Abstract Introduction Up to 41% of women experience female orgasm disorder/difficulty (FOD), a statistic unchanged for 50 years. Despite this, there is a paucity of validated treatments. Research has suggested cannabis as a treatment for female sexual disorders for more than 50 years. Yet a literature review revealed no studies evaluating cannabis as a treatment specifically for FOD and no studies comparing women with and without FOD. This study is the first to evaluate cannabis as a treatment for FOD specifically in women with and without FOD. Objective Evaluate the effect of cannabis use before partnered sex on women with and without FOD. Methods This IRB-approved observational study conducted between March 24, 2022, and November 18, 2022, evaluated baseline demographics, sexual behavior, mental health, cannabis use, and the orgasm subscale questions of the Female Sexual Function Index (FSFI), evaluating orgasm frequency, orgasm satisfaction, and orgasm ease, with and without cannabis before partnered sex. Results Of 1,037 survey responses, the researchers received 410 valid, completed surveys; failure to meet the study’s criteria required excluding 23 (5.6%) surveys. Among the 387 valid survey participants, the majority of women, 52% (n = 202) reported orgasm difficulty, were between the ages of 25–34 (45%, n = 91), reported their race as white (75%, n = 152), and were married or in a relationship (82%, n = 165). Among respondents reporting orgasm difficulty (n = 202), cannabis use before partnered sex increased orgasm frequency (72.8%, n = 147/202, p < .001), improved orgasm satisfaction (67%, n = 136/202, p < .001) or made orgasm easier (71%, n = 143/202, p < .001). Frequency of cannabis use before partnered sex correlated with increased orgasm frequency for women with FOD (n = 202, p< .001). Orgasm response to cannabis depended on the reasons for use (n = 202, p = .022). Women with FOD reported 24% more mental health issues, 52.6% more PTSD, 29% more depressive disorders, 13% more anxiety disorders, and 22% more prescription drug use than women without FOD. Women with FOD were more likely to report sexual abuse history than women without FOD (38.6%, n=74/202). Conclusions Fifty years of sexuality research support use of cannabis for sexual difficulties. This is the first study to look at FOD specifically, demonstrating significant benefit. Randomized controlled studies are needed to evaluate cannabis’ efficacy on FOD sub-types, mental health and physical health conditions and other clinical implications; evaluating dosage, strain, timing, and method of intake. References Laumann et al., 2005 Kontula & Miettinen, 2016 Keiman & Meston, 1997 Dawley et al., 1979 Gorzalka et al., 2010 Klein et al., 2012 Lewis, 1970 Moser et al., 2023. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: inhaleMD.