the prefrontal cortex. That's part of the premature ejaculation circuit we talked about earlier (frontal poles).
Remember that SSRI's only boost serotonin levels (available to neurons)
One direction and that has a host of potentially negative effects. Serotonin is too powerful and wears too many hats in the brain and gut to just juice it higher.
The beauty of CBD is that it appears to balance serotonin signaling:
Seven days of treatment with CBD reduced mechanical allodynia, decreased anxiety-like behavior, and normalized 5-HT activity.
The key word there is "normalize".
5-HT is the serotonin pathway.
Also, did you notice the anxiety note there?
That brings up our next topic on CBD and premature ejaculation.
Performance or social anxiety aspects for premature ejaculation.
Keep in mind that when they run the SSRI studies, the placebo group can have around a 10% improvement!
We discussed the best proxy for performance anxiety with the public speaking and CBD study above (detail here).
Let's look at CBD and social anxiety highlights.
We have an entire article on CBD and the anxiety pathway here.
Let's look at how CBD might affect premature ejaculation that is acquired (occurs after a specific situation or later in life).
There's an interesting crossroads between the endocannabinoid system (which CBD supports) and negative experiences.
What was fascinating is that this early exposure showed its effects (similar to social anxiety in people) via the endocannabinoid system:
Our data indicate lasting consequences in social behavior and pain sensitivity following peer-rejection in adolescent female rats. These behavioral impairments are accompanied by persistent alterations in CB1R signaling.
CB1 is the endocannabinoid receptor found mainly in the brain and central nervous system!
Interestingly, what can be learned (if negative) can be unlearned.
It's called "fear extinction".
Here's where CBD is interesting.
In one study, CBD was shown to be effective in removing this conditioned response:
CBD can enhance consolidation of extinction learning in humans and suggest that CBD may have potential as an adjunct to extinction-based therapies for anxiety disorders
Check out the CBD and social anxiety for a full review.
CBD and panic attacks also has some relevant studies that touch base on CBD and the fear response (uncontrollable bodily responses).
Just a head's up...a study showed that THC (the psychoactive chemical in cannabis) actually reduces activity in that key brain area for erectile dysfunction (the IFC). That's going the wrong direction.
CBD did not have that specific effect but generally tends to counter THC's effects in the body (see CBD versus THC for anxiety).
So...if we want to test CBD for erectile dysfunction, what's the best way to approach.
How much CBD for premature ejaculation and how to take it
It's important to start low and test CBD first.
This is generally 25-30 mg of CBD in a dose.
We have good research on CBD and anxiety with a range up to 300 mg (for neurogenesis long term effects).
The oils are probably best since we want a systemic effect (whole body and brain).
Put the oil under your tongue up to 60 seconds especially if sexual intercourse is expected shortly.
This can speed CBD into the bloodstream via the sublingual gland.
Then swallow the remaining oil.
Our CBD is isolate in MCT oil (coconut extract) so it doesn't have the bad taste and color and that full spectrum CBD will have.
Green oil with a strong hemp or wheatgrass smell is not exactly great for sexual attraction!
There is very little discernible taste or smell.
Test to see what works from 50 - 300 mgs before sex.
CBD generally peaks in the bloodstream about 1 hours after ingesting but the under-the-tongue effect is within a few minutes.
You can also use CBD oils as a lubricant since it's just two materials!
CBD isolate and MCT oil.
Both CBD and MCT are antibacterial and antimicrobial.
Our best estimates are about 100 mg for premature ejaculation but keep in mind that some of the effects on brain connectivity and anxiety are longer term.
That's why SSRI's need a few weeks to build up. Learn all about CBD and neurogenesis here.
The best CBD for premature ejaculation
A few key notes.
We don't want THC since it's shown to reduce activity in that important part of the premature ejaculation circuit (going the wrong way).
We want 3rd party tested for:
- No pesticides
- No bacteria
- No mold
- No heavy metals
- No solvents
It should also be organically grown in the US!
We just listed off everything we do at IndigoNaturals.
Afterall, our entire family uses the products.
One note...we don't recommend the balm since it has other ingredients that are not designed for intercourse.
The CBD oil is just fine however!