Sexual function following 3,4-Methylenedioxymethamphetamine (MDMA, or 'Ecstasy') consumption was subjectively evaluated in 35 healthy recreational users (20 men and 15 women, aged 21-48 years) with regard to four major domains of sexual activity: desire, erection (lubrication in women), orgasm and satisfaction. Desire and satisfaction were moderately to profoundly increased by MDMA in more than 90% of subjects. Orgasm was delayed but perceived as more intense. Erection was impaired in 40% of the men. It seems that MDMA impairs sexual performance, in spite of enhancement of sexual desire and the perception of greater satisfaction.