MDMA and Sexual Behavior: Ecstasy Users' Perceptions About Sexuality and Sexual Risk

Introduction

Recreational use of 3,4-methylenedioxymethamphetamine (MDMA, commonly called Ecstasy) expanded in the 1970s–1980s, and prior studies have reported mixed effects of the drug on sexuality. Some earlier work described increased sexual arousal and reports that MDMA functions as a sexual enhancer, while other studies—often involving frequent users or polydrug users—found diminished sexual interest or impaired sexual performance. Much of the existing literature is cross-sectional and conflated with use of other substances, making it difficult to establish whether sexual behaviours occurred specifically during MDMA episodes or reflected broader lifestyle patterns characterised by risk taking. Mcelrath set out to address these gaps using qualitative methods. The study aimed to (1) describe Ecstasy users' perceptions of the drug's effects on sensuality, sexuality, and sexual performance, and (2) examine sexual risk taking during episodes of MDMA use. Data were collected through in-depth interviews with current and former users in Northern Ireland to capture subjective accounts of drug effects and related sexual behaviours.