Sex on MDMA

What is sex on MDMA like?

I plan on using MDMA to engage in a sexual encounter with a very close friend. We’ll be using it together.Is sex on MDMA a good idea? What dangers should i look out for? what can I do to limit risks, or make the experience the best it can be??

Originally posted in SR 2.0 16/4/14. Reviewed 9/2/23

Opinions about sex on MDMA vary widely. It is often a matter of personal preference. But, certainly, is one of the «classical» combination for sex and drugs.  Generally, people tend to prefer engaging in sexual activity 3-4 hours after taking MDMA. At this point, the intense mental effects are beginning to subside, but the sensations of enhanced tactile stimulation and general well-being persist.

A Rollercoaster Ride for men

One potential issue for men is that MDMA can make it more difficult to achieve and maintain an erection. However, this effect diminishes after three to four hours for most people. Some people counteract this effect using anti-impotence drugs. This is an option in healthy persons and using reasonable dosages.

Another common experience for men using MDMA during sex is retarded ejaculation. This can be either an advantage or disadvantage depending on the person and the situation. Although many individuals prefer engaging in sexual activity after taking MDMA, some prefer it during the peak experience.

Is not just a question of erection, on MDMA you can explore thousands ways of creative and enhanced sexuality

MDMA: Sex enhancer or love potion?

Disinhibition can have positive aspects (especially if people know each other beforehand and are familiar with the experience). It may be easier to explore fantasies or propose activities that we repress in the usual state of consciousness.
If we are talking about sex with strangers, or people who have not previously experimented with MDMA, things may be different. It is important to maintain the measures to protect one’s own health  (contraceptives, PREP, condoms…). And be aware about self’s modified state of consciousness and impact on decisions.

Add a bit of paraphernalia to sex

To optimize the experience, it is best to look for an intimate space free of distractions and to adopt a good set and setting. Showers, bubble bath, massage, porn, erotic talk, fantasies, black light and UV paint, glow sticks, candy….Possibilities are unlimited.

This can involve being free of worries and leaving room for improvisation Moderate dosages (no higher than 100-120 mg) are recommended. Engaging in sexual activity is no more risky than dancing at a rave (from a cardiovascular point of view), so adding MDMA does not introduce significant differences. As always, general rules of risk reduction for MDMA apply.

LSD, MDMA and infliximab interactions

Hello I was wondering if you knew anything about tnf-alpha remicade(infliximab). I like to know if it is there are LSD, MDMA and infliximab interactions, dangerous for a person using this drug for IBD.

Originally posted in SR 2.0 . Reviewed 20/2/22

Infliximab is one of the most recent treatments available in inflamatory bowel disease (IBD, inflammatory bowel disease: Crohn’s Disease /Ulcerative Colitis). 

Infliximab is sometimes used intravenously in severe disease flares. In these circumstances the use of recreational drugs or psychedelics is contraindicated. The patient is usually hospitalized and in poor general condition. So he will not probably find psychedelics enjoyable. 

But, on other occasions it is used periodically subcutaneously. If the patient’s general condition (both physical and psychological) is acceptable, there are no data to assume that MDMA or LSD increase the risk significantly. An increase in adverse, toxic or toxic effects is not to be expected.



venlafaxine and MDMA interactions

Are there relevant venlafaxine and MDMA interactions?

Hi Doc
I take 150mg Venlafaxine daily. Now, when I take MDMA it doesn’t do anything. So it takes about 600mg to feel a mild effect is this down to the venlafaxine. In fact, Im not a regular MDMA user as now a standard dose of 200mg does nothing.

Originally posted in Evolution 3/11/14 . Reviewed 4/3/23

Venlafaxine belongs to a family of drugs (selective serotonin and norepinephrine reuptake inhibitors (SNRIs)) that decrease some psychological effects of MDMA.

There are no clinical trials that have studied the pharmacological effects of the combination MDMA + venlafaxine.

But, based on the mechanism of action and studies with similar drugs, this effect is likely to be present: that of decreasing the pleasant properties of MDMA.

Consequently, some people try to compensate for this problem by increasing the dose of MDMA. But that is not a good idea.Because this decrease in the psychological effects of MDMA does not necessarily imply that the effects on the heart and the rest of the body also decrease.

So, 600 mg is a very high dose that can be dangerous. On the other hand, the negative psychological effects of MDMA and the after effects can be potentiated, not only by the pharmacological combination, but also by the problem that motivated the use of venlafaxine (a depressive or anxiety disorder, in many cases).

To enjoy the effects of MDMA, it is advisable to be in a good state of health, both physically and mentally. It would be more reasonable to wait until your treatment is over and use safer doses.

Finally, a recent study linked the combination MDMA + venlafaxine to an increase in mortality. The impact in real conditions is probably low, but it is a fact to consider.


Risk of MDMA use in early pregnancy

I took MDMA without knowing I was pregnant. What is the risk in early pregnancy?

I took MDMA (a pink heart pill, about 150 mg) at a party a month ago. I  supposed that my period appeared the following week, and…surprise…I found out I was pregnant.

I feel really bad about the effects it may have had on my future child. The gynecologist told me that he does not know, that there are just a few studies, and that it is my responsibility. I have nightmares. No, I am not using drugs again. But I didn’t know that I had a pregancy at any time. To what extent is my child at risk?

Originally posted in SR 2.0 (Private 14/5/14) . Reviewed 20/7/22

Stay calm! The available scientific data suggests that sporadic and unintentional MDMA use during early pregnancy is unlikely to harm your baby. During pregnancy, only use necessary prescription drugs and talk to your doctor before taking any medications. Obviously, it is mandatory to avoid all recreational drugs.

Events like dental operations, taking antibiotics or pain relief drugs are common during early pregnancy. Very few medicines cause problems in isolation during the first few weeks of pregnancy because the fetus and placenta don’t establish circulation until later.

Amphetamine and methamphetamine are associated with fetal malformations in heart and face, but only in women who use these substances daily. . Studies on MDMA and pregnant animals also involve doses and frequencies that cannot be extrapolated to occasional use by humans.

It is worth noting that 10-15% of pregnancies end in miscarriage during the first trimester. This is natural since in many cases, chromosomal alterations and other malformations make the pregnancy unviable. Therefore, it is not uncommon for women to suffer miscarriages in the first few weeks of pregnancy. Even in this case, it is impossible to attribute this incident to MDMA sporadic use in the first weeks.



MDMA and blood donation

How much time should elapse between taking MDMA and donating blood?

Hi DoctorX,
Some days ago I went to donate blood in my local community center (they do this several times a year). However, when I said I had used MDMA two weeks earlier, they told me they could NOT use my blood.

Does this make any sense to you?

It was this really old fashioned looking rectal-exam type head nurse who looked «not amused», so it could very well be prejudice on her part. Should I simply not mention it next time?

Originally posted in SR 2.0 6/4/14 . Reviewed 14/2/23

No, it doesn´t make any sense at all.

The time and speed it takes for a given substance to be  eliminated from the body depends on  factors related to pharmacology.

And the most important of these is the «elimination half-life»: the time it takes for the body to eliminate half of the drug (t1/2). The t1/2 for MDMA is 9 hours.

100% of a drug is eliminated between 7 and 10 elimination half-lives.

For instance, the t1/2 for MDMA is 9 hours: and 100% of the drug is eliminated between 7 and 10 elimination half-lives, which is between 63 and 90 hours after use.

Two weeks after use, not a single molecule of the dose consumed will remain.

The WHO Clinical Guideline on Donation recommends that people with a history of intravenous drug use should not donate blood. This is a reasonable precautionary principle (possibility of undetected blood-borne viruses).

Regarding recreational drug use, the guideline states:

«There is no documented evidence that a donor’s recent ingestion of a «recreational» drug or alcohol has caused harm to the recipient of his or her blood. As in the case of prescribed medication,(…)  the recipient of the blood receives a very small residual amount,. This is unlikely to have any adverse effects».

And it only recommends discarding the donor in the case of obvious signs of intoxication at the time of donation, which also seems reasonable

Rejecting a blood donor solely on the basis of having consumed MDMA two weeks earlier is not justified on clinical grounds.

So, in a nutshell,

  • Rejecting a blood donor solely on the basis of having consumed MDMA two weeks earlier is not justified on clinical grounds.
  • Whether the nurse looks old-fashioned, dull, or has a face like the one you describe is not very important. That is all her problem. What is serious is the ignorance and prejudice that many health workers have towards drug users.
  • Technically, I can’t recommend  «don’t say anything» next time. If a health professional refuses your blood donation, you have the right to request a written explanation based on official guidelines. You could submit a written complaint to the hospital. And you could provide the documentation attached to this post.
  • Donating blood is an act of generosity. while you have the right to follow up on any mistreatment, you are not required to make extraordinary efforts.