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I know one anecdote doesn't invalid proper scientific research but ... erections and even orgasm is not impossible on MDMA. I (a guy) have definitely had a bunch of sex on MDMA, not always to completion but sometimes.
The paper you linked states this at the end of the introduction, emphasis mine:
I'm sure a young man with vigor might be able to overcome some of those effects.
Especially after a few hours after taking the drug since its strong effects don't last that long.
But the sexual physiological suppression is pretty strong and it's also strong in women.
She ain't no teenager with crazy hormones. Shea pushing menapause.
Things are already starting to work less dependably down there by that age.
And just to educate men who may not know this. It's difficult and painful for a woman to have sex when she is not sexually aroused. It's not just lubricant.
The genitals on women also go through physical changes. External genitalia plumps up. The muscles near the entrance relax and dialate. Lubricant forms all through the vagina increasing stretch. And also the muscles around the vagina relax.
When these things don't happen (especially the muscle changes), sex will be very painful and unpleasant and can result in tears and rips.
*(There was a long discussion on reddit a few years back where I told men that pressuring their girl to have sex when she wasn't in the mood will ultimately make her dislike you and not want to initiate sex or even be affectionate because it will be associated with pain. Pain that she will not tell you she is having because we have been conditioned In our society to not "ruin sex" for men by saying anything unsetting to them. Men's pleasure is prioritized and ruining it for them will result in hostility from them (usually).
Many women feel like it's easier to just give in than say no and risk the man getting mean or hostile. Or go around pouting. . So they do it even when they don't want to. And it always hurts. It's always unpleasant. - I got a lot of hate from men who did not like me telling them that they cause their partner pain when relentlessly asking for sex when their partner is not into it.
Men can't be better partners if they pretend that this isn't the reality of pressuring their partner for sex.
Those who acknowledge it are more likely to keep their partner and themselves happier.
Too much of sexual functioning for women is not taught and is unknown to most people, including women.
So MDMA + prolactin. Then it's all fun and games until you lactate