A Urologist’s Guide to Alcohol’s Impact on Sex
Throughout history, alcohol has played a prominent role in human culture and social interactions. It serves as a means of relaxation, celebration, and stress relief for many people. For others, it’s a form of liquid courage. Alcohol may be a go-to way to whoop it up for many, but it may also be the reason your sex life remains flaccid. The negative effects alcohol can have on health are well established. According to the Centers for Disease Control and Prevention, excessive alcohol use led to more than 140,000 deaths and 3.6 million years of potential life lost (YPLL) each year in the United States from 2015 to 2019, shortening the lives of those who died by an average of 26 years. Excessive drinking was also responsible for 1 in 5 deaths among adults aged 20-49 years.
Excessive alcohol use can lead to high blood pressure, heart disease, stroke, liver disease, and digestive issues. It has been linked to breast, mouth, throat, esophagus, liver, and colon cancers. Alcohol is an immunosuppressant, increasing the chances of getting sick. Alcohol has also been associated with mental illness, including depression and anxiety; cognitive dysfunction, including dementia; and violent and risky sexual behaviors. We’ve talked a lot here before about sexual health as a marker of overall health, so it shouldn’t surprise you that sex can also suffer when alcohol is consumed excessively. As a sexual health expert, I would be remiss not to consider alcohol consumption an important factor when trying to optimize the sex lives of my patients. What follows is an exploration of how alcohol affects different facets of sexual health and the importance of maintaining a balanced approach to alcohol consumption to promote a healthy and fulfilling sex life.
Alcohol and the Body
To better appreciate how alcohol affects sexual function, it is imperative to comprehend its physiological impact on the body as a whole. Upon consumption, alcohol enters the bloodstream, exerting various effects on both physical and mental states. These effects include:
Depressant Nature: Alcohol is fundamentally a central nervous system depressant, which means it slows down brain activity and respiratory rate. This results in reduced inhibitions, a sense of relaxation, and an altered state of judgment. But taken too far, alcohol can also lead to dizziness, nausea, vomiting, and passing out.
Impairment of Motor Skills: The influence of alcohol extends to the hindrance of coordination and motor skills, leading to diminished physical performance, including difficulties during sexual activities. That’s right, alcohol can make many of your body parts, not just your legs, feel weak.
Hormonal Fluctuations: Alcohol is capable of influencing hormone levels, including the crucial sex steroid hormones, testosterone and estrogen, both of which are pivotal for sexual health.
Alcohol’s Almost Immediate Effect on Sexual Function
Anyone familiar with drinking alcohol will tell you that it lowers inhibitions. Less inhibition can help some make the move they’ve been too scared to make or talk up that special someone they’ve been too shy to chat with before. But when it comes to sex, less inhibition can also sometimes put you at risk. Risky sexual behaviors can result in unintended pregnancy and increase your risk of sexually transmitted infections, including HIV. Not to mention, excessive alcohol consumption has the potential to impair judgment and decision-making, increasing the risk of engaging in sexual activities without clear and informed consent. Alcohol and/or other drugs are also often implicated in injuries that happen during sex, including penile fractures. So, while alcohol may have you feeling braver than your usual self, be careful that your sudden sexual boldness doesn’t get you into trouble.
Alcohol doesn’t just put you at risk sexually, it can also make it a challenge to perform in the first place. While alcohol may initially boost desire and arousal, excessive consumption can negatively affect erectile function in men, a phenomenon colloquially referred to as “whiskey dick.” This occurs because alcohol impedes normal blood flow to the penis, increases angiotensin, a hormone linked to erectile dysfunction, and depresses the central nervous system—making it harder to get or stay hard. Consuming alcohol in high amounts has also been associated with decreased vaginal lubrication and dyspareunia in women. This is at least partially due to alcohol’s dehydrating effects on the body. Alcohol can also extend the time required to reach orgasm for some individuals. While this may be construed as a beneficial effect, as it prolongs sexual pleasure, it can also lead to difficulties in reaching orgasm at all. Finally, alcohol has the potential to dull sensation, which may decrease sexual pleasure for both men and women. This diminished sensitivity may contribute to lower rates of sexual satisfaction in people who consume alcohol excessively.
It’s important to remember that the severity of alcohol’s effects on a person’s sexual function can vary depending on several factors. These include individual tolerance, the quantity of alcohol consumed, and the context in which it is consumed.
Chronic Alcohol Consumption and the Implications for Sexual Function
While moderate alcohol consumption may yield some short-term effects on sexual function, chronic alcohol abuse can precipitate more profound and enduring consequences:
Hormonal Imbalance: Prolonged alcohol abuse can disrupt the endocrine system, leading to imbalances in hormone levels. In men, this can translate to diminished testosterone production, a hormone critical for sexual desire and erectile function. Excessive alcohol consumption can also increase levels of estrogen in men, which can lead to gynecomastia, mood swings, and even hot flashes. In women, alcohol’s effects on estrogen levels can result in irregular menstrual cycles, decreased sexual desire, and possibly increased risk of breast cancer.
Sexual Dysfunction: Chronic alcohol abuse poses a substantial risk of sexual dysfunction that goes beyond just one bad performance in the bedroom. In men, this can manifest as persistent erectile dysfunction, chronically low or absent libido, and difficulty achieving ejaculation and orgasm. For women, it can lead to diminished sexual desire, persistent vulvovaginal dryness, discomfort or pain during sexual intercourse, and muted or absent orgasms.
Relationship Strain: Excessive alcohol consumption and abuse can place immense strain on relationships, which, in turn, can adversely affect sexual function. The emotional and psychological toll of excessive drinking and/or addiction can erode intimacy and communication between partners, contributing to sexual difficulties in a relationship.
Mental Health: As we briefly alluded to before, chronic alcohol consumption is often closely linked with mental health issues such as depression and anxiety, both of which can significantly contribute to sexual dysfunction.
Fertility Issues: For couples attempting to conceive, chronic alcohol consumption can diminish fertility in both men and women. Fertility issues arise because alcohol not only disrupts hormonal equilibrium but can also adversely affect sperm quality and quantity and menstrual regularity.
Tips on Finding a Balance
As with many things in life, when it comes to alcohol, moderation is key. Alcohol is not inherently bad, and in no way is this a judgment on people who consume it. Alcohol can be fun; it can even be tasty. But finding a healthy balance in your relationship with alcohol is key to optimizing your sexual health. Consuming alcohol in moderation significantly diminishes the likelihood of immediate and long-term sexual problems associated with excessive drinking. So pace yourself and set yourself a drink limit to avoid getting too tipsy.
Another helpful tip for modifying alcohol’s effect on your sex life is to make sure you communicate and know when to ask for help. Open and candid communication with one’s partner regarding alcohol use and its effects on sexual experiences is essential to a fulfilling sexual relationship. Such discussions facilitate informed decisions and enable couples to navigate the complexities of alcohol and intimacy together. If an individual or their partner grapples with alcohol abuse or addiction, and it is adversely affecting sexual function or the relationship as a whole, seeking professional assistance may be necessary. Therapy and support groups can serve as invaluable resources in addressing these often complex issues.
When planning to engage in sexual activities, consideration of the timing of alcohol consumption is important. Avoiding heavy drinking immediately before or during sexual encounters helps minimize alcohol’s impact on sexual performance and pleasure. And it definitely decreases your risk of a sex-related injury. Nothing ruins the mood more than bruising, swelling, and/or pain in your most private parts.
Conclusion
The relationship between alcohol and sexual function can be complicated. While moderate alcohol consumption can stimulate desire and reduce inhibitions, chronic and excessive alcohol abuse can result in a wide spectrum of sexual problems for both men and women. A little bit of alcohol may be the lubricant some need to feel sexual at all, but when consumed in excess can limit your ability to perform sexually and may even put you at risk. If you want to maximize your sexual health and wellness, it’s paramount to be cognizant of how alcohol has influenced your sexual experiences previously. If you’ve found yourself limp on more than one occasion or waking up regretting what happened the night before, it may be time to cut back on your drinking. Remember: alcohol isn’t inherently bad. It’s just that sometimes when consumed in excess, it can be bad for sex.