Sex and Ecstasy


For many people, taking illegal drugs is a method of escaping reality; of seeing, feeling, and thinking differently; and of exploring the world they know from an altered perspective.  The prospect of such an experience is especially enticing to young people, and substance use is often closely associated with clubs, concerts, parties, and other venues frequented by adolescents and young adults.  Ecstasy in particular tends to provide the experience they seek, and in its years of existence it has become one of the most popular and widely used illegal substances in the world.8 This article explains the experience of ecstasy as it relates to the sexual experience.

Branded a “club drug” for its frequent use in party-like settings, ecstasy has the ability to enhance one’s bodily sensations while they are under the influence.  Users may experience spikes in energy levels, increased mood and happiness, and the desire to be social and interact closely with the people around them.  It is in this respect that sex becomes a notable element of ecstasy use.  Given its ability to enhance the senses, ecstasy can alter the sexual experience.  Some people who have used ecstasy remark on its ability to increase feelings of sensuality and closeness with one’s partner during sex.  While these sensations can be enjoyable in the moment, sex under the influence of ecstasy (as well as any mild-altering substance) can present inconvenient or dangerous consequences after its pleasant effects have worn off.  The following sections present a detailed view of ecstasy through multiple lenses, expanding upon its chemical and social effects, as well as what can be expected when one chooses to mix the experience of using the drug and having sex.

What is Ecstasy?

MDMA (or 3, 4-methylenedioxymethamphetamine) is an illegal psychoactive and hallucinogenic drug more commonly known as “ecstasy”, “Molly,” “X,” or “E.”12 It is most often taken orally in pill form, yet intravenous administration has been reported in some cases.  There are modern scientific studies conducted on the clinical use of MDMA by

psychotherapists, who administer small doses to patients in order to encourage empathy, openness, and divulging of repressed emotional trauma in those suffering from anxiety or PTSD.  However, the drug is most often recognized for its recreational use as a “club drug,” as young adults on the lively scenes of raves and dance clubs appear to be its most frequent users.3

Ecstasy belongs to a group of psychoactive drugs known as entactogens, whose effects on serotonin levels cause an increase in prosocial behavior and interpersonal interaction.1 Specifically, ecstasy increases the activity of neurotransmitters like serotonin, dopamine, and norepinephrine in the user’s brain, causing the drug’s characteristic increases in mood.2

Serotonin (5-HT) regulates impulsivity and executive functions such as decision-making, and is the primary target of ecstasy in the brain.10 In fact, studies show that MDMA users possess significantly elevated impulsivity levels during use.8  Serotonin’s relationship to mood and sleep is also influenced by ecstasy, as increased levels cause spikes in mood and energy levels for the duration of the high.  The neurotransmitter dopamine affects a person’s mood and motivation.  When under the influence of ecstasy, increased levels of dopamine cause the user to feel happier and more active than usual.  Norepinephrine is related to alertness and stimulation, and is strongly affected by MDMA.  Increased levels of this neurotransmitter have both excitatory and mood dampening effects.  As a result, users are much more awake and aware while high.13 Qualities such as these are what attract so many young people who wish to gain increased satisfaction with their experiences at clubs and parties.

Risks Associated with Ecstasy

Although a sought-after form of psychological freedom, ecstasy is still an illegal substance that can be dangerous and even fatal.  Studies reveal that ecstasy dramatically harms nerves containing serotonin, and customary human dosages have the potential to irreversibly damage the system.  Heavy and extended use of the drug has been shown to cause depression, confusion, and memory impairment.2 In addition to its long-term detriments, ecstasy can cause the user to experience short-term – and in some cases life threatening – side effects. For example, the increase in mood and excitement associated with an ecstasy high can lead to increased dancing or physical activity, prolonged dehydration, and overall exhaustion.1 Further, laboratory studies on experiences during MDMA use have observed bodily reactions of increased heart rate and blood pressure, rapid breathing, thirst, jaw-clenching, increased internal body temperature (hyperthermia), organ failure, and death.2 Due to serotonin depletion, it is common for users to experience a post-ecstasy feeling of depression several days after coming down.

Ecstasy has also been found to have slightly distinctive effects on men and women respectively.  Statistics show that, overall, there are more ecstasy-related male deaths than female deaths.  This is due to the fact that men tend to consume larger amounts of ecstasy (in addition to other drugs) than do women, which contributes to the higher average.  Women who take ecstasy are more likely to experience hyponatremia, which is marked by low blood sodium levels caused by excess water intake.  Two common side effects of ecstasy are hyperthermia (increased body temperature) and increased thirst, which may influence susceptibility to hyponatremia.  Women also report that the effects of ecstasy last for longer periods of time than men have expressed.9

There are crucial differences between controlled (clinically administered) and recreational use of MDMA.  When used as a “club drug,” ecstasy can potentially be mixed with other dangerous types of psychoactive substances, causing experiences to vary greatly from those described by laboratory scientists.1 Pills may be ingested in combination with alcohol or other drugs, or may have been combined with separate substances prior to purchase by the user.  As ecstasy is an illegal and unregulated psychoactive substance, its use outside of controlled laboratory settings is not recommended.  Its side effects are shown to cause numerous health complications, and in some cases, prove fatal to the user.

Why Do People Take Ecstasy? 

Ecstasy users report experiencing an altered state of consciousness that changes the way they think and feel while under the influence. Most describe ecstasy as a social drug that is taken with friends for an evening out at a club, party, or rave. It is not uncommon for club- and rave-goers to use it for the stimulating effect that helps to maintain their energy levels while dancing for extended periods of time.  Users often describe a general enhancement of their senses while on ecstasy, which allows them to get caught up in an environment that often includes music, lights and large crowds of people dancing – all of which are described as being intensified when high.

In addition, the drug tends to increase the user’s feelings of sociability and closeness with others.4 People especially enjoy being touched when using ecstasy, as the tactile experience is magnified.  Experiments have also discovered that participants experience altered facial expression recognition while under the influence.  They are slow to perceive angry expressions, yet respond far more quickly to happy ones, once again revealing the overall social nature of the drug.1 Ecstasy’s trademarked prosocial effects can even influence the user’s speech, affecting how they discuss certain topics.  In a study conducted on the influence of MDMA on discussion of significant others, researchers discovered a connection between administration of the drug and the emotional nature of conversation.  Participants under the influence of ecstasy spoke of those close to them in a deep, positive and empathetic way.  These subjects also exhibited increased use of social and sexual terms, which reinforces the uninhibited nature of ecstasy users.12 Evidence repeatedly points to the fact that ecstasy fuels an increased desire for social interaction, which continues to attract young users in the most social situations.1, 5, 12 

Combining Sex and Ecstasy

Research suggests that ecstasy is inconsistent in its effects on sexual desire, as it can either inhibit the sexual response cycle or be “prosexual” in certain situations.11 Ecstasy is often described as a bonding drug, sometimes leading to affectionate physical contact such as touching, hugging or cuddling.  Most users do not express a desire for penetrative sex or initiating sex at all while high, but simply experience increased feelings of sensuality.  It is known to increase arousal, yet this is largely sympathetic, as its effects are more closely associated with emotional connection and close, affectionate touching than erotic interaction.  In a study conducted on the effects of psychoactive substances on sexual arousal and response, MDMA did not seem to affect subjects’ responses to erotic images.  It did, however, reveal slight increases in response to implicit sexual images (those with implied, rather than explicit, erotic content).4

While most heterosexual users feel no increased desire to engage in penetrative sex, some gay and bisexual women have reported using MDMA specifically to enhance their sexual experience. Users report emphasis on feelings of well-being, interpersonal closeness, and sensuality that is not necessarily accompanied by sexuality.4 This reinforces the concept of interactional experience that many users speak of: although they may not feel an amplified need for sex itself, they may desire the affection and intimacy that often accompanies sexual encounters.  One study interviewed subjects who described what sex was like on ecstasy: “Sex with ecstasy, it’s kind of like well…it’s kind of like having sex when you’re drunk. You just feel more relaxed. You feel everything’s a little more sensitive. Just like the touch or the kiss. It seems like it’s more passionate. It kind of seems like you’re in a sleazy romance novel.”9

While its effects do provide more intimate social and interactive experiences, use of ecstasy may increase one’s chances of engaging in high-risk sexual activity.  Many people feel regret after having sex while using the drug.

With the potential to decrease inhibition, ecstasy increases the likelihood of engaging in unprotected sex with casual partners, thus increasing the risk of unwanted pregnancies and/or contracting STIs, or sexually transmitted infections.11 A study of ecstasy use and STI prevalence in juvenile detainees revealed a correlation between the drug, the risky sexual behaviors that accompany its use, and the consequences thereof.  Some boys and girls who used the drug prior to incarceration reported symptoms of STIs, with boys experiencing penile drips or discharge, girls noting vaginal discharge, odors, or deep pelvic or vaginal pain during sex, and both describing sore bumps on or around their genitals.  Ecstasy use is especially common among young people, and can be attributed to a younger age of consensual penetrative sex.  Therefore, adolescents who partake in MDMA use are increasingly susceptible to STIs, such as HIV/AIDS, because they are more likely to engage in unsafe sexual practices.5

Chronic abuse of ecstasy has been shown to deteriorate stages of the sexual response cycle.  Serotonin (which is specifically affected by ecstasy) has two different effects on sexual function. One type of serotonin receptor provides a stimulating effect on sexual operations.  The other has an inhibitory sexual effect for males, which can lead to an inhibition of overall sexual function.  Given ecstasy’s ability to drastically increase serotonin production, prolonged use can lead to these inhibitory effects.  Research indicates that ecstasy use is linked to ejaculation latency and a significant increase in the post-ejaculatory gap. A study of male rats reveals that ecstasy disrupts sexual response and also impairs sexual reward mechanisms.11 Studies also show that poly-drug use, or the mixing/intake of multiple types of drugs simultaneously, can increase the likelihood of risky sexual practices.  Several studies reveal greater prevalence of unprotected sex, unwanted pregnancies, and contraction of STIs among subjects who report having used multiple drugs.5


“Sextasy” is the name used to refer to the combination of ecstasy and Viagra, the anti-impotency drug that works by increasing the temporal length of an erection. Sextasy is known for its stimulating effect (ecstasy) and its ability to enhance sexual ability (Viagra).  By combining the two, users attempt to achieve a greater euphoric experience than can be felt by using just one or the other.  The sextasy trend is most common among both heterosexual and homosexual young adult men who frequent clubs, yet has not been observed in younger adolescents.  The dangers of using sextasy have become more notable due to the occurrence of heart problems caused by increased blood flow.  Since both ecstasy and Viagra serve to dilate the blood vessels, a rapid increase in flow puts a person at a much greater risk for heart attack and stroke.14 Sextasy can also increase one’s chances of contracting sexually transmitted diseases.  Ecstasy’s dis-inhibitory effects combined with Viagra’s enhanced erectile functions can lead to more cases of unprotected sex among users.15 Another risk of combining ecstasy and Viagra is priapism – a potentially painful medical condition in which the erect penis or clitoris does not return to its flaccid state within four hours, despite the absence of both physical and psychological stimulation. While combining ecstasy and Viagra can produce intensely euphoric effects, the consequences of taking them together can be quite harmful.

Ecstasy and Pregnancy

Although there is a limited field of research surrounding the effects of MDMA on pregnancy and infants, studies do show that the drug can influence fetuses both inside and outside of the womb. Women who use amphetamines during pregnancy are more likely to experience pre-eclampsia – a condition in which an expectant mother will have high blood pressure and an increased amount of protein in the urine – and premature deliveries.7 Birth defects can often be observed prior to birth, while other developmental difficulties may reveal themselves as a baby grows.  Findings of a study conducted with UK mothers who had used the drug during their pregnancy indicated that, of 78 live born infants, 12 displayed congenital defects (2 with cardiovascular and 3 with musculoskeletal anomalies).  Further, decreased motor abilities have been reported in infants affected by a mother’s prenatal MDMA use, as well as developmental difficulties and milestone delays within the first year of life.  This can be attributed to the development of smaller brain structures associated with amphetamine use during pregnancy.  While not all birth defects mentioned are directly linked with ecstasy, they are often caused by its use in combination with other types of drugs and alcohol.6

Concluding Remarks  

Ecstasy is a common illegal club drug often used by young people to enhance the experience of concerts, raves, and parties.  It activates increased production of the neurotransmitter serotonin, causing the user to feel enhanced sensory stimulation, higher energy, and desire for closeness and interpersonal interaction.  While it may not directly increase one’s desire for sex, it can make a person feel more sensual and passionate toward their partner.  Sex under the influence of ecstasy can be risky, as lowered inhibitions may lead to unprotected sex and resulting complications, such as unwanted pregnancies and STIs.  As a member of the amphetamine drug family, ecstasy does have the potential to affect a fetus if used while pregnant, and long-term use can result in depression, cognitive and memory impairment, and decreased sexual response.


1. Garcia-Romeau, Albert et al.  “Clinical applications of hallucinogens: A review.”  Experimental and Clinical Pharmacology, Nov. 2016.  Accessed 16 Jan. 2017.

2. NIDA.  “MDMA (Ecstasy) Abuse.”  National Institute on Drug Abuse, Mar. 2006.  Accessed 19 Jan. 2017.

3. Matthews, Allison et al.  “Sex and Drugs: Sexual Risk Behavior among Regular Psychostimulant Consumers in Australia.”  National Drug and Alcohol research Centre, Dec. 2015. Accessed 19 Jan. 2017.

4. Schmid, Yasmin et al.  “Effects of methylphenidate and MDMA on appraisal of erotic stimuli and intimate relationships.”  European Neuropsychopharmacology, Jan. 2015. Accessed 19 Jan. 2017.

5. Stephens, Torrance et al.  “Self-reported ecstasy (MDMA) use and past occurrence of sexually transmitted infections (STIs) in a cohort juvenile detainees in the USA.”  Journal of Community Health: The Publication for Health Promotion and Disease Prevention, 27 Aug. 2014. Accessed 16 Jan. 2017.

6. Viteri, Oscar A. et al.  “Fetal Anomalies and Long-Term Effects Associated with Substance Abuse in Pregnancy: A Literature Review.”  Thieme Medical Publishers, 8 Dec. 2014. Accessed 21 Jan. 2017.

7. McDonnell-Dowling, Kate et al.  “Sources of variation in the design of preclinical studies assessing the effects of amphetamine-type stimulants in pregnancy and lactation.”  Behavioral Brain Research, 15 Feb. 2015.  Accessed  21 Jan. 2017.

8. Quednow, Boris B. et al.  “Elevated impulsivity and impaired decision-making cognition in heavy users of MDMA (“Ecstasy”).”  Psychopharmacology, Jan. 2007. Accessed 6 Feb. 2017.

9. Alott, Kelly et al.  “Are there sex differences associated with the effects of ecstasy/3,4-methylenedioxymethamphetamine (MDMA)?”  Neuroscience & Biobehavioral Reviews, 2006.  Accessed 6 Feb. 2017.

10. Kubicek, Katrina, PhDc, et al.  “Making Informed Decisions: How Attitudes and Perceptions Affect the use of Crystal, Cocaine and Ecstasy among Young Men who Have Sex with Men.”  US National Library of Medicine National Institutes of Health, 9 Oct. 2009.  Accessed 6 Feb. 2017.

11. Pfaus, James G. et al.  “Inhibitory and disinhibitory effects of psychomotor stimulants on the sexual behavior of male and female rats.”  Hormones and Behavior, Jun. 20. Accessed 6 Feb. 2017.

12. Baggott, Matthew J. et al.  “Intimate Insight: MDMA changes how people talk about significant others.”  Journal of Psychopharmacology, 28 Apr. 2015. Accessed 23 Jan. 2017.

13. “What are Neurotransmitters?”  Neurogistics Corporation.  Accessed 6 Feb. 2017.

14. Edgley, Ross.  “The Rise of Viagra abuse: Doctors warn against worrying ‘sextasy’ trend – where ecstasy is mixed with drug to enhance euphoria.”  The Daily Mail, 6 Mar. 2014.  Accessed 6 Feb. 2017.

15. ABC News.  “Ecstasy-Viagra Combo Grows Popular in Clubs.”  ABC News.  27 Sept.  Accessed 6 Feb. 2017

Last Updated: 2 March 2017.