Coke dick: Everything you should know about cocaine and erectile dysfunction

Written with
Dr Matthew Chan

You may know it as coke, Charlie, or gear.

Whatever you call cocaine, we know that this drug can help make you feel more confident and sometimes even horny.

But, it comes with a catch 22: cocaine can cause erection issues. 

“Cocaine increases your sexual desire, but stops you being able to get it up, despite normally being able to.”

Dr Matthew Chan, Medical Doctor

Research shows that in 2020 around 5.2 million people in the US had used cocaine (and that’s just the reported numbers we know about). One study has also found that erectile dysfunction (ED) affects over a quarter of men under 40.

That’s a lot of people.

So, we thought it was important to dive into the world of cocaine and erections – enlisting the help of Dr Matthew Chan and Psychosexual therapists Amanda Barge and Silva Neves.

What is coke dick?

Simply put, coke dick is when the use of cocaine stops you from being able to get an erection.

Coke dick can be short-term or long-term, and have physical and psychological effects. 

Signs of coke dick

You may have coke dick if you’ve taken cocaine on a one-off occasion (or take cocaine on a regular basis) and one or more of the following statements is also true:

  • You can’t get an erection at all
  • You struggle to keep an erection 
  • You aren’t able to enjoy an erection hard enough for sex

Can cocaine cause erectile dysfunction?

Coke can affect men's erections in different ways.

Coke & erections in the short-term

If you take coke for one night, you may not be able to get or stay hard during that one night — while the cocaine is still in your bloodstream. 

Although short-term use of coke can stop you from getting great erections, it’s mostly temporary, and therefore wouldn’t tend to be given an official ED diagnosis.

Coke & erections in the long-term

But, if you take part in excessive cocaine use more regularly, it may cause longer-term erection issues or even permanent damage – both psychologically and physically.

In this case, coke use could lead to erectile dysfunction.

How does cocaine affect erections?

Physical effects of coke on erections 

There are some physical effects of cocaine use that can contribute to erection issues (as well as some other sexual dysfunctions): 

Vasoconstriction (shorter-term) 

  • Once cocaine is in the bloodstream, it constricts the blood vessels in the body. The fancy medical term for this is vasoconstriction
  • The narrowing of blood vessels reduces blood flow to your penis, which can stop you from being able to get it up

Ejaculation issues (shorter and longer-term) 

  • There’s also evidence that taking coke can cause delayed ejaculation due to reduced sensitivity

Vascular damage (longer-term) 

  • Repeated use of cocaine over a longer time period has been linked to permanent vascular damage (the vascular system is also known as the circulatory system and is made up of the vessels that carry blood through the body)
  • This could potentially cause longer-term physical erectile difficulties, although not much research has been done in this area yet

Decreased libido (longer-term)

  • Libido and arousal can decrease in the longer term with too much coke use
  • This is because cocaine increases your dopamine, serotonin, and adrenaline levels (the happy hormones) in the 15-30 minute high after you take the drug. Repeated exposure to high levels of these hormones can desensitize the body to pleasurable activities over time

Priapism (longer-term) 

  • A medical emergency can happen with cocaine use called ‘priapism’. This is an erection that won’t go away for hours after stimulation
  • There's some medical research that suggests cocaine can mess with the usual process of ‘relaxing’ an erection. This means that the blood vessels stay constricted and the erection becomes ‘stuck’. In these cases, the penis won’t be getting enough new oxygenated blood to keep the tissue alive 
  • This can cause significant damage to penile tissue or even gangrene of the penis (where a loss of blood supply causes tissue to die). We know this sounds terrifying, but it only happens in rare cases 
  • Priapisms need urgent treatment to avoid long-term erectile issues
“Even though cocaine can really get the sex drive going, the physical effects it produces on blood flow and longer-term desensitivity to pleasure can really affect erections and ejaculation.”

Dr Matthew Chan, Medical Doctor

Psychological effects of coke on erections

Erections aren’t just a physical response. Getting hard requires the right signals from both the mind as well as the body.

To complicate matters, some of the physical effects of cocaine can lead to psychological erection issues down the line. 

Read on to see how cocaine can have a psychological impact on your penis: 

A physical coke dick experience can lead to anxiety of unreliable erections (shorter and longer-term)

  • This one is pretty common. If a guy can’t get it up one time after taking cocaine, then he may get it into his head that he'll have an unreliable erection next time he takes the drug before or during sex (or believe he will never get it up again on coke — which becomes a self-fulfilling prophecy)

Becoming dependent on cocaine to have sex (shorter and longer-term)

  • Some people also use coke as a way to boost their energy levels, confidence, and sexual desire
  • However, this can lead men to feel dependent on the drug to achieve feelings of sexual confidence, to have additional energy in the bedroom, and to experience higher libido 

Developing anxiety around having drug-free sex (shorter and longer-term) 

  • Relying on coke in the bedroom and associating taking coke with thinking “I’m a good lover” can cause additional psychological ED problems
  • Guys may start to feel anxious when having coke-free sex with a partner
  • This anxiety stops the right signals going to the penis to get hard

Increasing mental health issues (shorter and longer-term) 

  • Use of cocaine can increase feelings of stress, anxiety, paranoia, panic, and even depression
  • These feelings can appear during a ‘comedown’ (the period of time after taking drugs when the effects wear off). They can also become side effects of longer-term coke use
  • These are all some of the known psychological triggers which can then lead to erectile dysfunction

A correlation between cocaine use and other potential psychological ED causes (shorter and longer-term) 

  • Some people may be taking the party drug cocaine to distract them from other stresses in life such as pressure at work, lack of self esteem, feeling lonely, or having depression
  • If you're taking cocaine and suffering from erectile dysfunction, it could be one of these underlying psychological stressors causing your erection issues, rather than the cocaine itself

How long does coke dick last?

Coke could stop you from having an erection each time you use the drug. In this case, coke dick may last until the effects of the drug wear off or until the drug has left your system.

For most people, cocaine stays in their system for a few days (or longer if someone takes cocaine more frequently). However, most of it usually passes in the first day or so.

There isn't any hard (pardon the pun) evidence out there yet to say how long coke dick lasts after taking cocaine. As far as we know, cocaine erections differ from person to person, and it depends on how much cocaine you’ve taken.

Using cocaine more regularly could stop you from getting hard even when you haven’t taken any. This may need a more complex fix than just waiting for the coke to pass. Read on to find out more.

How to fix coke dick

Solutions for physical coke dick problems

If vasoconstriction occurs

  • If you’ve taken cocaine and you’re experiencing a one-time erection issue, you will need to stop taking the coke wait for it to leave your body before you can get hard again

If you’re experiencing delayed ejaculation issues

  • Sorry to sound like a party pooper, but the best fix for this is to stop taking cocaine altogether
  • If this feels like an impossible ask, you may need specialist input for drug addiction and psychosexual therapy to help

If you have more permanent vascular damage

  • We hate to say it, but cutting out cocaine is the best (and perhaps only) way to help prevent longer-term or permanent damage, or at the very least stop the damage from getting worse 

If coke has negatively impacted your libido

  • In this case, we recommend slowly coming off the drug. Psychosexual therapy could also support you here
  • This will help you to get your body back to normal, happy levels of hormones, and help you resensitize to sexual stimuli (basically get you feeling hornier again)

If you have a priapism

  • This one will involve an urgent trip to the hospital — you may need to have a needle inserted into your penis to drain off some of the blood and, in some cases, you'll need medications injected to help your penis come back down
  • This one makes us shudder, and we’re not sure a fun coke-filled night is worth the risk

And lastly, you should always avoid reaching for ED pills for physical coke dick problems 

Solutions for psychological coke dick problems

If you’re feeling dependent on cocaine to have sex

If sexual desire is an issue, it might be a good idea to find other ways to feel hornier, instead of relying on cocaine. This could include:

  • Practice mindful masturbation (enjoying masturbation with being focused on the here-and-now pleasure of solo sex). You can find mindful masturbation exercises here
  • Learn how to enjoy pleasure in general. For example, slow down when eating your favorite food, and enjoy every single mouthful (it sounds strange but it does help with being more pleasure-focused)
  • Explore your own erotic mind (find your best turn-ons and how can you incorporate them into your sex life)
  • Pay attention to when your optimal time for sexual desire is, and then allocate the right time for sexual desire. For example, for some men, it’s in the morning, and it can be harder to feel sexual desire after a big meal because your body is busy digesting
  • If confidence is an issue, Mojo’s online courses can help you regain confidence in the bedroom, without relying on cocaine

If you’ve developed anxious feelings about coke-free sex

  • Mojo’s digital platform is also there to help men tackle their sexual anxieties. We have a dedicated ‘Performance Anxiety’ course, as well as other useful exercises and meditations to help you reduce feelings of performance anxiety 
  • See a psychosexual therapist, who can help you address your anxiety of unreliable erections with talking therapy and specific sex therapy methods

If you think that general stress, anxiety, or depression is impacting your erections

"Overall, we’re here to reassure you that if you manage your drug use and look after your psychological wellbeing, the problems are usually temporary, and Mojo has plenty of tools and techniques to help you to get your unreliable erections back on track."

Silva Neves, Psychosexual & Relationship Therapist

Solutions for both physical and psychological coke dick problems 

Whether you’re experiencing a physical or psychological problem, if you’ve taken cocaine and you’re not getting hard, there’s a couple of key ways you can still enjoy sex with your partner.  

Don’t focus on penetration 

  • Having fun in the bedroom doesn’t mean you have to focus on your erection or penetrative sex
  • Extended foreplay, sensate and sensual massages, oral sex, kissing, using sex toys, and fantasy play are all ways to take pressure of the penis

Communicate with your partner

  • Talking to your partner can sound daunting, but is one of the best ways to reduce worries and anxious feelings, which will help you to get better erections
  • Once your partner understands what is going on downstairs, you can also focus on other types of intimacy that don’t have to involve a boner
“The important part will be chatting with your partner about what is going on and what might be helpful while you are struggling with your erections.” 

Amanda Barge, Psychosexual & Relationship Therapist

Cocaine and Viagra 

Viagra is one of the four main PDE5 inhibitors (ED pills) which include Sildenafil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra), and Avanafil (Stendra).

These drugs can be used to give you a one off erection, if you are experiencing physical ED. 

It may be tempting to take cocaine and ED pills at the same time if you’re looking for the desired effects of coke, combined with an erection hard enough for sex. 

However, mixing coke with ED pills could cause:

  • A stroke
  • A higher risk of priapism
  • The body to have too much serotonin (cocaine raises serotonin levels, and ED pills can raise them even higher). This can cause hallucinations
  • A risk of dependency with both drugs. Cocaine can be highly addictive and there’s a risk of becoming psychologically dependent on erection medications as well

How to avoid coke dick 

We have some good news and some bad news.

The bad news is that the best way to avoid coke dick is to avoid using cocaine altogether. Coke affects different men in different ways, but as a general rule, the less cocaine you take, the less likely you’ll find yourself experiencing coke dick. 

The good news is that Mojo is here to help you enjoy better erections, more sexual confidence, and overall more satisfying sex — without ever having to touch the party powder. 

Where to go from here

Sign up to Mojo’s trial to help you get your erections back on track, and to discover mind-blowing sex without relying on cocaine.  

You can also visit Mojo’s anonymous online Community Forum, where you can chat to other guys about their own coke dick experiences and how they overcame them.

Mojo aims to provide useful wellbeing resources to its users; however, you should not solely rely on opinions or advice available on the Website or given by the Community. Always seek advice from a qualified medical doctor or other healthcare professional before acting.

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