What is it Like to Have Sex on MDMA?

Sex on MDMA is great for women, but not so great for (most) men.

By Sam Eskenazi Last Updated: December 12, 2023
Last Updated: December 12, 2023

Drugs of all kinds are frequently associated with sex, but none are more closely linked with sexual activity than MDMA (ecstasy).

Famous for its stimulatory and pleasurable high, MDMA is a well-known party drug and is frequently taken to enhance one’s ability to connect with others and supercharge our sensory experience.

MDMA’s ability to dissolve barriers and enable people to connect with each other deeply and wholly is one of the primary reasons it’s being used in couples therapy today. 

But what is sex on MDMA really like? Is it safe? Can it affect our ability to enjoy sex while sober?

Summary: Sex On MDMA

  • Sex on MDMA feels more intense and pleasurable, with increased tactile sensations.
  • Some people combine MDMA and LSD, known as “candy flipping,” to enhance their effects even further.
  • MDMA can cause a loss of erections and even a loss of sexual desire in some people, so take caution.
  • Some studies suggest MDMA may help women suffering from HSDD (libido loss). 
  • MDMA can cause body temperature and heart rate to increase — combined with the added exertion of sex; this can be dangerous for people with heart disease.

What Is Sex On MDMA Like?

There are few psychedelics with a reputation for improving sexual experiences as MDMA. 

This impressive reputation comes down to four core aspects of the drug:  

  1. It’s a stimulant — providing a boost of physical energy lasting 3 or 4 hours. 
  2. It’s empathogenic — helping to establish a deep sexual connection between individuals. 
  3. It’s a psychedelic — with a particularly strong affinity for enhancing the senses. 
  4. It’s euphoric — dissolving feelings of stress or anxiety that prevent one from truly letting go and enjoying the moment. 

Studies and surveys have shown that MDMA is used to heighten sexual effects, both sexual performance and the length of sex, as well as to increase sensitivity. Users report that MDMA makes them feel like their skin has an almost “electric” feel to it [1].  

People use MDMA to make sex last longer, boost confidence, enhance stimulation and pleasurability, break down barriers, and set aside their daily stresses and exist in the present moment. All of this has a profoundly positive impact on sexual experiences overall.

Related: The Impact of Psychedelic Shrooms on Sex.

What Does Sex On MDMA Do to Your Body?

MDMA binds to the 5-HT serotonin receptors — activating them to induce a cascade of other neurological effects. It has a particular attachment to the 5-HT2A serotonin receptor, which is the same main target of LSD and psilocybin. Through stimulation of this receptor, users experience mild psychedelic hallucinations and sensations typically associated with taking higher doses of MDMA [3].

The drug also activates norepinephrine, commonly known as adrenaline; this is responsible for that burst of energy and the feeling that you can go all night when on MDMA [2].

Where the real magic happens is MDMA’s effects on oxytocin [14] — this is the chemical that makes us feel pleasure, solidifies emotional bonds, and is critically involved in one’s ability to experience an orgasm [15].

Are There Any Negatives To Having Sex On MDMA?

Sex on MDMA isn’t just an entirely positive thing, unfortunately. Just like with most things, there are a few potential negative implications MDMA can have on sexual experiences.

For one thing, male users of MDMA sometimes report that MDMA results in difficulty of being able to sustain an erection. This obviously gets in the way of sex [4]. This is even more likely with pills that don’t contain pure MDMA. People who took low-quality, adulterated pills or mixed MDMA with alcohol commonly report issues with getting or maintaining an erection.

Interestingly, some studies have found that this inability to achieve an erection during sex on MDMA only affects those 25 years old and younger. For older users, it happens extremely rarely [5].

Long-Term Complications Of Taking MDMA

Studies have shown that overuse of MDMA has a correlation to an overall decreased binding ratio in serotonin receptors. This essentially means that extreme MDMA use can cause neurotoxic effects on serotonin receptors, potentially reducing long-term feelings of pleasure and upsetting mental health [6].

One study showed that MDMA has the potential to induce anxiety disorder, even after only taking one dose [7]. However, this study also reported this induced anxiety faded within 2.5 months after taking the singular dose.

MDMA has a particular affinity for binding to the 5HT2B receptors, which are abundant in the brain and heart. Some experts hypothesize that taking MDMA too often could lead to valve disorders in the heart because of this effect. In 2012 a study reported that 8 of 29 patients who frequently used ecstasy had heart valve defects [16]. 

MDMA & LSD (Candy Flipping) & Sex

Candy flipping is the practice of combining MDMA with LSD.

As LSD has a much longer-lasting effect and takes hold quicker, users will often take LSD first, wait for it to kick in, and then a few hours later, take MDMA.

Studies have shown that LSD and MDMA combine together to create an even stronger MDMA-like effect, with increased release of serotonin and a stronger binding to the 5HT2A receptor [8]. Naturally, this further enhances the impact of MDMA on sexual satisfaction and performance. 

MDMA & Interactions With Other Drugs

Because of some issues with maintaining erections on MDMA, many people choose to mix MDMA and prescription erectile dysfunction medications such as Viagra (sildenafil) or Cialis (tadalafil). 

This combination can be dangerous because of the effect each medication has on the heart and circulatory system. 

MDMA is a stimulant and vasoconstrictor — causing blood vessels to tighten and heart rate to increase. This causes a spike in blood pressure. ED medications have the opposite effect, causing blood vessels to relax and allowing blood pressure to drop. 

While it sounds like these effects would cancel each other out, it’s not quite that simple. ED meds are highly specific to particular regions of the body — such as the base of the penis, the ears, and the eyes. MDMA has effects on all blood vessels, which could lead to arrhythmias, stroke, or other forms of vascular damage. 

The most concerning risk of mixing ED medications and MDMA is a side effect called priapism — which involves a painful, long-lasting erection. If the erection persists for too long, it can lead to serious side effects and loss of sensation in the penis.

Should You Take MDMA To Enhance Sex?

Sex on MDMA is often described as “electrifying” and “transcendental.” It’s known to enhance the connection between people, stimulate energy levels, and increase sensitivity during sex. Many people use it to help them achieve more intense orgasms, last longer, and breakthrough social barriers between two lovers. 

MDMA does, however, come with a certain set of risks, including the limited potential for long-term consequences, as well as the irritating possibility of causing temporary erectile dysfunction.


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