Alcohol and erection problems

Dear Dr. G,

I have an issue with my sexual relationship and am hoping you can help.

I am in my early thirties and have been with my girlfriend for two years.

When we first got together, our sex life was amazing, especially after a night out with a nice meal and wine.

However, over the last three months, I have been experiencing problems with erectile dysfunction, diminished libido, and an inability to ejaculate.

I think it all started after taking on a new job, which includes a lot of work-related entertainment and excessive alcohol consumption.

I first noticed not getting any morning erections and a decrease in libido.

Even when I achieved an erection, it was so weak that I could not complete penetration.

My girlfriend asked me to see a doctor, who thinks my alcohol consumption is the root cause of my problems.

He even mentioned a term called “Whiskey Dick” for alcohol-induced sexual dysfunction.

I am confused because alcohol often helps couples get in the mood for sex.

It certainly helped me get hard when I first started with my girlfriend.

So, I want to ask Dr. G for some clarification.

Can you explain the impact of mixing alcohol and sex?

Can alcohol induce sexual dysfunction?

What levels of alcohol consumption can cause sexual dysfunction?

Can abstinence really restore sexual function completely?

Yours truly,
Whiskey Dicky

Being a little tipsy thanks to alcohol has long been portrayed as a love-making initiator. It is a common belief that alcohol can help individuals loosen up, enhancing excitement and readiness for sexual activities. Alcohol in small doses is known to stimulate testosterone production in both men and women, heightening sexual desire and arousal.

Alcohol is also associated with lowering sexual inhibitions, making individuals feel sexier and more confident. Hence, moderate alcohol consumption is recognised for helping couples get in the mood for sex. Chronic and persistent alcohol consumption is known to induce sexual dysfunction, leading to marked distress and interpersonal difficulty.

Sexual dysfunction in alcoholics may be due to the depressant effect of alcohol itself, alcohol-related diseases, or various psychological impairments related to alcohol use. Alcohol-related diseases, such as liver cirrhosis, impair hormonal balance in men, resulting in testosterone deficiency.

Additionally, alcohol-induced neuropathy is recognised for causing erectile dysfunction and other sexual dysfunctions in men. The spectrum of sexual dysfunction includes recurrent or persistent failure to achieve or maintain an erection, persistent or recurrent deficiency of sexual desire, and persistent or recurrent delay in or absence of orgasm.

Alcohol-induced erectile dysfunction is often labelled as “whiskey dick” and this erectile failure in alcoholic men is well-documented in medical literature. Erectile dysfunction (ED) is significantly higher in men consuming more than three standard units of alcohol (12 g ethanol) daily and in those smoking more than 10 cigarettes a day.

One study reported that 61% of patients dependent on alcohol experienced sexual dysfunction, with erectile dysfunction being the most common, followed by reduced sexual desire. Erectile dysfunction and reduced sexual desire frequently coexist.

Another study revealed that among 97 male inpatients admitted for alcoholism treatment, 71% had suffered from sexual dysfunction for more than 12 months before admission. The disturbances included diminished sexual desire, ejaculatory incompetence, erectile impotence, and even premature ejaculation.

Alcohol consumption is also linked to greater risk-taking in both males and females, though it appears to be more of a driving factor for males. According to medical literature, men are more likely to engage in risky sexual behaviour, such as intercourse without protection, when under the influence of alcohol.

Apart from increasing the risks of sexually transmitted infections, excessive alcohol consumption also increases the risk of engaging in sexual violence. The exact mechanism of alcohol-induced sexual dysfunction is unknown. However, excessive alcohol consumption reduces testosterone production and causes neurotoxicity. Both hormonal and neuronal damage are reversible with the cessation of alcohol consumption.

There is ample evidence that alcohol-induced sexual dysfunction, for the most part, is reversible with alcohol abstinence. The extent and speed of recovery depend on the amount and duration of excessive alcohol consumption.

So, on one hand a moderate alcohol intake is linked to enhancing testosterone production for sex in both men and women. This leads to a relaxing effect, helps lower inhibitions, enhances self-confidence, and reduces tension, allowing lovers to explore.

On the other hand, too much alcohol may not guarantee a “hard” ending. Dr. G is often put on the spot by men puzzled by conflicting data on mixing alcohol with sex. His view is that alcohol may be a man’s worst enemy; however, moderation is always the spirit that will help men love their enemy!