Ketamine abuse also affects sexual health
Eeke C M Leerssen, W. V. D. van der Sanden, V. D. de Kemp, Robert A. Schipper, Michel I. A. Wyndaele, L. D. Kort
Sexual Medicine July 22, 2026 DOI: 10.1093/sexmed/qfag049 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional study Peer reviewed |
|---|---|
| Sample size | 123 |
| Population | Men with ketamine-induced uropathy, mean age 28 years (range 18-50) |
| Measures | International Index of Erectile Function (IIEF-5 and/or IIEF-15), International Consultation on Incontinence Questionnaire LUTS Quality of Life module (ICIQ-LUTSqol) |
| Topics | Esketamine Ketamine |
| Key findings | Among men with ketamine-induced uropathy, fewer than half were sexually active in the prior four weeks, and most of those who were reported sexual health problems: 63% had erectile dysfunction on the IIEF-5 and 51% on the IIEF-15, 39% reported reduced or absent ejaculation volume, and 52% reported pain during ejaculation. The authors contend that awareness of ketamine's sexual health effects is needed alongside its bladder effects. |
Abstract
Abstract Introduction Recreational ketamine use is rapidly increasing, and ketamine-induced uropathy (KIU) is gaining recognition for its severe impact on quality of life (QoL), including pain, hematuria, lower urinary tract symptoms (LUTS), and potential negative effects on sexual function. This study investigates the prevalence of sexual dysfunction among men with KIU.
Methods: Male patients with KIU completed the International Index of Erectile Function (IIEF-5 and/or IIEF-15). Erectile dysfunction (ED) was defined as a score of ≤21 on IIEF-5 or ≤ 25 on domain A of IIEF-15. Patients who had not been sexually active in the previous four weeks (a score of 0 on IIEF-5 or within any domain of IIEF-15) were excluded. The impact of LUTS on sexual life and its perceived severity were assessed using items 10a and 10b of the International Consultation on Incontinence Questionnaire LUTS Quality of Life module (ICIQ-LUTSqol). A score > 5 on item 10b was considered indicative of a (major) problem.
Results: A total of 123 men with KIU, mean age 28 years (range: 18-50 years), completed the questionnaire(s): 81 (66%) completed IIEF-5, and 88 (72%) IIEF-15. Only 42% (N = 37) had been sexually active in the preceding four weeks. Mean IIEF-5 score in these patients was 18 (SD 5.7), with 63% meeting the criteria for ED. Mean IIEF-15 domain A score was 50 (SD 16.3), with 51% classified as having ED. Beyond ED, 39% reported reduced or absent ejaculation volume, and 52% reported mild to severe pain during ejaculation. Overall, 58-75% reported that LUTS had at least some negative impact on their sexual life, and 64% perceived this impact as a (major) problem.
Discussion: Less than half of men with KIU were sexually active in the past four weeks, with the majority reporting sexual health issues, including frequent erectile dysfunction and ejaculatory dysfunction, which were often perceived as significant problems. Awareness is needed among current and potential recreational ketamine users, as well as their healthcare providers, regarding the detrimental effects of ketamine not only on bladder function but also on sexual health.
Comparable studies
Other cross-sectional and survey studies on ketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| 5-Year Trends in Use of Hallucinogens and Other Adjunct Drugs among UK Dance Drug Users People who use drugs in dance contexts | 2006 | Repeated-measures cross-sectional survey | |
| Preliminary analysis of positive and negative syndrome scale in ketamine-associated psychosis in comparison with schizophrenia Healthy subjects, ketamine abusers, and schizophrenia patients | 2014 | Cross-sectional study | n = 998 |
| Ketamine as a primary predictor of out-of-body experiences associated with multiple substance use Online survey respondents | 2011 | Cross-sectional survey | n = 192 |
| Self-reported prevalence of dependence of MDMA compared to cocaine, mephedrone and ketamine among a sample of recreational poly-drug users Global non-treatment-seeking sample of last year users of MDMA, cocaine, mephedrone,... | 2014 | Cross-sectional survey | |
| Near-Death States Reported in a Sample of 50 Misusers Previous ketamine misusers who reported a ketamine-related near-death experience | 2010 | Cross-sectional survey | n = 50 |