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Alcohol and ED: What You Need to Know

9 min read
Alcohol and ED: What You Need to Know

For many people, alcohol and sex go hand-in-hand - especially since "a few drinks" is thought to boost sexual desire. That said, around 87 million adult men in the U.S. are regular drinkers - with around 1 in 20 men  falling into the category of 'heavy drinkers'. With both alcohol consumption and erectile dysfunction (ED) so prevalent, it's only natural that people question whether there is a link.

Here, we'll delve deeper into exploring that link - looking at what the latest science tells us about how alcohol affects the body, along with the physiological conditions needed to maintain healthy sexual function in men.

How can alcohol affect erectile function?

There are several ways that alcohol can have an effect on erectile function and sexual performance. From short-lived effects like a reduced blood flow to the penis or reduced sensitivity through to longer-term effects like cardiovascular disease and hormone imbalances, virtually all of the observed effects are negative.

To get a better understanding of how alcohol can contribute to erectile dysfunction, it's useful to take a more detailed look at how drinking interacts with different functions within the body and how these affect sexual intercourse.

Short-term effects

"Short-term" effects of drinking alcohol on sexual function and the penis are those that happen immediately after or very shortly after alcohol enters your system. They include:

1. Reduced blood flow

Alcohol functions as a depressant which affects the central nervous system. This means it can constrict the blood vessels throughout the body, leading to reduced blood flow - including to the penis. Since the penis relies on a healthy blood flow to become erect, any reduction in the flow of blood can result in trouble getting or maintaining an erection.

2. Interaction with ED drugs

Alcohol can negatively interact with erectile dysfunction drugs such as Viagra (sildenafil) and Cialis (tadalafil). In some cases, the alcohol will counteract the positive effects of the ED medication - rendering them ineffective. What's more, alcohol can worsen the common side effects of ED medications, resulting in other physical symptoms, like headaches and problems regulating your temperature.

3. Reduced inhibition (from small, infrequent drinks)

In the spirit of balance, it's important to acknowledge that occasional small amounts of alcohol can have a positive effect on sexual desire and a person's sex life. Since there can be psychological factors involved with sexual dysfunction (including the effect of anxiety on the ability to get an erection) - a small amount of alcohol can reduce inhibitions and ease any psychological issues preventing proper sexual function.

In spite of this, it's very important to understand that excessive alcohol consumption will almost always have the opposite effect, often increasing anxiety, as well as contributing to the other issues we've talked about here.

Long-term effects

A "long-term" effect of alcohol intake on ED is defined as a symptom that develops typically over a long period - often as a result of regular drinking across a number of years, they can often include:

1. Hormone imbalances

Excessive drinking and alcohol abuse can seriously impact a series of hormones your body would otherwise naturally produce. The most significant of these hormones is testosterone - with studies showing that heavy alcohol consumption reduces testosterone levels in the blood 

Excessive drinking and alcohol abuse can seriously impact a series of hormones your body would otherwise naturally produce.

Scientists believe that testosterone increases blood flow to the penis and functions as the main driver for sex drive and libido in men - so reduced testosterone levels can contribute to alcohol-related erectile dysfunction.

2. Liver damage

When your liver filters alcohol from your blood, some of the liver cells die While a healthy liver can regenerate, heavy drinking in the long-term can prevent this happening effectively, leading to liver disease or permanent damage to the organ.

Science has recognized a link between liver issues and treatment and erectile dysfunction - which represents a clear link between prolonged drinking (or alcohol dependence syndrome) and sexual dysfunction.

Illustration of the Stages of Liver Damage

Illustration of the Stages of Liver Damage

3. Cardiovascular (heart) issues

Many heart issues result from plaque building up in the arteries—a process known as "atherogenesis." Moderate-to-heavy drinking is proven to contribute to atherogenesis, and this plaque build-up reduces the flow of blood to the heart and throughout the body's blood vessels.

As an organ, the penis requires a healthy flow of blood to function properly - so any issues affecting the heart or its ability to circulate blood around your vascular system are likely to contribute to erectile dysfunction.

4. Nervous system damage

Although the causes and mechanisms are still being investigated, people with an alcohol use disorder are often shown to experience damage and degeneration in neurological cells Since the autonomic nervous system controls the penile blood vessels and causes an erection to occur, damage to this system caused by excessive alcohol consumption has a clear link to erectile dysfunction.

5. Psychological dependence

Humans are creatures of habit - and for many people, habits around alcohol form quickly. If effective sexual performance or the ability to get an erection comes when you drink alcohol, an absence of alcohol in sexual situations could then lead to anxiety - fueling a desire to drink again.

Humans are creatures of habit - and for many people, habits around alcohol form quickly.

This creates a problem as reliance on alcohol builds. As the amount a person drinks increases, so too do the short and long-term physiological effects explored here.

Alcohol and cardiovascular disease

Although we've touched on heart issues and their link to alcohol-related ED above, it's worth taking a more in-depth look at how cardiovascular diseases are linked to both alcohol intake and erectile dysfunction.

Cardiovascular diseases (CVDs) are the leading cause of death globally - responsible for nearly 18 million deaths each year. Data from a huge range of studies over the last 20 years shows a range of complex associations between alcohol intake and a range of cardiovascular diseases and conditions, including:

  • Hypertension (high blood pressure)
  • Coronary heart disease (plaque build up in the blood vessels)
  • Stroke
  • Peripheral arterial disease (blocking of blood vessels to, and in, the legs)
  • Cardiomyopathy (Degeneration of heart muscle tissue)

While the range of symptoms that lead to, or result from, these conditions is broad - virtually all also have an effect on the ability to achieve or maintain an erection. Since the heart is the driving force behind the body's entire circulatory system, its proper function is essential for penile health.

Also, since both the heart and the penis are organs, the optimum conditions for the heart (ie. healthy effective muscle, an effective nervous system, and minimal or no arterial plaque) are also optimum conditions for the penis.

Since the heart is the driving force behind the body's entire circulatory system, its proper function is essential for penile health.

This makes the links between heart health and erectile dysfunction two-fold. Firstly, cardiovascular disease or an unhealthy heart creates a system that is less likely to be able to provide the healthy blood flow needed to achieve an erection. Secondly, the conditions that have led to poor heart health will almost certainly have taken a toll on the penis's ability to function properly too.

Alcohol withdrawal and ED

Since it is clear that alcohol consumption can cause erectile dysfunction, it's probably unsurprising to discover that it's common for people to attempt to manage alcohol-related ED by cutting alcohol out of their lives. While helpful longer-term, this can have complications you should be aware of if you are a current heavy drinker.

If your alcohol consumption is fairly low, stopping or cutting down on alcohol is unlikely to present any significant psychological or psychological issues. However, the risks of suddenly stopping drinking (sometimes known as going "cold turkey") if you have a heavy drinking habit or you consider yourself to be an alcoholic can be significant - both in a broad health sense and in terms of any effect on sexual function.

While not directly relating to ED, any responsible information you read about alcohol withdrawal should outline the full spectrum of health risks, which include:

Withdrawal Symptoms Ranging from mild anxiety and tremors to severe complications such as seizures and delirium tremens (DTs), which can be life-threatening.
Emotional and Psychological Distress Anxiety, depression, irritability, and mood swings are common as the brain adjusts to the absence of alcohol.
Sleep Disturbances Insomnia and changes in sleep patterns can occur, leading to fatigue and exacerbating emotional distress.
Physical Health Issues

Abrupt cessation can lead to sudden changes in blood pressure, heart rate, and the potential for cardiovascular events.

There may also be a risk of developing or exacerbating other health issues such as liver disease, gastrointestinal problems, and nutritional deficiencies.

As such, it's absolutely essential to seek professional medical advice if you're planning on stopping alcohol in an effort to reduce the symptoms of erectile dysfunction.

Assuming it is safe for you to stop drinking, withdrawal and its impact on the body and mind should be thought of in two stages - short-term and longer-term symptoms and results.

Short-term impact of alcohol withdrawal on ED

Increased Anxiety and Stress May worsen ED as the body adjusts to the absence of alcohol.
Sleep Disturbances Poor sleep can temporarily exacerbate ED symptoms due to reduced testosterone levels and overall vitality.
Blood Pressure Fluctuations Can affect blood flow to the penis, temporarily impacting erectile function.
Potential for Improved Sensitivity Reduction in alcohol-induced numbness might improve penis sensitivity, although it could be inconsistent during initial withdrawal.

Long-term impact of alcohol withdrawal on ED

Hormonal Recovery Gradual normalization of testosterone levels can improve libido and erectile function.
Improved Cardiovascular Health Reduced risk of vascular problems associated with chronic alcohol use, enhancing blood flow needed for erections.
Neurological Benefits Recovery from alcohol-induced nerve damage can improve signals between the brain and penis.
Psychological Improvement Reduction in long-term stress, anxiety, and depression associated with alcohol abuse can alleviate ED.
Lifestyle Changes Impact Positive lifestyle changes that can help support sobriety—like exercise and diet—can further improve ED.

Effect of alcohol on sexual health and drive

Alcohol can have a huge range of effects on an individual's sexual health and drive, influencing everything from arousal and performance to long-term reproductive health.

Let's take a more detailed look:

Reduced Inhibition Initially, alcohol can reduce social inhibitions and anxiety, potentially increasing the desire for sexual activity, but this is often at the cost of impaired judgment and decision-making - along with the possibility of a reliance on alcohol in sexual situations into the future.
Impaired Sexual Performance   Even small to moderate amounts of alcohol can impair sexual performance by affecting erectile function, delaying ejaculation, or reducing sexual sensitivity.
Decreased Sexual Desire Chronic alcohol use can lead to decreased libido due to hormonal imbalances, particularly lowering testosterone levels, which are crucial for sexual drive.
Risky Sexual Behaviors Impaired judgment from alcohol consumption can lead to risky sexual behaviors, increasing the risk of sexually transmitted infections (STIs) and unplanned pregnancies.
Fertility Issues  Long-term alcohol abuse can affect male fertility, impacting both sperm quality and quantity.
Erectile Dysfunction (ED) Alcohol is related to ED in a number of significant ways, not least potential heart issues, liver problems, hormone imbalances, nervous system damage, and psychological issues, all of which can contribute to ED.

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Alcohol and ED: A Summary

Alcohol is such an ingrained part of so many people's lives that it's often difficult to appreciate the significant impact it can have - not least on erectile dysfunction. If you experience ED in any way - even temporary erectile dysfunction - considering your alcohol consumption is an incredibly worthwhile first step, simply because it can impact erectile health in so many ways.

Alcohol is such an ingrained part of so many people's lives that it's often difficult to appreciate the significant impact it can have - not least on erectile dysfunction.

From hormone imbalances and nerve damage to increasing the chance of liver and heart diseases, the effects of a moderate to heavy alcohol intake on the body and the ability to function sexually are significant. Of course, all that said, a healthy relationship with alcohol and a low level of consumption should ordinarily cause no problems - but since everyone is physically and psychologically different, it's perfectly reasonable to say that the impact of alcohol on ED will vary for everyone too.

If you suspect alcohol could be to blame for any ED symptoms you experience, it's a very good idea to talk to a medical professional and discuss positive steps you could take. The good news is, treatment, support, medications, and your body's ability to recover from many of the effects of alcohol, make it perfectly possible to see prompt and lasting recovery from many alcohol-related ED issues.

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