Dear Dr. G,

I have a sexual relationship issue with my wife and hope you can help.

My wife and I have been married for 15 years and we have two beautiful children. When we first got married, we had an active sex life.

However, over the last three years, I have been encountering problems with erectile dysfunction, diminishing libido and inability to ejaculate.

It all started during the pandemic when my consumption of alcohol at home was a bit excessive.

I noticed that I’ve not been getting any morning erection and experiencing low libido.

Even when I achieved erection, the rigidity was so weak that I cannot complete the penetration.

My wife asked me to consult the doctor, who reckons my alcoholic consumption is the root cause of my problems.

As a result, I was advised by my wife to make a New Year’s resolution to avoid alcohol altogether.

I often considered alcoholic beverages as being helpful in getting couples in the mood for sex.

Can you clarify the impact of mixing booze and sex?

Can alcohol induce sexual dysfunctions?

What levels of alcohol consumption can cause sexual dysfunction?

Can abstinence really restore sexual function completely?

Yours truly,

Boozy Bob

Alcohol has long been portrayed as a form of love potion by many cultures, as it is common belief that alcohol can get individuals to loosen up enhanced excitement and be ready for sexual activities.

Small alcoholic consumption is well recognised to stimulate the production of testosterone in both men and women, enhancing the sexual desire in couples.

Alcohol has also been associated with lowering sexual inhibitions making individuals feel sexier with more sexual confidence.

On the other hand, chronic and persistent alcohol use is known to induce sexual dysfunction, which leads to marked distress and interpersonal difficulty.

Sexual dysfunction in alcohol may be due to the depressant effect of alcohol itself, alcohol-related disease or due to a multitude of psychological forces related to the alcohol use.

The spectrum of sexual dysfunction includes recurrent or persistent, partial or complete failure to attain or maintain an erection, persistent or recurrent deficiency or absence of desire for sexual activity giving rise to marked distress and persistent or recurrent delay in or absence of orgasm. In fact, alcoholic induced erectile dysfunction is often labelled as “whiskey dick”.

Erectile failure in alcoholic men is well documented, erectile dysfunction is found to be significantly higher in men consuming more than three standard units of alcohol (12 g ethanol) daily and in subjects smoking more than 10 cigarettes/day.

One study reported that 61% of patient’s dependent on alcohol reported sexual dysfunction, the most common being erectile dysfunction followed by reduced sexual desire. Erectile dysfunction and reduced sexual desire were frequently seen to be coexisting.

Another study revealed 97 male inpatients admitted for the treatment of alcoholism, 71% suffered from sexual dysfunction for a period of more than 12 months prior to admission to a hospital.

The disturbances noted were diminished sexual desire, ejaculatory incompetence, erectile impotence and even premature ejaculation.

On the other hand, alcoholic consumption is also linked to greater risk-taking in both males and females, it appears to be more of a driving factor for males.

Based on various medical literature, men are more likely to engage in risky sexual behavior, such as intercourse without barrier protection, when under alcoholic influence.

Apart from increasing the risks of sexually transmitted infections, men under excessive alcoholic consumption also increase the risks of engaging in sexual violence.

The exact mechanism of alcohol induced sexual dysfunction is unknown. However, excessive alcoholic consumption is well-recognised to reduce the gonadal testosterone production and neurotoxicity.

Both the endocrinological and neuronal damage are reversible by the cessation of alcohol consumption.

This is echoed by ample evidence that alcohol-induced sexual dysfunction, for the most part, is reversible with alcohol abstinence.

Such information can be used in motivational counselling of heavy drinkers to provide impetus for change.

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