Does Alcohol Cause Erectile Dysfunction?
It’s a long-held belief that alcohol use increases sexual desire while inhibiting sexual performance. Alcohol affects the brain by decreasing inhibitions which may increase sexual desire. Increasing amounts of alcohol depress the activity of the brain.
The effect of alcohol on erectile dysfunction seems to parallel what is known about its effects on heart disease. A little may be beneficial, much more than that is harmful. This should not be a surprise because there are many parallels between erectile dysfunction and heart disease. Erectile dysfunction should be taken seriously as a marker of blood vessel disease. An early warning sign that may serve as an impetus for some men to adjust their lifestyle habits, improving both their sexual and overall health.
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How Much Alcohol Is Too Much?
The blurred line on when alcohol use becomes harmful has led the U.S. Centers for Disease Control and Prevention (CDC) to define moderate drinking for men and women.
- Moderate drinking for men is defined as no more than two drinks per day.
- Moderate drinking for women is defined as no more than one drink per day.
These guidelines for moderate alcohol consumption should not be misinterpreted to mean that alcohol use below these levels is safe. How fast the liver breaks down alcohol and how the body is affected by the metabolites produced when alcohol is broken-down varies by person.
Knowing that alcohol use has some beneficial and harmful effects in terms of sexual function, researchers investigated exactly how many drinks per week made the risks of sexual dysfunction higher than the benefits. They found it was eight drinks per week or more.
Speaking of lifestyle factors, it will probably not surprise you that there is also a strong connection between nicotine and erectile dysfunction as well.
Short-Term Erectile Dysfunction
Alcohol has many effects on the body that can increase your risk for erectile dysfunction. Alcohol abuse is the leading cause of impotence and sexual dysfunction. Over 60% of men surveyed who are dependent on alcohol reported sexual dysfunction. Erectile dysfunction was most common, followed by reduced sexual desire.
Nervous System Depressant
Alcohol is a central nervous system depressant. The central nervous system comprises the brain and spinal cord. Slowed responses in the central nervous system mean that responses to sensory information are delayed.
The first step in getting and sustaining an erection is being sexually stimulated. Sensory receptors send messages to the brain. The brain responds by signaling blood vessels to release nitric oxide, increasing blood flow to the penis. This is true even when taking ED medications. Alcohol’s depressant effects can slow your body’s response to sexual stimulation.
Alcohol acts as a diuretic. Diuretics increase urine production and therefore decrease blood volume. When blood volume falls, angiotensin increases. When blood volume is low, angiotensin is released to constrict blood vessels and maintain blood pressure. Blood flow and oxygen delivery into the penis are reduced when blood vessels constrict.
Mild dehydration also affects mood and cognitive performance. Dehydration causes headaches and difficulty concentrating. Researchers found that men with mild dehydration also had increased fatigue and anxiety.
Men who consume large amounts of alcohol have lower testosterone levels. Decreased testosterone levels can lead to:
- Reduced libido
- Decreased spontaneous erections
- Erectile dysfunction
- Depressed mood
- Poor concentration and memory
- Sleep disturbances
- Reduced muscle mass
- Increased body fat
Alcohol damages Leydig cells, the testosterone-producing cells in the testes. Researchers found that testosterone levels begin to decrease within 72 hours of alcohol consumption. This is because alcohol inhibits two key enzymes involved in the production of testosterone.
Besides a direct effect on testosterone production, alcohol also inhibits the release of luteinizing hormone (LH) in the brain. Gonadotropin-releasing hormones are released from the hypothalamus and stimulate the release of LH from the pituitary. LH stimulates the Leydig cells in the testes to produce testosterone. Alcohol negatively impacts testosterone production in two places within the pathway.
Heavy alcohol consumption can increase estrogen. Alcohol increases the function of the enzyme aromatase, which converts testosterone to estradiol and androstenedione into estrone. Increased estrogen levels can lead to infertility, low libido, and an increased risk of ED.
Long-Term Erectile Dysfunction
Impotence, testicular atrophy, gynecomastia, and loss of sexual interest result from decreased testosterone and increased estrogen levels in men.
The prevalence of sexual disorders in men who are long-term alcohol users ranges from 8% to 58%. In a study of 17,000 men being treated for alcoholism, 8% were impotent. Over half of hospitalized men with alcoholism reported ED.
Researchers screened 1,300 male alcoholics and enrolled 66 nonsmoking alcoholics who did not use other substances and had an average age of 36.6 years. They found that these men with high alcohol use, who were non-smokers and non-drug users:
- Consumed alcohol an average of 6.1 days per week
- Consumed a minimum of 6 ounces of alcohol per day for a minimum of five days per week in the past year
- Had increased levels of FSH
- Reported decreased libido
- Had decreased progesterone synthesis
- Reported erectile dysfunction (71%)
- Had no changes in semen appearance, pH, or viscosity
- Had decreased sperm count
Researchers also found increased LH levels, which suggest that alcohol’s effect on testosterone is largely at the testicular level, not the brain.
Read More: Erectile Dysfunction (ED) in Your 20s and 30s, What You Need to Know
Other Ways Alcohol Impacts Sexual And Reproductive Health
Besides affecting testosterone production, nervous system function, and blood flow, alcohol can impact other areas of sexual and reproductive health, including:
- Reduced libido: Alcohol use increases estrogen production and decreases testosterone production, which can adversely affect your libido. Both testosterone and growth hormone levels naturally decline with aging. Therefore, adding the effects of alcohol can lead to a loss of interest in sex and decreased arousal. On the other hand, making healthy lifestyle and habit changes can boost your libido.
- Shrinking of sex organs: Up to three-quarters of men with advanced liver damage from long-term alcohol abuse have testicular atrophy. Experts speculate that this may be because of alcohol’s damaging effects on the testes, alcohol-induced decrease in LH, or a side effect of another factor such as malnutrition or drug use.
- Decreased fertility: Alcohol use in men can not only decrease a man’s fertility by its effects on sperm and testosterone production, but it may also affect fetal development. These potential effects have only been studied in animals because of the huge number of confounding variables in human development, but they are important to consider. Read more to learn about the many factors that can harm your chances of getting pregnant.
- Unintended pregnancy: According to the Centers for Disease Control and Prevention (CDC), approximately 45% of all pregnancies in the U.S. are unintended. Approximately 7.3% of pregnancies are alcohol-exposed pregnancies. Men and women who use alcohol may pay less attention to birth control and take risks they may not have had they not drank alcohol.
- Spread of sexually transmitted infections (STIs): According to the Centers for Disease Control and Prevention (CDC), alcohol use increases the risk of acquiring and transmitting sexually transmitted infections (STIs) through unprotected sex, sex with multiple partners, or sex with a partner at higher risk for STIs. The CDC reported 26 million new STIs in Americans in 2018.
- Relationship difficulties: Alcohol use can increase the risk of depression, anxiety, and substance abuse. All three of these can affect intimacy. Whether alcohol is being used to self-treat mental health issues or is a factor in worsening these health issues, there is a connection between intimacy and mental health, and alcohol use may worsen intimacy problems.
How To Deal With Sexual Dysfunction Caused By Alcohol
Erectile dysfunction is one of many sexual health outcomes men may experience from excessive alcohol use. Dealing with the sexual dysfunction caused by alcohol will largely depend on your symptoms. However, your symptoms will probably be a result of a combination of decreased testosterone levels, changes in blood flow, and psychological factors. Below are lifestyle and medication options to consider, besides decreasing or abstaining from alcohol use.
Decreased Testosterone Levels
If you suspect that your testosterone levels may be low, Invigor Medical offers a consultation with a licensed healthcare provider and hormone testing.
If your testosterone levels are low, discuss whether testosterone replacement therapy may be appropriate for you with your Invigor Medical provider.
Changes In Blood Flow
Dehydration, low blood pressure, and blood vessel damage can all cause ED. During your consultation with your doctor, you may discuss these options to treat ED:
These medications increase blood flow into the penis by either increasing nitric oxide (oral ED medications) or dilating blood vessels (Trimix).
Alcohol abuse and mental health disorders commonly co-occur. Alcohol can increase the risk of underlying mental health disorders, and alcohol is frequently used to manage the symptoms associated with these conditions.
Men who are experiencing stress, anxiety, depression, substance abuse, or other mental disorders should seek counseling and therapy to help work through their feelings and receive appropriate treatment.
If you have an unhealthy relationship with alcohol, tell your doctor. There are many treatment options available to help.
If you are experiencing stress or anxiety that hasn’t risen to the level of requiring medical treatment, consider these 7 Tips to Reduce Anxiety and Manage Stress
Besides medical and psychological treatment, consider making any pertinent lifestyle changes, such as
- Maintaining a healthy weight
- Engaging in physical activity regularly
- Stopping smoking
- Decreasing or abstaining from alcohol use
Alcohol affects men’s sexual health in many ways. Your doctor can help you determine whether the symptoms you are experiencing result from excessive alcohol consumption. They can work with you to determine the best course of action to restore your sexual, psychological, and overall physical health.