Welcome to Ask a Cleveland Sex Therapist. Want to ask Matt a question that could be tackled in a future column? Click here. Now, onto this week’s topic.
Hey Matt,
My boyfriend and I recently went to a rave and took some MDMA ahead of time. I thought it would make me want to have sex more but it did the opposite. It this common?
-Shelly
Hey Shelly! Thanks for the question. Ya know, I have never partaken in MDMA and feel like I may have missed the boat. At 38, I just think my heart would explode. But enough about my relationship with ecstasy, let’s talk more about the reality of taking MDMA and how movies and television only got it half right. First, let’s talk about what MDMA actually is because I think understanding what a substance is doing in your body can help make sense of why an experience went sideways. MDMA, sometimes called ecstasy or molly, is a psychoactive drug that affects several neurotransmitter systems in the brain, particularly serotonin, while also affecting dopamine and norepinephrine. People often associate it with feelings of euphoria, emotional openness, increased energy, empathy, connection, and heightened sensory experiences. Basically, MDMA can turn the volume up to one hundred a lot of experiences, which is probably part of the reason it has become associated with sex, intimacy, clubs, festivals, and other experiences where people are seeking escape or pleasure.
There can absolutely be positive experiences with MDMA. This is where movies and tv shows come in, typically displaying the euphoric impact of the drug. Some people describe feeling unusually connected to their partner, less inhibited, more affectionate, and more comfortable talking about emotions. Touch can feel incredible. Music can feel incredible. Being close to another person can feel incredibly intense. Interestingly, MDMA has also been studied in clinical settings, particularly in combination with psychotherapy for PTSD, because of some of these effects on fear, emotional processing, and interpersonal connection. That research is very different from recreationally taking MDMA before sex, but it helps explain why people sometimes describe the drug as creating this profound sense of openness and connection.
But here is the part that sometimes gets lost when we talk about MDMA and sex: heightened sensation does not automatically equal better sex. MDMA has been shown to cause anxiety, nausea, sweating, jaw clenching, increased heart rate and blood pressure, overheating, dehydration, dizziness, difficulty concentrating, and changes in sexual functioning. Some penis owners may have difficulty getting or maintaining an erection or reaching orgasm. Other people may feel incredibly mentally turned on while discovering that their genitals are not exactly cooperating. You can feel horny as hell and still have a body that is shutting down when you want it to turn on. As you can probably see, the down side doesn’t get talked about as much as the fun stuff.
Something we need to remember about drugs are that they do not necessarily manufacture an entirely new emotional state from scratch. Your mindset, expectations, environment, the people around you, how safe you feel, how much you took, what else you consumed, and what was actually in the substance can all influence the experience. If you were already nervous about sex, uncomfortable with the situation, overwhelmed by sensation, worried about your performance, or simply not feeling completely safe, MDMA does not guarantee those feelings disappear. Sometimes an altered state can actually make certain sensations or emotions feel much bigger. One of the realities of recreational MDMA is that something sold as “molly” is not necessarily pure MDMA. Even if you have experience taking it and have taken what you believe was the same amount before, sleep, hydration, food, medications, other drugs, your physical health, and your mental state can contribute to a completely different experience.
Now, let’s talk about sex. One of the impacts I want to highlight is that MDMA can alter judgment and your ability to recognize or communicate what you want in the moment. That deserves particular attention when we’re talking about consent. Feeling emotionally close to somebody while intoxicated does not automatically mean you actually want every sexual activity that is happening. If something started feeling just simply wrong, your nervous system may have responded accordingly. Sometimes the best thing you can do during a sexual experience is what Regina told Gretchen to do in Mean Girls and stop trying to make “fetch” happen, in this case, “fetch” meaning sex.
So, Shelly, if you had a negative experience, I would be curious about what “negative” actually means for you. Did you become anxious? Did you feel physically sick? Were you unable to get aroused or orgasm? Did sex suddenly feel overwhelming? Did you feel emotionally uncomfortable with your partner? Did something happen that you didn’t actually want? Those are very different experiences, and understanding exactly what happened can give you much more information than simply concluding, “MDMA and sex don’t work for me.”
If you choose to use MDMA again, remember that educating yourself more about the drug has a huge impact. Knowing as much as possible about what you are taking, avoiding risky drug combinations, paying attention to overheating and hydration, and having clear conversations about sex and boundaries while everyone is sober can reduce some risks, although recreational MDMA use can never be made completely risk free. If you take prescription medications, particularly medications that affect serotonin or other neurotransmitters, talking with a medical professional about potential interactions is important.
Most importantly, one bad sexual experience while using MDMA does not necessarily tell you anything profound about your sexuality. Sometimes our brains and bodies respond unpredictably to psychoactive substances. Instead of asking, “What is wrong with me that I didn’t enjoy this?” I would explore what your body was communicating. What specifically felt bad? When did the experience shift? What did you need in that moment that you weren’t getting? There may be much more useful information in those questions than in trying to force yourself to have the experience you thought you were supposed to have. I wish I could tell you that what you see in entertainment is one hundred percent the truth but as well know, that just isn’t the case, especially with MDMA.
Matt Lachman is a Licensed Professional Clinical Counselor and Supervisor, AASECT Certified Sex Therapist, and owner of Cleveland Sex Therapy, located in the heart of Gordon Square. Since opening Cleveland Sex Therapy in 2019, Matt has been dedicated to promoting sex positivity and inclusivity in his work with individuals, couples, and polyamorous relationships. When he’s not helping clients navigate their sexual and relational journeys, you can find him enjoying a cold brew at Gypsy Beans, sipping a cocktail at Luxe, or relaxing on his couch watching reruns of Happy Endings. Ask a question of your own here.
Disclaimer: The advice provided in this column is intended for general informational purposes only and should not be considered a substitute for professional therapy or mental health treatment. Each individual’s situation is unique, and the insights offered here may not address the complexities of your specific circumstances. If you’re experiencing challenges related to your mental health, relationships, or sexuality, I strongly encourage you to reach out to a licensed therapist or mental health professional for personalized support. You’re not alone—help is available.
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