Many men believe that alcohol can improve their sex life. It relaxes them, reduces their inhibitions, gives them more confidence, and increases their sexual desire. Some advertisements even use the rhyme: “A drink a day keeps erectile dysfunction away”.
But it is important to realize that alcohol can have the opposite effect too. In fact, alcohol is actually one of the common causes of erectile dysfunction. Alcohol is a central nervous system depressant. Excess alcohol can inhibit mood, lessen sexual desire, and make it difficult for a man to achieve erections. Long-term alcohol abuse can cause permanent damage to penile arteries and even cause impotence.
The effects of alcohol on sexual performance have been known in most cultures for hundreds of years. Even Shakespeare noted the effects of excess alcohol consumption in Macbeth (Act 2, Scene 3): “Drink sir, is a great provoker … it provokes the desire but takes away the performance.” Some men use the slang term “brewers droop” to define the impotence that occurs when they consume “one too many”.
What is the physiological reason for alcohol causing erectile dysfunction? The sexual urge that causes men to have an erection begins in the brain. Chemicals in the brain called neurotransmitters send signals down the spinal cord which stimulate blood flow to the penis and cause the blood vessels in the penis to dilate and expand. When there aren’t sufficient brain signals to stimulate the blood flow needed to induce an erection, erectile dysfunction occurs. Alcohol can impair the signals between the brain and the genitals. It can also dull a person’s ability to experience pleasure, including excitement and intensity of orgasm.
In addition, alcohol can disrupt hormone levels – in particular, testosterone and estrogen. Low levels of testosterone are known to cause changes in sexual function, including loss of sexual desire, erectile dysfunction, decreased frequency of morning erections, and infertility. Sometimes, alcohol abuse can cause shrinkage of the testes (testicular atrophy).
Furthermore, alcohol dehydrates the body. In order for a man to become sexually aroused, the body must have a certain volume of blood to bring oxygen and greater sensation to the genitals. With a lower blood volume, the body struggles with sexual performance.
There are also serious long-term effects caused by chronic alcoholism. Prolonged alcohol abuse can impair the impulses between the brain and the genitals and sometimes cause irreversible damage to the nerves in the penis that control erections. In addition, it can cause a variety of secondary disorders that make sexual activity and erections more difficult. These disorders include liver disease, pancreatitis, obesity, and atherosclerosis (hardening of the arteries).
Most studies show that men who are dependent on alcohol have a 60 to 70 percent chance of suffering from sexual problems. The most common of these are erectile dysfunction, premature ejaculation, and loss of sexual desire. One study showed that chronic alcoholism can cause impotence even after the complete cessation of drinking for many years.
In one study conducted at the University of Washington, sober men were able to achieve an erection more quickly than intoxicated men, and some men were unable to have an erection at all after drinking. However, significant impairment was not seen unless blood alcohol levels were extremely high (higher than the criterion for drunk driving).
A recent article published in 2014 in Indian Journal of Psychological Medicine reviewed all of the existing literature on sexual dysfunction in patients with alcohol dependence. The rates of sexual dysfunction ranged from 40 – 95.2%, with much higher rates among men with chronic alcohol abuse.
In addition to physical changes, prolonged alcohol abuse can cause extreme distress and interpersonal difficulties, which can in turn worsen the abuse (as well as the erectile dysfunction). According to the National Institute on Alcohol Abuse and Alcoholism, alcohol use beyond moderation (“social drinking”) is associated with relationship problems that include marital conflicts, infidelity, economic insecurity, violence, and divorce. In addition, 90 percent of all sexual assaults involve alcohol consumption.
Another danger of combining sex and alcohol is the risk of exposure to a sexually transmitted disease. Studies show that both men and women are more likely to engage in casual sexual behavior when alcohol is involved. Approximately 50% of unintended sexual relations occur when alcohol is consumed. A study of alcohol use among college students showed that students who use alcohol are twice as likely to have multiple sex partners and seven times more likely to have unprotected sex. Approximately 60% of all STD transmissions occur when alcohol is consumed just prior to sex.
What is the Treatment for Alcohol-Related Erectile Dysfunction?
The first step in treatment for alcohol-related erectile dysfunction is dealing with the alcoholism. If the problem is recognized early enough, many of the negative physical and psychological effects can be reversed.
Obviously, it will be necessary to reduce alcohol consumption. But is it necessary to avoid alcohol completely?According to most experts, moderation is key. The U.S. Centers for Disease Control and Prevention (CDC) defines moderate drinking as a maximum of two drinks a day for men. (One drink equals about 12 ounces of beer, five ounces of wine, or one ounce of hard liquor.) The liver breaks down alcohol at a rate of about 10 grams of alcohol (a standard-size drink)per hour, so regularly drinking more than that means that toxins from alcohol can build up in your body and affect your organs, including those involved in sex.
Professional treatment is often needed in order to limit alcohol consumption. Such treatment may involve group therapy, cognitive behavioral therapy, physical therapy, and meditation. Support groups such as Al-Anon can be very helpful in providing guidance. A strong social network and family support is also essential. Families and friends need to be educated on how to assist (rather than enable) the drinker.
Drug therapy for erectile dysfunction may also be suggested. Usually the first course of action is a medication such as Viagra, Cialis, or Levitra. Mechanical aids and various natural options may also be helpful.
Of course, the common treatments for erectile dysfunction will do nothing to repair relationships that may have been damaged by alcohol abuse. For that reason, marital therapy may also be an important piece of a successful treatment plan.
The good news is that alcohol-related erectile dysfunction can be treated successfully. But it may take some time and effort, and it will involve honesty with yourself, your partner, and your doctor.