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Colin MacKenzie M.D.
November 24, 2020

Introduction

Are you a heavy drinker? Have you ever thought how alcohol affects your sex life? Did you know that excessive alcohol intake can cause sexual dysfunction? This article will provide insight into alcohol-induced sexual dysfunction.

Sexual dysfunction is a condition defined as having difficulty with sexual desire, orgasm, arousal, or performance. Stress, emotional instability, medications, age, and even heavy drinking can cause it.

Excessive drinking can give rise to sexual problems in both men and women. Alcohol is a central nervous system (CNS) depressant and thus, it dampens the mood, decreases sexual desire, and makes it more difficult for a man to achieve an erection or either gender to achieve an orgasm while intoxicated. According to one study, chronic drinking is the primary cause of impotence and other disturbances in sexual dysfunction.[1] Usually, if a person has one type of sexual disorder, a second type of sexual disorder is likely to be present as well.  This blog entry will review a few of the sexual problems caused by heavy alcohol consumption:

Erectile Dysfunction

Erectile dysfunction is the most common sexual problem caused by heavy drinking in men.[2] One study has shown that non-alcoholic, sober men can get an erection more quickly than intoxicated men, and some men are not able to get an erection at all after alcohol intake.  

Alcohol leads to erectile dysfunction by interrupting or slowing down the neurological impulses from the brain to the penis that normally controls erectile function.  This leads to a reduction in blood flow to the penis preventing erection. Alcohol also causes dehydration, which reduces total body blood volume and results in the release of angiotensin, a signaling protein, which causes constriction of the blood vessels, including those blood vessels feeding the penis.  Constriction of these blood vessels further inhibits blood flow to the penis and thus, erection.  Alcohol caused erectile dysfunction is commonly given the colloquial name “whiskey dick”. 

Research demonstrates that men who consume more than three drinks per day where found to have a significantly higher rate of erectile dysfunction.  Chronic alcohol use can lead to erectile dysfunction in a number of ways including neurological deficits, vascular problems, decreased release of nitric oxide, secondary impact from other organ dysfunctions (liver disease), or endocrine problems.  For example, regular alcohol use suppresses sex hormones.  The hormones impacted by alcohol can be either those sex hormones secreted by the brain, such as gonadotropin-releasing hormone, or those secreted by the gonads, such as testosterone, with the end result being hypogonadism (diminished activity of the gonads).  Without sufficient testosterone, erectile function, as well as other sex types of sexual dysfunction, is more likely. 

Decreased Sexual Desire

Chronic drinking leads to a loss of libido (i.e. decreased sexual energy, desire, or excitement).[3] Excessive drinking, especially long-term, regular use, can result in depression-like symptoms and can diminish a person’s desire to take part in any activity, including sex. Therefore, the person suffers a lack of interest, and sex seems more like a job rather than intimacy with a partner.

Sexual Pain Disorder 

Sexual pain disorder refers to pain caused by, or during, intercourse and is experienced exclusively by women. There can be various causes of pain during coitus and can range from neurological, anatomical, endocrine, or psychosocial. Many women try to hide the pain with the use of alcohol, and subsequently become dependent upon it, which causes the condition to worsen. 

Orgasm Disorder

Heavy alcohol intake can lead to premature, delayed, or inability to orgasm even after a normal sexual excitement phase. Women, particularly, suffer from an inability to orgasm while under the influence of alcohol. Men, on the other hand, experience premature, delayed, or nonexistent ejaculation. Orgasm disorders can be a function of depressed neurological function due to acute intoxication or a sign of a more serious problem from chronic alcohol use such as an alcohol-induced autonomic neuropathy. The autonomic nervous system, comprised of the parasympathetic and sympathetic nervous systems, is critical to normal sexual function.  Alcoholism can cause a degeneration of the autonomic system, and if either the parasympathetic or sympathetic systems are impacted, orgasm can be partially or completely impaired. Furthermore, achieving orgasm requires a normal sexual arousal phase.  If alcohol causes enough emotional or cognitive disruption to inhibit arousal, then orgasm will be likewise impaired.

Sexual Aversion Disorder

Though acute intoxication can lead to disinhibition for sexual activity; chronic, excessive drinking can bring about a strong dislike or aversion to sexual activities.  If alcohol is responsible for creating any of the other sexual disorders chronically, then sexual activity itself can become a source of stress and aversion. Sexual aversion disorders lead to evasion of any sort of genital sexual interaction. This can create interpersonal problems and disrupt relationships.  Stress from these inter-personal issues can then create a vicious cycle where the person uses more alcohol as a means to cope which then exacerbates the original alcohol-induced sex disorder. 

Vaginal Dryness

Alcohol being a diuretic causes dehydration which leads to vaginal dryness.

Decreased Sex Hormones

As mentioned above, chronic alcohol use lowers the levels of testosterone and other gonadotropins, which lessens sexual drive and function.[2]

Bottom Line

Heavy drinking can lead to many sexual problems such as erectile dysfunction and sexual pain disorders. Thus, to live a healthy sex life, one must overcome the abusive use of alcohol. 

 

References

1.      Arackal, B.S. and V. Benegal, Prevalence of sexual dysfunction in male subjects with alcohol dependence. Indian J Psychiatry, 2007. 49(2): p. 109-12.

2.      La Vignera, S., et al., Does alcohol have any effect on male reproductive function? A review of literature. Asian J Androl, 2013. 15(2): p. 221-5.

3.      Fernandes, A. and A.J.M.S. De Sousa, Alcohol dependence and sexual dysfunction: A clinical review. 2014. 3(4).