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Prevalence of sexual dysfunction in male subjects with alcohol dependence

Indian J Psychiatry. 2007 Apr-Jun; 49(2): 109–112.

Bijil Simon Arackal

Deaddiction Centre, National Institute of Mental Health and Neurosciences, Bangalore – 560 029, India

Vivek Benegal

Deaddiction Centre, National Institute of Mental Health and Neurosciences, Bangalore – 560 029, India

Deaddiction Centre, National Institute of Mental Health and Neurosciences, Bangalore – 560 029, India

Correspondence: Dr. Vivek Benegal, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore – 560 029, India. E-mail: [email protected]

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

This article has been cited by other articles in PMC.

Abstract

Background:

Chronic and persistent alcohol use is known to induce sexual dysfunction, which leads to marked distress and interpersonal difficulty.

Aim:

We attempted to assess the prevalence of sexual dysfunction in a clinical sample of subjects with alcohol dependence.

Materials and Methods:

One hundred male subjects admitted to a deaddiction centre with a diagnosis of alcohol dependence syndrome with simple withdrawal symptoms (F10.30, ICD-10 criteria) were assessed for sexual dysfunction using a sexual dysfunction checklist, constructed using items from the Diagnostic Criteria for Research [ICD-10] for sexual dysfunction.

Results:

Seventy-two per cent had one or more sexual dysfunction, the most common being premature ejaculation, low sexual desire and erectile dysfunction. The amount of alcohol consumed appeared to be the most significant predictor of developing sexual dysfunction.

Conclusion:

Sexual dysfunction is common in patients with alcohol dependence. Heavy drinking proportionately increases the risk. Clinicians need to routinely assess sexual functioning in alcoholic patients so that other factors contributing to sexual dysfunction can be ruled out.

Keywords: Alcohol dependence, sexual dysfunction

Chronic and persistent alcohol use is known to induce sexual dysfunction, which leads to marked distress and interpersonal difficulty. This, in turn, is known to worsen the alcohol abuse. Sexual dysfunction in the alcoholic 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.[1] The spectrum of sexual dysfunction encompasses:

  1. Decreased sexual desire—persistent or recurrent deficiency or absence of desire for sexual activity giving rise to marked distress and interpersonal difficulty;

  2. Sexual aversion disorder—persistent or recurrent aversion and avoidance of all genital sexual contact leading to marked distress and interpersonal difficulty;

  3. Difficulty in erection—recurrent or persistent, partial or complete failure to attain or maintain an erection until the completion of the sex act;

  4. Difficulty in achieving orgasm—persistent or recurrent delay in or absence of orgasm, following a normal sexual excitement phase;

  5. Premature ejaculation—persistent or recurrent ejaculation with minimal sexual stimulation, before, on or shortly after penetration and before the person wishes it, which causes marked distress. [2]

Alcohol abuse is the leading cause of impotence and other disturbances in sexual dysfunction.[3] Episodic erectile failure in alcoholic men is fairly routine, 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.[4] Van Thiel and Lester[5] reported that 61% of patients 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.[6–9] Vijayasenan,[10] found that of 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 (58%), ejaculatory incompetence (22%), erectile impotence (16%) and premature ejaculation (4%). Virtually all aspects of the human sexual response are affected by alcohol especially sexual desire and erection. [11]

Schiavi et al.[12] failed to find any difference in sexual dysfunction in alcoholics abstinent for 2-3 months in comparison with a nonalcoholic control group, speculating that alcohol-induced sexual dysfunction was reversible with abstinence. The aim of the present study was to estimate the prevalence of sexual dysfunction in males with alcohol dependence. We specifically assessed male subjects admitted to a treatment center with a diagnosis of alcohol dependence syndrome, without obvious hepatic cirrhosis or other co-morbidity. Female patients were excluded from the study as the number of women who use alcohol in India are few and the number of female alcoholics who avail of treatment centers are too few to contribute to significant statistical power. Also, the spectrum of sexual dysfunction is different in the female from the male.

MATERIALS AND METHODS

One hundred male subjects, consecutively admitted to the Deaddiction Centre of the National Institute of Mental Health And NeuroSciences (NIMHANS), Bangalore, India, with a diagnosis of Alcohol Dependence Syndrome With Simple Withdrawal Symptoms (F10. 30, ICD-10 criteria) [WHO][13] were recruited for the study. All subjects gave informed consent for taking part in the study. Subjects were initially assessed on the schedules for clinical assessment in neuropsychiatry (SCAN)[14] by a trained psychiatrist (VB). All patients were subjected to detailed clinical and biochemical examinations including blood glucose and liver enzymes. Patients with significantly high levels of liver enzymes or physical findings suggestive of hepatic cirrhosis were referred for ultrasound assessment of the abdomen.

Subjects were included if they were:

  1. between 20-50 years of age

  2. married or had a regular sexual partner

Patients were excluded if they had a

  1. Clinically assessed history of primary sexual dysfunction [prior to initiation of alcohol use]

  2. Co-morbid physical disorders: diabetes mellitus, hypertension, signs and symptoms suggestive of alcoholic cirrhosis, a clinical diagnosis of endocrine disorders, other systemic illnesses, history of genito-urinary surgery and neurological or spinal cord lesions.

  3. Co-morbid psychiatric disorders: schizophrenia, delusional disorder, anxiety disorders and mood disorders including dysthymia. Patients who had symptoms of depression or anxiety not fulfilling a syndromal diagnosis were included in the study.

  4. Substance use other than alcohol and tobacco.

  5. Use of drugs affecting sexual function (antipsychotics, antidepressants, antihypertensives, steroids, disulfiram etc.)

All the above subjects were assessed for the prevalence of one or more sexual dysfunction experienced over the past 12 months using a sexual dysfunction checklist (Appendix A) by a trained psychiatrist (BSA). The checklist contains items corresponding to 12 areas of sexual dysfunction described in the Diagnostic Criteria for Research, ICD-10 Classification of Mental and Behavioural Disorders.[15] This was necessary as the SCAN does not contain a detailed assessment for the ICD-10 section on Sexual dysfunction not caused by organic disorder or disease (F52). The disorders specifically tapped by the checklist were aversion towards sex, low sexual desire, difficulty in achieving and in maintaining erection, premature ejaculation, inhibited or delayed ejaculation orgasm with flaccid penis, anorgasmia, pain at the time of coitus, dissatisfaction with frequency of intercourse per week (in the last year and in a representative week 5 years earlier), partner and, own sexual function.

Sexual dysfunction was rated for the last one year and temporary or situational complaints were ignored. Data regarding the quantity of alcohol usually consumed per day [in standard drinks; where 1 drink = 30 ml. Spirits = 330 ml. Beer = 1/3 sachet of arrack] and duration of dependence, was extracted from the items corresponding to the section on Mental and Behavioural disorders due to use of alcohol [F10.0] in the SCAN and used in the analyses. However, only the presence or absence of tobacco consumption and not a measure of severity was used for analyses. The ratings were sought after two weeks of inpatient stay after the period of detoxification with benzodiazepines.

RESULTS

The 100 male subjects had a mean age of 37.09 (± 6.74) years. The quantity of alcohol consumed per day was 20.6 (± 9.07) standard drinks [8-42 drinks per day]. The mean duration of alcohol dependence was 8.59 (± 6.64) years. 87% of the subjects also used tobacco [chewing and / or smoking]. Seventy-two of the 100 subjects reported one or more sexual dysfunction. Four (4%) subjects reported aversion to sex to the extent that they had not attempted sexual intercourse in the last one year. Consequently, the prevalence of sexual dysfunction other than aversion to sex and low sexual desire, had to be calculated after excluding these 4 subjects.

Premature ejaculation was reported by 36 out of 96 (37.5%) subjects, out of which, 27 (28.12%) had complaints of ejaculating within the first minute itself and the rest (9.38%) ejaculated within three minutes of intromission. The next most frequent sexual dysfunction reported was low sexual desire, which was reported by 36 out of 100 subjects. Erectile dysfunction was reported by 33.3% of the subjects with difficulty in achieving erection in 19 subjects (19.79%) and difficulty in maintaining erection in 13 subjects (13.54%).

Fourteen subjects (14.58%) had a lack of pleasure at the time of ejaculation (anorgasmia) and 10 (10.41%) had inhibited or delayed ejaculation. Next was the complaint of dissatisfaction with the frequency of sexual intercourse in 26 people (27.03%) and dissatisfaction with own sexual function reported by 19 patients (19.79%).

Nine subjects (9.37%) had dissatisfaction with the sexual relationship with their partner and eight subjects reported (8.33%) orgasm with flaccid penis. Coital pain or feeling of pain in genitals at the time of sexual intercourse was seen in six subjects (6.1%).

There was a significant reduction in the frequency of sexual intercourse per week over the last five years having decreased from a mean of 4.6 (± 2.6) times per week to 2.2 (± 2.2) times per week currently. Forty-eight per cent of the sample had more than one sexual dysfunction. Of the 24 subjects with only one complaint, the most frequent complaint was that of premature ejaculation in 18 subjects.

The number of sexual dysfunction complaints was significantly associated with the amount of alcohol consumed per day. On curve-fitting the data, there was a significant positive linear relationship (F = 10.54; dF 87; P = 0.002) []. However, there was no correlation between the reduction in frequency of sexual intercourse over the last five years and the amount of alcohol consumed.

Linear regression illustrates the predictive relationship between the amount of alcohol consumed and the likelihood of any sexual dysfunction.

There appeared to be no significant correlations between the subjects’ ages and duration of alcohol dependence with the number of complaints of dysfunction. People with tobacco use were no more likely to have more sexual dysfunction than those without tobacco use [t = -1. 32; dF 97; P = 0.19].

DISCUSSION

Sexual dysfunction appears to be common among male subjects with alcohol dependence. Seventy-two per cent of the subjects with alcohol dependence complained of one or more problems with sexual functioning. This is similar to what has been reported in earlier studies.[10,16] Multiple co-existing dysfunctions seemed to be the norm in the sample studied. The most common condition reported in our study was premature ejaculation followed closely by low sexual desire and erectile dysfunction.

The number of symptoms reported appeared to be a function of the amount of alcoholic beverage consumed. The chance of developing sexual dysfunctions appears to increase with increasing quantity of alcohol consumed. Higher levels of alcohol intake may result in greater neurotoxic effects. It has been reported that heavy alcohol use may contribute to a reversible vagal neuropathy, which is perhaps reversible on abstinence.[17] However, chronic heavy use of alcohol is also known to significantly alter gonadal hormones. [9]

There is also a significant population, which has psychogenic sexual dysfunction, which is likely in a situation of marital conflict, which commonly exists in the families of alcoholics.[18] There is some evidence of this with more than a third of the subjects reporting dissatisfaction with their spouses’ responses and / or decreased frequency. This cannot be conclusive without data on nocturnal erection or sexual activity in alternate situations. One of the limitations of this exploratory study is that marital functioning was not specifically assessed.

Counterintuitively, the likelihood of developing sexual dysfunction did not depend on the number of years of alcohol dependence or on the age of the subject. One reason for these findings may be the narrow range of ages at presentation and durations of dependence across the group.

Tobacco use though, was not found to be a significant determinant of sexual dysfunction. This is contrary to all reported evidence.[19] This finding is most likely to be due to our treatment of tobacco use as a categorical (present / absent) variable in a situation where almost 90% of the sample was using tobacco. Future studies need to use indices of severity to avoid this error.

The exclusive focus on male alcoholics was necessitated by the fact that the prevalence of alcohol use by females in India, and consequent alcohol dependence is exceedingly low. Having a non-drinking or low-drinking control sample, would have lent greater depth to these findings.

Nevertheless, this study highlights the ubiquitousness of sexual problems in the heavy-drinking population. It also stresses the need for addiction medicine specialists to note the possibility of sexual problems in their clients. In addition, it highlights the need for sexual medicine specialists to consider the effects of heavy alcohol use on sexual functioning. However, there is ample evidence that alcohol-induced sexual dysfunction, for the most part, is reversible with cessation of alcohol use.[18] Thus, this information can be used in motivational counselling of heavy drinkers to provide impetus for change. Clinicians are well advised to routinely assess sexual functioning in patients with alcohol dependence.

Appendix A

Sexual dysfunction checklist

In the past 12 months… Yes = 1 No = 0
Global Situational
  1. Has the prospect of having sex with your partner produced such aversion, fear or anxiety that you avoided any sexual activity (Aversion to sex)?

  2. Have you had a lack or loss of sexual desire, which has led you to initiating sexual activity with your partner or engaging in solitary masturbation, at a frequency clearly lower than previous levels (Low sexual desire)?

  3. Have you had a difficulty in getting an erection sufficient for intercourse (Difficulty achieving erection)?

  4. Have you had difficulty in maintaining erection (full erection occurs during the early stages of lovemaking but disappears when intercourse is attempted or before ejaculation if it occurs) (Difficulty maintaining erection)?

  5. Have you found that frequently (or always) you have ejaculated before you would like to: before entry?

    < 1 min?

    < 3 min?

    (Premature ejaculation)

  6. Have you frequently had problems in ejaculating even when erect (Inhibited / delayed ejaculation)?

  7. Have you ever ejaculated without getting full erection (Orgasm with flaccid penis)?

  8. Do you have difficulty in reaching the peak of pleasure at the time of ejaculation (Anorgasmia)?

  9. Have you felt pain in the genitals during sexual intercourse (Coital pain)?

  10. Are you satisfied with the frequency of sex (Frequency dissatisfaction)?

  11. Are you satisfied with your sexual relationship with your partner (Dissatisfaction of sexual relation with partner)?

  12. Are you satisfied with your sexual performance (Dissatisfaction with own sexual function)?

Footnotes

Source of Support: Nil

Conflict of Interest: None declared

REFERENCES

1. Gelder M, Gath D, Mayon R, Cowen P. Oxford Text book of Psychiatry. 3rd ed. Oxford, UK: Oxford University Press; 1996. Etiology of sexual dysfunction. [Google Scholar]2. American Psychiatric Association: Diagnostic and Statistical Manual. 4th ed. Washington DC: American Psychiatric Association; 1994. [Google Scholar]3. Mendelson JH, Mello NK. Medical progress, Biologic concomitants of Alcoholism. N Engl J Med. 1979;301:912–21. [PubMed] [Google Scholar]4. Mirone V, Ricci E, Gentile V, Basile Fasolo C, Parazzini F. Determinants of erectile dysfunction risk in a large series of Italian men attending andrology clinics. Eur Urol. 2004;45:87–91. [PubMed] [Google Scholar]5. Van Thiel DH, Lester R. The effect of chronic alcohol abuse on sexual function. th Clin Endocrinol Metab. 1979;8:499–510. [PubMed] [Google Scholar]6. Jensen SB, Gludd C. Sexual dysfunction in men with alcoholic liver cirrhosis: A comparative study. Liver. 1985;5:94–100. [PubMed] [Google Scholar]7. Fahrner EM. Sexual dysfunction in male alcohol addicts, prevalence and treatment. Arch Sex Behav. 1987;16:247–57. [PubMed] [Google Scholar]8. Fagan PJ, Schmidt CW, Wise TN, Derogatis LR. Alcoholism in patients with sexual disorders. J Sex Marital Ther. 1988;14:245–52. [PubMed] [Google Scholar]9. Gumus B, Yigitoglu MR, Lekili M, Vyanik BS, Muezzinoglu T, Buyuksu C. Effect of long term alcohol abuse on male sexual function and serum gonadal hormone levels. Int Urol Nephrol. 1998;30:755–9. [PubMed] [Google Scholar]11. Miller NS, Gold MS. The human sexual response and alcohol and drugs. J Subst Abuse Treat. 1988;5:171–7. [PubMed] [Google Scholar]12. Schiavi RC, Stimmel BB, Mandelli J, White D. Chronic alcoholism and male sexual function. Am J Psychiatry. 1995;152:1045–51. [PubMed] [Google Scholar]13. World Health Organization, Geneva 1992 . The ICD 10 Classification of Mental and Behavioral disorders. Oxford University Press; 1994. Clinical descriptions and diagnostic guidelines. [Google Scholar]14. Wing JK, Babor T, Brugha T, Burke J, Cooper JE, Giel R, et al. SCAN. Schedules for clinical assessment in neuropsychiatry. Arch Gen Psychiatry. 1990;47:589–93. [PubMed] [Google Scholar]15. World Health Organization. The ICD-10 classification of mental and behavioral disorders: Diagnostic criteria for research. Geneva: World Health Organization; 1993. [Google Scholar]16. Jensen SB. Sexual function and dysfunction in younger married alcoholics. A comparative study. Acta Psychiatr Scand. 1984;69:543–9. [PubMed] [Google Scholar]17. Villalta J, Estruch R, Antunez E, Valls J, Urbano-Marquez A. Vagal neuropathy in chronic alcoholics: Relation to ethanol consumption. Alcohol Alcohol. 1989;24:421–8. [PubMed] [Google Scholar]18. Van Thiel DH, Gavaler JS, Sanghvi A. Recovery of sexual function in abstinent alcoholic men. Gastroenterology. 1983;84:677–82. [PubMed] [Google Scholar]19. Corona G, Mannucci E, Petrone L, Ricca V, Mansani R, Cilotti A, et al. Psychobiological correlates of smoking in patients with erectile dysfunction. Int J Impot Res. 2005;17:527–34. [PubMed] [Google Scholar]

Prevalence of sexual dysfunction in male subjects with alcohol dependence

Indian J Psychiatry. 2007 Apr-Jun; 49(2): 109–112.

Bijil Simon Arackal

Deaddiction Centre, National Institute of Mental Health and Neurosciences, Bangalore – 560 029, India

Vivek Benegal

Deaddiction Centre, National Institute of Mental Health and Neurosciences, Bangalore – 560 029, India

Deaddiction Centre, National Institute of Mental Health and Neurosciences, Bangalore – 560 029, India

Correspondence: Dr. Vivek Benegal, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore – 560 029, India. E-mail: [email protected]

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

This article has been cited by other articles in PMC.

Abstract

Background:

Chronic and persistent alcohol use is known to induce sexual dysfunction, which leads to marked distress and interpersonal difficulty.

Aim:

We attempted to assess the prevalence of sexual dysfunction in a clinical sample of subjects with alcohol dependence.

Materials and Methods:

One hundred male subjects admitted to a deaddiction centre with a diagnosis of alcohol dependence syndrome with simple withdrawal symptoms (F10.30, ICD-10 criteria) were assessed for sexual dysfunction using a sexual dysfunction checklist, constructed using items from the Diagnostic Criteria for Research [ICD-10] for sexual dysfunction.

Results:

Seventy-two per cent had one or more sexual dysfunction, the most common being premature ejaculation, low sexual desire and erectile dysfunction. The amount of alcohol consumed appeared to be the most significant predictor of developing sexual dysfunction.

Conclusion:

Sexual dysfunction is common in patients with alcohol dependence. Heavy drinking proportionately increases the risk. Clinicians need to routinely assess sexual functioning in alcoholic patients so that other factors contributing to sexual dysfunction can be ruled out.

Keywords: Alcohol dependence, sexual dysfunction

Chronic and persistent alcohol use is known to induce sexual dysfunction, which leads to marked distress and interpersonal difficulty. This, in turn, is known to worsen the alcohol abuse. Sexual dysfunction in the alcoholic 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.[1] The spectrum of sexual dysfunction encompasses:

  1. Decreased sexual desire—persistent or recurrent deficiency or absence of desire for sexual activity giving rise to marked distress and interpersonal difficulty;

  2. Sexual aversion disorder—persistent or recurrent aversion and avoidance of all genital sexual contact leading to marked distress and interpersonal difficulty;

  3. Difficulty in erection—recurrent or persistent, partial or complete failure to attain or maintain an erection until the completion of the sex act;

  4. Difficulty in achieving orgasm—persistent or recurrent delay in or absence of orgasm, following a normal sexual excitement phase;

  5. Premature ejaculation—persistent or recurrent ejaculation with minimal sexual stimulation, before, on or shortly after penetration and before the person wishes it, which causes marked distress. [2]

Alcohol abuse is the leading cause of impotence and other disturbances in sexual dysfunction.[3] Episodic erectile failure in alcoholic men is fairly routine, 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.[4] Van Thiel and Lester[5] reported that 61% of patients 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.[6–9] Vijayasenan,[10] found that of 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 (58%), ejaculatory incompetence (22%), erectile impotence (16%) and premature ejaculation (4%). Virtually all aspects of the human sexual response are affected by alcohol especially sexual desire and erection. [11]

Schiavi et al.[12] failed to find any difference in sexual dysfunction in alcoholics abstinent for 2-3 months in comparison with a nonalcoholic control group, speculating that alcohol-induced sexual dysfunction was reversible with abstinence. The aim of the present study was to estimate the prevalence of sexual dysfunction in males with alcohol dependence. We specifically assessed male subjects admitted to a treatment center with a diagnosis of alcohol dependence syndrome, without obvious hepatic cirrhosis or other co-morbidity. Female patients were excluded from the study as the number of women who use alcohol in India are few and the number of female alcoholics who avail of treatment centers are too few to contribute to significant statistical power. Also, the spectrum of sexual dysfunction is different in the female from the male.

MATERIALS AND METHODS

One hundred male subjects, consecutively admitted to the Deaddiction Centre of the National Institute of Mental Health And NeuroSciences (NIMHANS), Bangalore, India, with a diagnosis of Alcohol Dependence Syndrome With Simple Withdrawal Symptoms (F10. 30, ICD-10 criteria) [WHO][13] were recruited for the study. All subjects gave informed consent for taking part in the study. Subjects were initially assessed on the schedules for clinical assessment in neuropsychiatry (SCAN)[14] by a trained psychiatrist (VB). All patients were subjected to detailed clinical and biochemical examinations including blood glucose and liver enzymes. Patients with significantly high levels of liver enzymes or physical findings suggestive of hepatic cirrhosis were referred for ultrasound assessment of the abdomen.

Subjects were included if they were:

  1. between 20-50 years of age

  2. married or had a regular sexual partner

Patients were excluded if they had a

  1. Clinically assessed history of primary sexual dysfunction [prior to initiation of alcohol use]

  2. Co-morbid physical disorders: diabetes mellitus, hypertension, signs and symptoms suggestive of alcoholic cirrhosis, a clinical diagnosis of endocrine disorders, other systemic illnesses, history of genito-urinary surgery and neurological or spinal cord lesions.

  3. Co-morbid psychiatric disorders: schizophrenia, delusional disorder, anxiety disorders and mood disorders including dysthymia. Patients who had symptoms of depression or anxiety not fulfilling a syndromal diagnosis were included in the study.

  4. Substance use other than alcohol and tobacco.

  5. Use of drugs affecting sexual function (antipsychotics, antidepressants, antihypertensives, steroids, disulfiram etc.)

All the above subjects were assessed for the prevalence of one or more sexual dysfunction experienced over the past 12 months using a sexual dysfunction checklist (Appendix A) by a trained psychiatrist (BSA). The checklist contains items corresponding to 12 areas of sexual dysfunction described in the Diagnostic Criteria for Research, ICD-10 Classification of Mental and Behavioural Disorders.[15] This was necessary as the SCAN does not contain a detailed assessment for the ICD-10 section on Sexual dysfunction not caused by organic disorder or disease (F52). The disorders specifically tapped by the checklist were aversion towards sex, low sexual desire, difficulty in achieving and in maintaining erection, premature ejaculation, inhibited or delayed ejaculation orgasm with flaccid penis, anorgasmia, pain at the time of coitus, dissatisfaction with frequency of intercourse per week (in the last year and in a representative week 5 years earlier), partner and, own sexual function.

Sexual dysfunction was rated for the last one year and temporary or situational complaints were ignored. Data regarding the quantity of alcohol usually consumed per day [in standard drinks; where 1 drink = 30 ml. Spirits = 330 ml. Beer = 1/3 sachet of arrack] and duration of dependence, was extracted from the items corresponding to the section on Mental and Behavioural disorders due to use of alcohol [F10.0] in the SCAN and used in the analyses. However, only the presence or absence of tobacco consumption and not a measure of severity was used for analyses. The ratings were sought after two weeks of inpatient stay after the period of detoxification with benzodiazepines.

RESULTS

The 100 male subjects had a mean age of 37.09 (± 6.74) years. The quantity of alcohol consumed per day was 20.6 (± 9.07) standard drinks [8-42 drinks per day]. The mean duration of alcohol dependence was 8.59 (± 6.64) years. 87% of the subjects also used tobacco [chewing and / or smoking]. Seventy-two of the 100 subjects reported one or more sexual dysfunction. Four (4%) subjects reported aversion to sex to the extent that they had not attempted sexual intercourse in the last one year. Consequently, the prevalence of sexual dysfunction other than aversion to sex and low sexual desire, had to be calculated after excluding these 4 subjects.

Premature ejaculation was reported by 36 out of 96 (37.5%) subjects, out of which, 27 (28.12%) had complaints of ejaculating within the first minute itself and the rest (9.38%) ejaculated within three minutes of intromission. The next most frequent sexual dysfunction reported was low sexual desire, which was reported by 36 out of 100 subjects. Erectile dysfunction was reported by 33.3% of the subjects with difficulty in achieving erection in 19 subjects (19.79%) and difficulty in maintaining erection in 13 subjects (13.54%).

Fourteen subjects (14.58%) had a lack of pleasure at the time of ejaculation (anorgasmia) and 10 (10.41%) had inhibited or delayed ejaculation. Next was the complaint of dissatisfaction with the frequency of sexual intercourse in 26 people (27.03%) and dissatisfaction with own sexual function reported by 19 patients (19.79%).

Nine subjects (9.37%) had dissatisfaction with the sexual relationship with their partner and eight subjects reported (8.33%) orgasm with flaccid penis. Coital pain or feeling of pain in genitals at the time of sexual intercourse was seen in six subjects (6.1%).

There was a significant reduction in the frequency of sexual intercourse per week over the last five years having decreased from a mean of 4.6 (± 2.6) times per week to 2.2 (± 2.2) times per week currently. Forty-eight per cent of the sample had more than one sexual dysfunction. Of the 24 subjects with only one complaint, the most frequent complaint was that of premature ejaculation in 18 subjects.

The number of sexual dysfunction complaints was significantly associated with the amount of alcohol consumed per day. On curve-fitting the data, there was a significant positive linear relationship (F = 10.54; dF 87; P = 0.002) []. However, there was no correlation between the reduction in frequency of sexual intercourse over the last five years and the amount of alcohol consumed.

Linear regression illustrates the predictive relationship between the amount of alcohol consumed and the likelihood of any sexual dysfunction.

There appeared to be no significant correlations between the subjects’ ages and duration of alcohol dependence with the number of complaints of dysfunction. People with tobacco use were no more likely to have more sexual dysfunction than those without tobacco use [t = -1. 32; dF 97; P = 0.19].

DISCUSSION

Sexual dysfunction appears to be common among male subjects with alcohol dependence. Seventy-two per cent of the subjects with alcohol dependence complained of one or more problems with sexual functioning. This is similar to what has been reported in earlier studies.[10,16] Multiple co-existing dysfunctions seemed to be the norm in the sample studied. The most common condition reported in our study was premature ejaculation followed closely by low sexual desire and erectile dysfunction.

The number of symptoms reported appeared to be a function of the amount of alcoholic beverage consumed. The chance of developing sexual dysfunctions appears to increase with increasing quantity of alcohol consumed. Higher levels of alcohol intake may result in greater neurotoxic effects. It has been reported that heavy alcohol use may contribute to a reversible vagal neuropathy, which is perhaps reversible on abstinence.[17] However, chronic heavy use of alcohol is also known to significantly alter gonadal hormones. [9]

There is also a significant population, which has psychogenic sexual dysfunction, which is likely in a situation of marital conflict, which commonly exists in the families of alcoholics.[18] There is some evidence of this with more than a third of the subjects reporting dissatisfaction with their spouses’ responses and / or decreased frequency. This cannot be conclusive without data on nocturnal erection or sexual activity in alternate situations. One of the limitations of this exploratory study is that marital functioning was not specifically assessed.

Counterintuitively, the likelihood of developing sexual dysfunction did not depend on the number of years of alcohol dependence or on the age of the subject. One reason for these findings may be the narrow range of ages at presentation and durations of dependence across the group.

Tobacco use though, was not found to be a significant determinant of sexual dysfunction. This is contrary to all reported evidence.[19] This finding is most likely to be due to our treatment of tobacco use as a categorical (present / absent) variable in a situation where almost 90% of the sample was using tobacco. Future studies need to use indices of severity to avoid this error.

The exclusive focus on male alcoholics was necessitated by the fact that the prevalence of alcohol use by females in India, and consequent alcohol dependence is exceedingly low. Having a non-drinking or low-drinking control sample, would have lent greater depth to these findings.

Nevertheless, this study highlights the ubiquitousness of sexual problems in the heavy-drinking population. It also stresses the need for addiction medicine specialists to note the possibility of sexual problems in their clients. In addition, it highlights the need for sexual medicine specialists to consider the effects of heavy alcohol use on sexual functioning. However, there is ample evidence that alcohol-induced sexual dysfunction, for the most part, is reversible with cessation of alcohol use.[18] Thus, this information can be used in motivational counselling of heavy drinkers to provide impetus for change. Clinicians are well advised to routinely assess sexual functioning in patients with alcohol dependence.

Appendix A

Sexual dysfunction checklist

In the past 12 months… Yes = 1 No = 0
Global Situational
  1. Has the prospect of having sex with your partner produced such aversion, fear or anxiety that you avoided any sexual activity (Aversion to sex)?

  2. Have you had a lack or loss of sexual desire, which has led you to initiating sexual activity with your partner or engaging in solitary masturbation, at a frequency clearly lower than previous levels (Low sexual desire)?

  3. Have you had a difficulty in getting an erection sufficient for intercourse (Difficulty achieving erection)?

  4. Have you had difficulty in maintaining erection (full erection occurs during the early stages of lovemaking but disappears when intercourse is attempted or before ejaculation if it occurs) (Difficulty maintaining erection)?

  5. Have you found that frequently (or always) you have ejaculated before you would like to: before entry?

    < 1 min?

    < 3 min?

    (Premature ejaculation)

  6. Have you frequently had problems in ejaculating even when erect (Inhibited / delayed ejaculation)?

  7. Have you ever ejaculated without getting full erection (Orgasm with flaccid penis)?

  8. Do you have difficulty in reaching the peak of pleasure at the time of ejaculation (Anorgasmia)?

  9. Have you felt pain in the genitals during sexual intercourse (Coital pain)?

  10. Are you satisfied with the frequency of sex (Frequency dissatisfaction)?

  11. Are you satisfied with your sexual relationship with your partner (Dissatisfaction of sexual relation with partner)?

  12. Are you satisfied with your sexual performance (Dissatisfaction with own sexual function)?

Footnotes

Source of Support: Nil

Conflict of Interest: None declared

REFERENCES

1. Gelder M, Gath D, Mayon R, Cowen P. Oxford Text book of Psychiatry. 3rd ed. Oxford, UK: Oxford University Press; 1996. Etiology of sexual dysfunction. [Google Scholar]2. American Psychiatric Association: Diagnostic and Statistical Manual. 4th ed. Washington DC: American Psychiatric Association; 1994. [Google Scholar]3. Mendelson JH, Mello NK. Medical progress, Biologic concomitants of Alcoholism. N Engl J Med. 1979;301:912–21. [PubMed] [Google Scholar]4. Mirone V, Ricci E, Gentile V, Basile Fasolo C, Parazzini F. Determinants of erectile dysfunction risk in a large series of Italian men attending andrology clinics. Eur Urol. 2004;45:87–91. [PubMed] [Google Scholar]5. Van Thiel DH, Lester R. The effect of chronic alcohol abuse on sexual function. th Clin Endocrinol Metab. 1979;8:499–510. [PubMed] [Google Scholar]6. Jensen SB, Gludd C. Sexual dysfunction in men with alcoholic liver cirrhosis: A comparative study. Liver. 1985;5:94–100. [PubMed] [Google Scholar]7. Fahrner EM. Sexual dysfunction in male alcohol addicts, prevalence and treatment. Arch Sex Behav. 1987;16:247–57. [PubMed] [Google Scholar]8. Fagan PJ, Schmidt CW, Wise TN, Derogatis LR. Alcoholism in patients with sexual disorders. J Sex Marital Ther. 1988;14:245–52. [PubMed] [Google Scholar]9. Gumus B, Yigitoglu MR, Lekili M, Vyanik BS, Muezzinoglu T, Buyuksu C. Effect of long term alcohol abuse on male sexual function and serum gonadal hormone levels. Int Urol Nephrol. 1998;30:755–9. [PubMed] [Google Scholar]11. Miller NS, Gold MS. The human sexual response and alcohol and drugs. J Subst Abuse Treat. 1988;5:171–7. [PubMed] [Google Scholar]12. Schiavi RC, Stimmel BB, Mandelli J, White D. Chronic alcoholism and male sexual function. Am J Psychiatry. 1995;152:1045–51. [PubMed] [Google Scholar]13. World Health Organization, Geneva 1992 . The ICD 10 Classification of Mental and Behavioral disorders. Oxford University Press; 1994. Clinical descriptions and diagnostic guidelines. [Google Scholar]14. Wing JK, Babor T, Brugha T, Burke J, Cooper JE, Giel R, et al. SCAN. Schedules for clinical assessment in neuropsychiatry. Arch Gen Psychiatry. 1990;47:589–93. [PubMed] [Google Scholar]15. World Health Organization. The ICD-10 classification of mental and behavioral disorders: Diagnostic criteria for research. Geneva: World Health Organization; 1993. [Google Scholar]16. Jensen SB. Sexual function and dysfunction in younger married alcoholics. A comparative study. Acta Psychiatr Scand. 1984;69:543–9. [PubMed] [Google Scholar]17. Villalta J, Estruch R, Antunez E, Valls J, Urbano-Marquez A. Vagal neuropathy in chronic alcoholics: Relation to ethanol consumption. Alcohol Alcohol. 1989;24:421–8. [PubMed] [Google Scholar]18. Van Thiel DH, Gavaler JS, Sanghvi A. Recovery of sexual function in abstinent alcoholic men. Gastroenterology. 1983;84:677–82. [PubMed] [Google Scholar]19. Corona G, Mannucci E, Petrone L, Ricca V, Mansani R, Cilotti A, et al. Psychobiological correlates of smoking in patients with erectile dysfunction. Int J Impot Res. 2005;17:527–34. [PubMed] [Google Scholar]

Prevalence of sexual dysfunction in male subjects with alcohol dependence

Indian J Psychiatry. 2007 Apr-Jun; 49(2): 109–112.

Bijil Simon Arackal

Deaddiction Centre, National Institute of Mental Health and Neurosciences, Bangalore – 560 029, India

Vivek Benegal

Deaddiction Centre, National Institute of Mental Health and Neurosciences, Bangalore – 560 029, India

Deaddiction Centre, National Institute of Mental Health and Neurosciences, Bangalore – 560 029, India

Correspondence: Dr. Vivek Benegal, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore – 560 029, India. E-mail: [email protected]

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

This article has been cited by other articles in PMC.

Abstract

Background:

Chronic and persistent alcohol use is known to induce sexual dysfunction, which leads to marked distress and interpersonal difficulty.

Aim:

We attempted to assess the prevalence of sexual dysfunction in a clinical sample of subjects with alcohol dependence.

Materials and Methods:

One hundred male subjects admitted to a deaddiction centre with a diagnosis of alcohol dependence syndrome with simple withdrawal symptoms (F10.30, ICD-10 criteria) were assessed for sexual dysfunction using a sexual dysfunction checklist, constructed using items from the Diagnostic Criteria for Research [ICD-10] for sexual dysfunction.

Results:

Seventy-two per cent had one or more sexual dysfunction, the most common being premature ejaculation, low sexual desire and erectile dysfunction. The amount of alcohol consumed appeared to be the most significant predictor of developing sexual dysfunction.

Conclusion:

Sexual dysfunction is common in patients with alcohol dependence. Heavy drinking proportionately increases the risk. Clinicians need to routinely assess sexual functioning in alcoholic patients so that other factors contributing to sexual dysfunction can be ruled out.

Keywords: Alcohol dependence, sexual dysfunction

Chronic and persistent alcohol use is known to induce sexual dysfunction, which leads to marked distress and interpersonal difficulty. This, in turn, is known to worsen the alcohol abuse. Sexual dysfunction in the alcoholic 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.[1] The spectrum of sexual dysfunction encompasses:

  1. Decreased sexual desire—persistent or recurrent deficiency or absence of desire for sexual activity giving rise to marked distress and interpersonal difficulty;

  2. Sexual aversion disorder—persistent or recurrent aversion and avoidance of all genital sexual contact leading to marked distress and interpersonal difficulty;

  3. Difficulty in erection—recurrent or persistent, partial or complete failure to attain or maintain an erection until the completion of the sex act;

  4. Difficulty in achieving orgasm—persistent or recurrent delay in or absence of orgasm, following a normal sexual excitement phase;

  5. Premature ejaculation—persistent or recurrent ejaculation with minimal sexual stimulation, before, on or shortly after penetration and before the person wishes it, which causes marked distress. [2]

Alcohol abuse is the leading cause of impotence and other disturbances in sexual dysfunction.[3] Episodic erectile failure in alcoholic men is fairly routine, 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.[4] Van Thiel and Lester[5] reported that 61% of patients 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.[6–9] Vijayasenan,[10] found that of 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 (58%), ejaculatory incompetence (22%), erectile impotence (16%) and premature ejaculation (4%). Virtually all aspects of the human sexual response are affected by alcohol especially sexual desire and erection. [11]

Schiavi et al.[12] failed to find any difference in sexual dysfunction in alcoholics abstinent for 2-3 months in comparison with a nonalcoholic control group, speculating that alcohol-induced sexual dysfunction was reversible with abstinence. The aim of the present study was to estimate the prevalence of sexual dysfunction in males with alcohol dependence. We specifically assessed male subjects admitted to a treatment center with a diagnosis of alcohol dependence syndrome, without obvious hepatic cirrhosis or other co-morbidity. Female patients were excluded from the study as the number of women who use alcohol in India are few and the number of female alcoholics who avail of treatment centers are too few to contribute to significant statistical power. Also, the spectrum of sexual dysfunction is different in the female from the male.

MATERIALS AND METHODS

One hundred male subjects, consecutively admitted to the Deaddiction Centre of the National Institute of Mental Health And NeuroSciences (NIMHANS), Bangalore, India, with a diagnosis of Alcohol Dependence Syndrome With Simple Withdrawal Symptoms (F10. 30, ICD-10 criteria) [WHO][13] were recruited for the study. All subjects gave informed consent for taking part in the study. Subjects were initially assessed on the schedules for clinical assessment in neuropsychiatry (SCAN)[14] by a trained psychiatrist (VB). All patients were subjected to detailed clinical and biochemical examinations including blood glucose and liver enzymes. Patients with significantly high levels of liver enzymes or physical findings suggestive of hepatic cirrhosis were referred for ultrasound assessment of the abdomen.

Subjects were included if they were:

  1. between 20-50 years of age

  2. married or had a regular sexual partner

Patients were excluded if they had a

  1. Clinically assessed history of primary sexual dysfunction [prior to initiation of alcohol use]

  2. Co-morbid physical disorders: diabetes mellitus, hypertension, signs and symptoms suggestive of alcoholic cirrhosis, a clinical diagnosis of endocrine disorders, other systemic illnesses, history of genito-urinary surgery and neurological or spinal cord lesions.

  3. Co-morbid psychiatric disorders: schizophrenia, delusional disorder, anxiety disorders and mood disorders including dysthymia. Patients who had symptoms of depression or anxiety not fulfilling a syndromal diagnosis were included in the study.

  4. Substance use other than alcohol and tobacco.

  5. Use of drugs affecting sexual function (antipsychotics, antidepressants, antihypertensives, steroids, disulfiram etc.)

All the above subjects were assessed for the prevalence of one or more sexual dysfunction experienced over the past 12 months using a sexual dysfunction checklist (Appendix A) by a trained psychiatrist (BSA). The checklist contains items corresponding to 12 areas of sexual dysfunction described in the Diagnostic Criteria for Research, ICD-10 Classification of Mental and Behavioural Disorders.[15] This was necessary as the SCAN does not contain a detailed assessment for the ICD-10 section on Sexual dysfunction not caused by organic disorder or disease (F52). The disorders specifically tapped by the checklist were aversion towards sex, low sexual desire, difficulty in achieving and in maintaining erection, premature ejaculation, inhibited or delayed ejaculation orgasm with flaccid penis, anorgasmia, pain at the time of coitus, dissatisfaction with frequency of intercourse per week (in the last year and in a representative week 5 years earlier), partner and, own sexual function.

Sexual dysfunction was rated for the last one year and temporary or situational complaints were ignored. Data regarding the quantity of alcohol usually consumed per day [in standard drinks; where 1 drink = 30 ml. Spirits = 330 ml. Beer = 1/3 sachet of arrack] and duration of dependence, was extracted from the items corresponding to the section on Mental and Behavioural disorders due to use of alcohol [F10.0] in the SCAN and used in the analyses. However, only the presence or absence of tobacco consumption and not a measure of severity was used for analyses. The ratings were sought after two weeks of inpatient stay after the period of detoxification with benzodiazepines.

RESULTS

The 100 male subjects had a mean age of 37.09 (± 6.74) years. The quantity of alcohol consumed per day was 20.6 (± 9.07) standard drinks [8-42 drinks per day]. The mean duration of alcohol dependence was 8.59 (± 6.64) years. 87% of the subjects also used tobacco [chewing and / or smoking]. Seventy-two of the 100 subjects reported one or more sexual dysfunction. Four (4%) subjects reported aversion to sex to the extent that they had not attempted sexual intercourse in the last one year. Consequently, the prevalence of sexual dysfunction other than aversion to sex and low sexual desire, had to be calculated after excluding these 4 subjects.

Premature ejaculation was reported by 36 out of 96 (37.5%) subjects, out of which, 27 (28.12%) had complaints of ejaculating within the first minute itself and the rest (9.38%) ejaculated within three minutes of intromission. The next most frequent sexual dysfunction reported was low sexual desire, which was reported by 36 out of 100 subjects. Erectile dysfunction was reported by 33.3% of the subjects with difficulty in achieving erection in 19 subjects (19.79%) and difficulty in maintaining erection in 13 subjects (13.54%).

Fourteen subjects (14.58%) had a lack of pleasure at the time of ejaculation (anorgasmia) and 10 (10.41%) had inhibited or delayed ejaculation. Next was the complaint of dissatisfaction with the frequency of sexual intercourse in 26 people (27.03%) and dissatisfaction with own sexual function reported by 19 patients (19.79%).

Nine subjects (9.37%) had dissatisfaction with the sexual relationship with their partner and eight subjects reported (8.33%) orgasm with flaccid penis. Coital pain or feeling of pain in genitals at the time of sexual intercourse was seen in six subjects (6.1%).

There was a significant reduction in the frequency of sexual intercourse per week over the last five years having decreased from a mean of 4.6 (± 2.6) times per week to 2.2 (± 2.2) times per week currently. Forty-eight per cent of the sample had more than one sexual dysfunction. Of the 24 subjects with only one complaint, the most frequent complaint was that of premature ejaculation in 18 subjects.

The number of sexual dysfunction complaints was significantly associated with the amount of alcohol consumed per day. On curve-fitting the data, there was a significant positive linear relationship (F = 10.54; dF 87; P = 0.002) []. However, there was no correlation between the reduction in frequency of sexual intercourse over the last five years and the amount of alcohol consumed.

Linear regression illustrates the predictive relationship between the amount of alcohol consumed and the likelihood of any sexual dysfunction.

There appeared to be no significant correlations between the subjects’ ages and duration of alcohol dependence with the number of complaints of dysfunction. People with tobacco use were no more likely to have more sexual dysfunction than those without tobacco use [t = -1. 32; dF 97; P = 0.19].

DISCUSSION

Sexual dysfunction appears to be common among male subjects with alcohol dependence. Seventy-two per cent of the subjects with alcohol dependence complained of one or more problems with sexual functioning. This is similar to what has been reported in earlier studies.[10,16] Multiple co-existing dysfunctions seemed to be the norm in the sample studied. The most common condition reported in our study was premature ejaculation followed closely by low sexual desire and erectile dysfunction.

The number of symptoms reported appeared to be a function of the amount of alcoholic beverage consumed. The chance of developing sexual dysfunctions appears to increase with increasing quantity of alcohol consumed. Higher levels of alcohol intake may result in greater neurotoxic effects. It has been reported that heavy alcohol use may contribute to a reversible vagal neuropathy, which is perhaps reversible on abstinence.[17] However, chronic heavy use of alcohol is also known to significantly alter gonadal hormones. [9]

There is also a significant population, which has psychogenic sexual dysfunction, which is likely in a situation of marital conflict, which commonly exists in the families of alcoholics.[18] There is some evidence of this with more than a third of the subjects reporting dissatisfaction with their spouses’ responses and / or decreased frequency. This cannot be conclusive without data on nocturnal erection or sexual activity in alternate situations. One of the limitations of this exploratory study is that marital functioning was not specifically assessed.

Counterintuitively, the likelihood of developing sexual dysfunction did not depend on the number of years of alcohol dependence or on the age of the subject. One reason for these findings may be the narrow range of ages at presentation and durations of dependence across the group.

Tobacco use though, was not found to be a significant determinant of sexual dysfunction. This is contrary to all reported evidence.[19] This finding is most likely to be due to our treatment of tobacco use as a categorical (present / absent) variable in a situation where almost 90% of the sample was using tobacco. Future studies need to use indices of severity to avoid this error.

The exclusive focus on male alcoholics was necessitated by the fact that the prevalence of alcohol use by females in India, and consequent alcohol dependence is exceedingly low. Having a non-drinking or low-drinking control sample, would have lent greater depth to these findings.

Nevertheless, this study highlights the ubiquitousness of sexual problems in the heavy-drinking population. It also stresses the need for addiction medicine specialists to note the possibility of sexual problems in their clients. In addition, it highlights the need for sexual medicine specialists to consider the effects of heavy alcohol use on sexual functioning. However, there is ample evidence that alcohol-induced sexual dysfunction, for the most part, is reversible with cessation of alcohol use.[18] Thus, this information can be used in motivational counselling of heavy drinkers to provide impetus for change. Clinicians are well advised to routinely assess sexual functioning in patients with alcohol dependence.

Appendix A

Sexual dysfunction checklist

In the past 12 months… Yes = 1 No = 0
Global Situational
  1. Has the prospect of having sex with your partner produced such aversion, fear or anxiety that you avoided any sexual activity (Aversion to sex)?

  2. Have you had a lack or loss of sexual desire, which has led you to initiating sexual activity with your partner or engaging in solitary masturbation, at a frequency clearly lower than previous levels (Low sexual desire)?

  3. Have you had a difficulty in getting an erection sufficient for intercourse (Difficulty achieving erection)?

  4. Have you had difficulty in maintaining erection (full erection occurs during the early stages of lovemaking but disappears when intercourse is attempted or before ejaculation if it occurs) (Difficulty maintaining erection)?

  5. Have you found that frequently (or always) you have ejaculated before you would like to: before entry?

    < 1 min?

    < 3 min?

    (Premature ejaculation)

  6. Have you frequently had problems in ejaculating even when erect (Inhibited / delayed ejaculation)?

  7. Have you ever ejaculated without getting full erection (Orgasm with flaccid penis)?

  8. Do you have difficulty in reaching the peak of pleasure at the time of ejaculation (Anorgasmia)?

  9. Have you felt pain in the genitals during sexual intercourse (Coital pain)?

  10. Are you satisfied with the frequency of sex (Frequency dissatisfaction)?

  11. Are you satisfied with your sexual relationship with your partner (Dissatisfaction of sexual relation with partner)?

  12. Are you satisfied with your sexual performance (Dissatisfaction with own sexual function)?

Footnotes

Source of Support: Nil

Conflict of Interest: None declared

REFERENCES

1. Gelder M, Gath D, Mayon R, Cowen P. Oxford Text book of Psychiatry. 3rd ed. Oxford, UK: Oxford University Press; 1996. Etiology of sexual dysfunction. [Google Scholar]2. American Psychiatric Association: Diagnostic and Statistical Manual. 4th ed. Washington DC: American Psychiatric Association; 1994. [Google Scholar]3. Mendelson JH, Mello NK. Medical progress, Biologic concomitants of Alcoholism. N Engl J Med. 1979;301:912–21. [PubMed] [Google Scholar]4. Mirone V, Ricci E, Gentile V, Basile Fasolo C, Parazzini F. Determinants of erectile dysfunction risk in a large series of Italian men attending andrology clinics. Eur Urol. 2004;45:87–91. [PubMed] [Google Scholar]5. Van Thiel DH, Lester R. The effect of chronic alcohol abuse on sexual function. th Clin Endocrinol Metab. 1979;8:499–510. [PubMed] [Google Scholar]6. Jensen SB, Gludd C. Sexual dysfunction in men with alcoholic liver cirrhosis: A comparative study. Liver. 1985;5:94–100. [PubMed] [Google Scholar]7. Fahrner EM. Sexual dysfunction in male alcohol addicts, prevalence and treatment. Arch Sex Behav. 1987;16:247–57. [PubMed] [Google Scholar]8. Fagan PJ, Schmidt CW, Wise TN, Derogatis LR. Alcoholism in patients with sexual disorders. J Sex Marital Ther. 1988;14:245–52. [PubMed] [Google Scholar]9. Gumus B, Yigitoglu MR, Lekili M, Vyanik BS, Muezzinoglu T, Buyuksu C. Effect of long term alcohol abuse on male sexual function and serum gonadal hormone levels. Int Urol Nephrol. 1998;30:755–9. [PubMed] [Google Scholar]11. Miller NS, Gold MS. The human sexual response and alcohol and drugs. J Subst Abuse Treat. 1988;5:171–7. [PubMed] [Google Scholar]12. Schiavi RC, Stimmel BB, Mandelli J, White D. Chronic alcoholism and male sexual function. Am J Psychiatry. 1995;152:1045–51. [PubMed] [Google Scholar]13. World Health Organization, Geneva 1992 . The ICD 10 Classification of Mental and Behavioral disorders. Oxford University Press; 1994. Clinical descriptions and diagnostic guidelines. [Google Scholar]14. Wing JK, Babor T, Brugha T, Burke J, Cooper JE, Giel R, et al. SCAN. Schedules for clinical assessment in neuropsychiatry. Arch Gen Psychiatry. 1990;47:589–93. [PubMed] [Google Scholar]15. World Health Organization. The ICD-10 classification of mental and behavioral disorders: Diagnostic criteria for research. Geneva: World Health Organization; 1993. [Google Scholar]16. Jensen SB. Sexual function and dysfunction in younger married alcoholics. A comparative study. Acta Psychiatr Scand. 1984;69:543–9. [PubMed] [Google Scholar]17. Villalta J, Estruch R, Antunez E, Valls J, Urbano-Marquez A. Vagal neuropathy in chronic alcoholics: Relation to ethanol consumption. Alcohol Alcohol. 1989;24:421–8. [PubMed] [Google Scholar]18. Van Thiel DH, Gavaler JS, Sanghvi A. Recovery of sexual function in abstinent alcoholic men. Gastroenterology. 1983;84:677–82. [PubMed] [Google Scholar]19. Corona G, Mannucci E, Petrone L, Ricca V, Mansani R, Cilotti A, et al. Psychobiological correlates of smoking in patients with erectile dysfunction. Int J Impot Res. 2005;17:527–34. [PubMed] [Google Scholar]

Alcohol and Temporary Erectile Dysfunction

Nothing can put a damper on an amorous mood faster than a case of alcohol-related erectile dysfunction (ED), also known in more vulgar terms as “whiskey dick. ” While you and your partner may be excited to parlay your margarita buzz into an evening of sex, there could be times when your penis won’t rise to the occasion.   

Alcohol and sex have a complicated relationship. According to a recent study on behavior-related erectile dysfunction in the Journal of Sexual Medicine, when alcohol is consumed in moderation (1 to 2 drinks a day), it is shown to increase desire and reduce anxiety about sexual performance, both of which are beneficial to ED. However, when it is consumed in excess, alcohol can have quite the opposite effect. The following is a closer look at the association between alcohol and erectile dysfunction.

What is it?

Alcohol-induced erectile dysfunction is a temporary condition due to overindulging in alcohol. This could refer to the inability to achieve an erection at all or a situation in which a person gets an erection that is weaker or shorter-lasting than desired.

Why does it occur? 

Because erectile dysfunction is usually the result of multiple factors, it can be difficult to isolate one variable from the rest to study it. However, researchers generally agree that excessive alcohol consumption affects male sexual function in the following ways:

  • As a depressant, alcohol has a slowing effect on the activity of the Central Nervous System (CNS). The CNS is made up of the brain and spinal cord, and it is responsible for bringing in information from the senses and relaying information to the rest of the body. When the CNS is depressed by alcohol, thinking and reasoning are impaired, reaction times slow, and motor skills and coordination suffer. Unfortunately, the signals between the brain and penis are not immune to the slowing effect of alcohol, sometimes resulting in ED when a man drinks too much.
  • Alcohol is a diuretic, meaning that it causes a person to urinate more frequently than usual and can result in dehydration. Dehydration decreases the volume of blood in the body, also decreasing blood flow to the penis and making it more difficult to get an erection.
  • Lastly, dehydration increases the body’s level of angiotensin, which is a hormone associated with erectile dysfunction.

Are certain types of alcohol more likely to cause it?

As far as we know, no. Any type of alcohol can cause the symptoms, and it is more likely related to the actual amount of alcohol present rather than the alcohol itself. 

What should I do if it happens to me?

First of all, relax and know that it could happen to anyone who indulges in alcohol from time to time. Open, honest communication with your partner is the best policy (as in most situations related to sexual dysfunction), but if you prefer not to have this conversation, you can always partake in other sexual/sensual activities that do not require an erection, like oral sex, petting, or massages.

If it happens to your partner, the advice is similar. Recognize that alcohol-related ED is common, and it is not a reflection of your partner’s feelings for or attraction to you. Try not to make a big deal out of it and enjoy other activities with your partner if you are both so inclined.

When does it become more serious?

An occasional case of alcohol-induced ED is nothing to fret about, but if you repeatedly find yourself unable to achieve an erection, even while sober or after drinking a small amount of alcohol, you could benefit from speaking with your doctor about your situation. Additionally, if you worry that your alcohol consumption may be excessive or out of your control, seek counselling from a medical professional.

Resources

American Addiction Centers Editorial Staff. (2020, November 3). Is Alcohol Wreaking Havoc on Your Sexual Performance? DrugAbuse.com. https://drugabuse.com/blog/is-alcohol-wreaking-havoc-on-your-sexual-performance/

Jewell, T. Medically reviewed by Deborah Weatherspoon, Ph.D., R.N., CRNA. (2019, May 23). Does Alcohol Dehydrate You? Healthline. https://www.healthline.com/health/does-alcohol-dehydrate-you/

Martin, M. Medically reviewed by Dr. Mike Bohl, MD, MPH. (2020, May 15). “Whiskey Dick” or alcohol-induced erectile dysfunction. Roman. https://www.getroman.com/health-guide/whiskey-dick-erectile-dysfunction/

Santos-Longhurst, A. Medically reviewed by Janet Brito, Ph.D., LCSW, CST. (2019, October 29). 14 FAQs About “Whiskey Dick.” Healthline. https://www.healthline.com/health/healthy-sex/whiskey-dick

Sivaratnam, L., Selimin, D.S., Abd Ghani, S.R., Nawi, H.M., Nawi, A.M. (2021). Behavior-Related Erectile Dysfunction: A Systematic Review and Meta-Analysis. The Journal of Sexual Medicine, 18(1), 121-143. https://www.jsm.jsexmed.org/article/S1743-6095(20)30930-9/fulltext

Alcohol consumption and erectile dysfunction: meta-analysis of population-based studies

A handful of studies26, 27, 28 have documented the harmful effects of chronic alcohol consumption on sexual functioning but hardly any study found potential beneficial effects of alcohol on ED. We have demonstrated through meta-analysis the possible beneficial effects of alcohol on ED.

The relationship between alcohol and ED was complex from the data: consuming 1–7 drinks/week appeared to confer the lowest risk (OR=0.73; P=0.101) but it was not statistically significant, and only 8 or more drinks/week was significant (OR=0.85; P=0.007). It appears that alcohol consumption, much similar to its relationship with cardiac survival, is related to sexual function in a J-shaped manner, with moderate consumption conferring highest protection and higher consumption conferring less benefits.

Considering that ED and heart diseases share similar cardiovascular risk factors, and the well-known chronic cytotoxic effects of alcohol on general health,29 hepatic function30 and immune function,31 general health might be a mediator between the association of high alcohol consumption and ED. This J-shaped relationship finding might explain why studies have shown harmful effects of heavy alcoholism on sexual function, that is alcoholism entails excessive drinking and carries the increased risk of ED at the tail of the J curve. However, caution has to be exercised in the extrapolation, as our results did not show a statistically significant OR for consuming 1–7 drinks/week, and did not demonstrate any harmful effects of alcohol on sexual function. In fact, three large studies9, 16, 18 have demonstrated progressively smaller ORs of ED for increasing levels of alcohol consumption.

We attempted to identify the cutoff level of alcohol consumption where risks outweigh benefits, by identifying the ‘number of drinks/week’ that has an OR closest to 1. To our surprise, the category ‘8 or more drinks/week’ generated an OR that barely missed the unity and was statistically significant. Although we were unable to pinpoint the level of alcohol consumption where risks (OR>1) outweigh benefits (OR<1), we were at least able to say that ‘8 or more drinks/week’ is likely to be a cutoff where the OR for ED becomes less than 1. Whether consuming more or less alcohol would yield a smaller OR was indeterminate.

The results from the two cohort studies complicated the picture even further: they did not show any significant effects of alcohol consumption on ED. The cross-sectional analysis of the HPFS data demonstrated a protective association of alcohol on ED, much in a J-shaped manner, but after follow-up of the subjects the cohort analysis did not find any significant associations between alcohol consumption and ED. Since the level of evidence from a cohort study is generally higher than from a cross-sectional study, due to less confounding and recall bias, the evidence from the HPFS cohort should weigh more heavily in our analysis. This suggests that the apparent protective association of alcohol consumption on ED was probably due to confounding (since recall, selection, observer and volunteer biases were less likely in the selected population-based cross-sectional studies). However, the sensitivity analysis demonstrated a significant protective association of alcohol consumption with higher level of statistical adjustments (less confounding), not with age adjustment alone (more confounding), and suggests that with better statistical adjustments (reduction of confounding) the demonstration of protective association might be possible. The sensitivity analysis on study sample size found that smaller studies demonstrated larger effects than larger studies, and might suggest that the estimate obtained from larger studies would be more reliable (effect towards null), although their estimates did not differ significantly. The relative importance of each study with regard to their sample sizes was taken care of by the differential weighting of the random effects model.

A major limitation of previous population-based studies was their relatively small sample sizes, and we sought to overcome this sample size problem by pooling data across studies, although we suspected that the OR for ‘1–7 drinks/week’ was not statistically significant due to inadequate sample size.

The meta-analyses had four limitations, (1) confounding, (2) definitions of ED and alcohol consumption, (3) weak causal inference and (4) heterogeneity.

Limitation 1

Confounding can reduce the internal validity of a study, and since ED is a multifactorial disorder, the association between alcohol and ED as demonstrated could be confounded by some other factors not adjusted for. First, the effect size for alcohol consumption was not large, and the significant effect could be due to residual confounding. Second, we obtained pooled estimates based on ORs that were adjusted for different numbers of variables from different studies, and therefore each included study had a different level of confounding. Our minimum requirement for inclusion was that the ORs had to be age-adjusted, other than this if more variables were adjusted for the better. However referring to Figure 1, if confounding was a problem, one would find ORs that were adjusted for more variables to lie closer to unity (that is, no effect) and those that were only age-adjusted to be closer to zero (that is, protective association), but this did not appear to be the case.

Limitation 2

Alcohol consumption was assessed in many ways, one by grams of alcohol, and most by the number of drinks/week, but the categories were different. We took a conservative approach in pooling the data, for example, if the categories in Millett et al. ‘s17 study were none/1–4/⩾4 drinks/week, we excluded the OR for the ‘open-ended’ ⩾4 drinks/week and only included the OR for 1–4 drinks/week into our final 1–7 drinks/week category, and likewise we only included the OR for 3–4 drinks/week from Cho et al.‘s21 study in the 1–7 drinks/week category. We believe that this conservative approach in pooling the results should ensure the reliability of our results.

The included studies used two broad definitions of ED, one that was based on IIEF-5 or IIEF-15, and the other that was based on a single self-reporting question. Sensitivity analysis showed that the summary estimates based on each definition were different, and only the self-reported one was significant (OR=0.73; 99% CI, 0.61–0.88; P<0.001) but not the IIEF one (OR=0.95; 99% CI, 0.65–1.40; P=0.739), and the latter was not statistically significant. This finding raises serious doubts to the use of single question self-reported composite measures of ED, which many studies worldwide used, since it appears that the summary estimate for each definition was different. However, since the estimates did not differ significantly (P=0.1057), this difference could be due to chance.

Limitation 3

Causal inference from the cross-sectional design is weak. The alternatives for better causal inference are either a cohort study or a randomized controlled trial, but in either case few studies have been done. We sought to support our meta-analysis results with the research findings from cohort studies (MMAS and HPFS), but the cohorts did not demonstrate any significant relationships between alcohol consumption and risk of ED. The cross-sectional HPFS supported our meta-analysis results of the cross-sectional studies in demonstrating a significant protective association, but the cohort HPFS did not, and this suggests that the protective association demonstrated in cross-sectional studies might have resulted from confounding. Another possible explanation was that men who developed ED opted not to drink alcohol, whereas men without ED continued to drink alcohol. As a result, an apparent ‘harmful effect’ of not drinking alcohol was found, which was the inverse of protective association of drinking alcohol in terms of ORs. Since the cohort study design has better causal inference, the results from the two cohort studies suggest that alcohol neither causes nor prevents ED from developing. Also, the statistical association was found after pooling a large number of studies, and may have limited biological significance for an individual drinker.

Limitation 4

We found significant heterogeneity in two of the three meta-analysis estimates. In general, there can be many sources of heterogeneity in meta-analysis, and we can only surmise the sources in this study, which may include varying number of controlled confounders, different definitions of ED and alcohol consumption and the diverse populations included. We used the random effects model that is preferred to the fixed effects model when significant heterogeneity exists.

The geographical regions covered in this meta-analysis include South America (Brazil), Europe (Italy, Belgium), Africa (Egypt, Nigeria), Middle East (Turkey) and Asia-Pacific (Australia, China, Japan, Korea, Malaysia, Pakistan). Therefore our results have limited generalizability to other regions (for example, North America).

Two reasons might have propagated the myth that alcohol consumption is a risk factor for ED. First, that alcohol consumption enhanced sexual desire but impaired sexual performance is perhaps a short-lived effect of alcohol and will not cause ED permanently. Second, that severe alcoholism impairs sexual functions may be an extreme example and is confounded by underlying deterioration of general health, and unless it is excessive it is unlikely to cause ED permanently. More research has to be done to assess the association between acute (we did not investigate) and chronic (which we investigated) alcohol consumption and development of ED, particularly using large-scale cohorts since randomized controlled trials may be unethical.

This is the first study that systematically reviewed and meta-analyzed the association between alcohol consumption and ED. Our meta-analysis found a significant protective association of regular (chronic) alcohol consumption on ED in cross-sectional studies, in particular for the consumption of 8 or more drinks/week. Evidence from large cohort studies suggests that regular alcohol consumption is not significantly associated with ED development. Therefore this study has demonstrated, in the least, that chronic alcohol consumption is not a risk factor for ED. We hope to demonstrate with the results of this study that the association between alcohol consumption and development of ED might not be as straightforward as it seemed, and the undue popularity of alcohol being labeled as a risk factor for ED was probably unjustified since there was little research evidence to support it.

Whiskey Dick: How Alcohol Affects Erections

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If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

How many times have you had a drink or two to get in the mood? Alcohol has a reputation as a sexual performance enabler and enhancer. Unfortunately, this has led many of us to overindulge, leading to the only thing worse than a hangover: whiskey dick.

“Whiskey dick” is a real thing; it is better known as alcohol-related erectile dysfunction (ED). Essentially, whiskey dick is the inability to get a sufficient erection after consuming alcohol. You might not be able to get an erection at all or get one that’s weaker or doesn’t last as long as you like. 

How many drinks does that take? It’s not an easy question to answer. Alcohol tolerance varies widely, depending on your body chemistry and factors such as how much you drink and how often, and so does the body’s reaction to it—including any side effects in sexual function.  

Foods for erectile dysfunction: what the science says

Alcohol acts as a depressant on the central nervous system (CNS)—meaning, it has a sedating effect on the brain and body. Think of alcohol’s typical effects: the pleasant effects like relaxation and a feeling of warmth. Alcohol also comes with some negative effects, though, like lack of inhibition, a decline in motor skills, and—you guessed it—whiskey dick (Mathew, 2021). 

In the case of whiskey dick, alcohol affects some of the critical systems involved in sexual arousal, erection, blood circulation, and nerve sensitivity (Wang, 2018).

  • During sexual arousal, the brain sends messages to the penis, telling it to become erect. The intoxicating effects of alcohol may slow the signals between the brain and body, resulting in ED.
  • Drinking alcohol causes dehydration, which lowers blood volume and reduces circulation. Since erections rely on healthy blood flow, this may lead to erectile problems.
  • Alcohol may interfere with testosterone production, leading to low testosterone levels and poor erections.
  • Long-term heavy drinking can also affect blood vessel health, which may decrease blood flow to the penis.

Alcohol has an interesting relationship with ED. At low-to-moderate levels (up to 1–2 drinks per day for men), alcohol may actually help erections and protect against ED. This is thought to be due to alcohol’s ability to decrease performance anxiety and increase sexual desire. However, binge drinking or drinking too much can lead to a loss of penis nerve sensitivity, lower libido, sexual dysfunction, and other effects. So it all depends on how much you drink (Sivaratnam, 2021).

The best way to prevent whiskey dick is to avoid heavy drinking. 

Alcohol consumption can interfere with sexual arousal in both genders. Alcohol causes dehydration, and it depresses your central nervous system. Just as with men, these effects can reduce circulation and nerve sensitivity associated with arousal. Some studies show that women have decreased arousal, sexual desire, and sexual satisfaction, especially with heavy alcohol use (George, 2019). 

Alcoholism: signs, causes, and treatments

For most, whiskey dick will last only as long as it takes for you to sober up. After that, you should be able to get back to normal erections. However, chronic heavy drinking may also be one cause of true ED.

Drinking too much alcohol can also increase your chances of developing high blood pressure (hypertension), damaging blood vessels throughout the body. That can impede blood flow to your brain, heart, and penis, raising your risk of stroke, heart disease, and ED (Day, 2019). 

If you experience whiskey dick, your body may be telling you to take a look at how much you’re drinking.

The 2020–2025 Dietary Guidelines for Americans say that to reduce your risk of serious health problems, it’s best to drink only in moderation. That’s defined as no more than two drinks a day for men and one daily drink for women (USDA/HHS, 2020). Your sex life can only benefit.

  1. Day, E., & Rudd, J. (2019). Alcohol use disorders and the heart. Addiction (Abingdon, England), 114(9), 1670–1678. doi: 10.1111/add.14703. Retrieved from https://pubmed. ncbi.nlm.nih.gov/31309639/
  2. George W. H. (2019). Alcohol and sexual health behavior: What we know and how we know it. Journal of Sex Research, 56(4-5), 409–424. doi: 10.1080/00224499.2019.1588213. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30958036/
  3. Mathew F, Goyal A. (2021). Ethanol. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK556147/
  4. Sivaratnam, L., Selimin, D. S., Abd Ghani, S. R., Nawi, H. M., & Nawi, A. M. (2021). Behavior-related erectile dysfunction: a systematic review and meta-analysis. The Journal of Sexual Medicine, 18(1), 121–143. doi: 10.1016/j.jsxm.2020.09.009. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33223424/
  5. U.S. Department of Agriculture and U.S. Department of Health and Human Services (USDA/HHS). (2020). Dietary Guidelines for Americans, 2020-2025. 9th Edition. Retrieved from https://www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025. pdf.
  6. Wang, X. M., Bai, Y. J., Yang, Y. B., Li, J. H., Tang, Y., & Han, P. (2018). Alcohol intake and risk of erectile dysfunction: a dose-response meta-analysis of observational studies. International Journal of Impotence Research, 30(6), 342–351. doi: 10.1038/s41443-018-0022-x. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30232467/

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Sexual Dysfunction and Alcoholism – Vertava Health

How Does Alcoholism Contribute To Sexual Dysfunction?

Alcoholism is a chronic, progressive disease influenced by environmental, psychological, and genetic factors—it’s characterized by a person’s obsession, and compulsion to drink alcohol, and inability to stop; despite harmful consequences.

Progressive means that the ability to moderate alcohol consumption becomes worse over time. Alcoholism is both mentally and physically addictive; whereby a person becomes preoccupied with alcohol; and focuses less attention on their life; and the people in it.

How Does Alcohol Lead To Sexual Problems?

In American culture, a lot of people enjoy a glass of wine, or another libation to loosen up, or “set the mood.” The problem is that alcohol is actually a depressant, and drinking a lot of it decreases sexual desire, and dampens the mood. For this reason, heavy drinking proportionately increases the risk of sexual dysfunction.

The biggest problem is that even though a small amount of alcohol has the potential to contribute to sexual desire, it can decrease sexual performance at the same time. In both men and women, alcohol can cause an inability to climax during sex.

Sexual dysfunction encompasses the following areas:

  • Sexual Pain Disorder – Pain from intercourse. These are almost exclusively experienced by women, and occur when sexual intercourse causes intense pain. Many women attempt to mask the pain with alcohol, then become dependent upon it, which only makes the condition worse. In a lot of cases, pain disorders result from deep-seated anxiety, sensitivity, or fear.
  • Sexual Arousal Disorder – Inability to become physically aroused during sexual activity. In men, this is more commonly referred to as erectile dysfunction. Arousal disorders are among the most common problems reported by those suffering from alcoholism.
  • Decreased Sexual Desire – Lack of interest in sex. This is considered a loss of libido, which is sexual energy, excitement, and desire. Heavy drinking can exhaust a person’s desire to do anything; including sex. The depression-like symptoms of alcoholism often lead to apathy and can make sex seem like more of a chore than intimacy with one’s partner.
  • Orgasm Disorder – Delayed, premature, or inability to orgasm. Women may have an inability to orgasm while intoxicated. Men with alcoholism often experience premature, non-existent, or delayed ejaculation. Orgasm disorders can result from anxiety and tend to co-occur with alcoholism—which is also known to increase anxiety.
  • Sexual Aversion Disorder – A strong dislike or disinclination of sexual activities. Sexual aversion disorders tend to result in avoidance of any kind of genital sexual contact and can result in a relationship, and other interpersonal problems.


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Alcoholism And Sexual Dysfunction Occurs In Both Men And Women

It’s pretty safe to say that at this point, most of us understand that alcoholism knows no gender, demographics, age, status, or race—neither does sexual dysfunction. Sexual problems are, however, more likely to happen in people over 40 years old; whereas alcoholism can occur at any age. Additionally, sexual dysfunction occurs differently in men and women.

How Does Alcohol Affect Women Sexually?

In women suffering from alcoholism “the most common forms of sexual dysfunction observed include dyspareunia (painful sexual intercourse), high rates of genitourinary health problems, and low vaginal lubrication, revealing problems with sexual arousal” (National Library of Medicine).

Furthermore, women with alcoholism and vaginismus (sexual pain disorder) have relapsed and used alcohol to deal with their sexual dysfunction The same can true for other women who use alcohol to achieve sexual excitement or relaxation during sex.

From the Center for Disease Control and Prevention (CDC), “binge drinking is a risk factor for sexual assault, especially among young women in college settings. Each year, about 1 in 20 college women are sexually assaulted. Research suggests that there is an increase in the risk of rape or sexual assault when both the attacker and victim have used alcohol prior to the attack.”

How Does Alcohol Affect Men Sexually?

Alcohol abuse is the leading cause of impotence and other disturbances in sexual dysfunction. Erectile dysfunction in men addicted to alcohol is fairly common but found to be significantly higher in men consuming more than 3 standard units of alcohol daily, and in subjects smoking more than 10 cigarettes per day.

Not only that, “excessive alcohol use can interfere with testicular function and male hormone production resulting in impotence, infertility, and reduction of male secondary sex characteristics such as facial and chest hair” (CDC).

Similar to experiences by women, “excessive alcohol use is commonly involved in sexual assault. Also, alcohol use by men increases the chances of engaging in risky sexual activity including unprotected sex, sex with multiple partners, or sex with a partner at risk for sexually transmitted diseases.”

Can Sexual Dysfunction And Alcoholism Result In Divorce?

Alcohol abuse is one of the top 10 reasons marriages end in the United States. Sexual dysfunction due to alcoholism only makes it that much worse. It can lead to an inability for a man or woman to complete their agreement in marriage, and as a result, they lose their spouse to alcohol.

In a study by the National Library of Medicine, “it is evident that sex-related factors and sexual dysfunctions are related to divorce seeking behavior and contributed to 22% cases. ” Similarly, from a separate field study by NLM, “a consumption increase of 1 liter of alcohol per capita brings about an increase in the divorce rate of about 20%.”

Unfortunately, when given the opportunity to quit, a lot of men and women suffering alcoholism are unable to walk away from it. In marriage, it usually comes down to a decision, it’s either me or the alcohol…

The problem with alcoholism is that drinking alcohol actually becomes a person’s perceived purpose; it becomes a complete obsession with alcohol. When given the choice, so many men and women fail to see that if they continue drinking, they might lose the person they’re supposed to spend the rest of their life with, and because of their obsession with alcohol, they have no idea.

What Is Considered Good Sexual Health?

The World Health Organization defines sexual health as a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination, and violence.

It gets better. You can overcome alcoholism, and have a full-life and meaningful relationship as a result. There are a lot of different suggested approaches to help you strengthen your sexual health; some of those suggestions include:

  • Exercise
  • Lose weight
  • Quit smoking
  • Learn to maintain healthy relationships
  • Marriage counseling
  • Focus on your mental health
  • Learn to handle stress
  • Overcome anxiety
  • Attend alcohol rehab
  • Recover from alcoholism

With an individualized (dual diagnosis) treatment at an alcohol rehab center, all of these suggestions can become a reality. So many men and women don’t believe that they can overcome alcoholism, but that is so far from the truth. There might not always be a cure for addiction, but there is a treatment. Find yours today.

Find The Right Treatment To Overcome Alcoholism

If you or a loved one is struggling with alcohol abuse or addiction contact a treatment specialist today. We will help you find the right alcohol treatment program that suits your needs. All calls are 100 percent confidential.

90,000 WHO said women should give up alcohol and drew criticism

https://ria.ru/20210617/alkogol-1737404364.html

WHO said women should give up alcohol and drew criticism

WHO said that women should give up alcohol, and drew criticism – RIA Novosti, 06/17/2021

WHO said that women should give up alcohol, and drew criticism

The World Health Organization called on women of childbearing age to stop drinking alcohol because of harm to health, this is stated in the project RIA Novosti, 17.06.2021

2021-06-17T14: 38

2021-06-17T14: 38

2021-06-17T17: 37

Society

WHO

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MOSCOW, June 17 – RIA Novosti. The World Health Organization has called on women of childbearing age to stop drinking alcohol because of harm to their health, according to the draft Global Plan of Action against Alcohol 2022-2030.According to the document, countries should raise public awareness about the dangers of alcoholic beverages, but special attention should be paid to children, pregnant women and women of childbearing age. This is due to the fact that drinking alcohol before and during childbearing can lead to the development of various diseases and disorders. as well as problems with social behavior and learning ability, the text says. It is noted that this also has a negative impact on the physical and psychological well-being of the mother.These statements caused widespread criticism among netizens, and the organization itself was accused of sexism. “WHO proposes to” prohibit women of childbearing age from drinking. “Do we value women only for their ability to bear children? men, then where is the call to men of “childbearing age” to stop drinking? “So, last year the number of such cases in Russia reached 50 435 – three thousand more than the year before last (47 427 deaths).

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14: 38 06/17/2021 (updated: 17:37 06/17/2021)

WHO declared that women should give up alcohol, and drew criticism

MOSCOW, June 17 – RIA Novosti. The World Health Organization has called on women of childbearing age to stop drinking alcohol because of harm to health, according to the draft Global Action Plan Against Alcohol 2022-2030.

According to the document, countries should raise public awareness of the dangers of alcoholic beverages, but special attention should be paid to children, pregnant women and women of childbearing age.

This is due to the fact that drinking alcohol before and during childbearing can lead to the development of various diseases and disorders, as well as to problems with social behavior and learning ability, the text says.It is noted that this also has a negative impact on the physical and psychological well-being of the mother.

These statements drew widespread criticism among netizens, and the organization itself was accused of sexism.

May 31, 17:00 Science Scientists have named a factor that aggravates the effect of alcohol on the liver

“WHO proposes to prohibit women of childbearing age from drinking.” men, then where is the call for men of “childbearing age” to quit drinking? “- one of the Twitter users was indignant.

“Dear WHO, I think ‘women of childbearing age’ will not appreciate your offer. Stop giving sanctimonious advice, please,” wrote another.

Earlier, Rosstat reported an increase in mortality caused by excessive alcohol consumption. So, last year the number of such cases in Russia reached 50 435 – three thousand more than the year before last (47 427 deaths).

“If you don’t want to carry, don’t carry it.” Russia and France are arguing about how to call champagne

Photo author, Sergei Bobylev / Tass

The French producer of premium alcoholic drinks Moet Hennessy announced the suspension of the supply of its champagne to Russia due to the entry into force amendments to the law on the regulation of alcoholic beverages. The new legislation has outraged French winemakers and officials. The Russian authorities claim that in this way they want to protect the domestic alcohol market.

Amendments to the federal law “On the regulation of alcoholic beverages” were adopted by the State Duma and approved by the Federation Council last week and signed by President Putin on July 2. The law, in particular, allows the use of the term “champagne” only in relation to “Russian champagne” produced on the territory of Russia.

“Moet Hennessy Russia has alerted its partners to local legislative changes regarding sparkling wine labeling for champagne bottles. These provisions lead to a temporary suspension of product shipments to assess the impact of this new law,” the company’s head of communications said on Monday. Anne Catherine Grimal.

The law does not prohibit the use of a geographical designation for wine products (including the word Champagne), but now the manufacturer must necessarily indicate on the counter-label the type of product – “sparkling wine”.

The French authorities and winemakers were seriously outraged by the new Russian amendments, and the country’s agriculture minister, Julien Denormandy, even decided to remind Moscow that the word “champagne” is of French origin.

French Foreign Minister Jean-Yves Le Drian said on Tuesday that France is analyzing the new Russian law, and that if the analysis reveals a violation of World Trade Organization (WTO) rules by Russia, then Moscow “cannot be ruled out.”A representative of the European Commission told RIA Novosti that the EC will contact the Russian authorities about the new law, “expressing their concerns and disagreement.”

Over the past few days, heated absentee disputes have flared up between the countries. The BBC Russian service has collected the most vivid quotes from the speeches of each of the parties.

(In interview , 20 minutes )

“We are shocked by this decision.Russia assigns a name that Champagne has been developing for 300 years. This is a very painful blow for us. […] The AOC (“origin control”) certificate is recognized by the EU, and the name “champagne” is protected in more than 120 countries, but not in Russia. This law is an extremely harsh departure [from international rules]. For twenty years we have been negotiating with Russia to get AOC protection there. […] We intend to defend ourselves and use French diplomats and the EU to change this unacceptable law. “

(In an interview with RIA Novosti)

I even think that this (Moet Hennessy’s decision to suspend supplies to Russia – ed.) Is a kind of blackmail without any evidence. Champagne is supplied to Russia by another two dozen other manufacturers, and none of them was outraged. If you don’t want to carry, don’t carry it. In Russia, sparkling wine is no worse. Our consumers will not be left without sparkling wine of the same quality, taste and aroma. […] We never force anyone to name alcoholic products differently than the manufacturer himself calls it.We just ask you to prove its compliance with Russian standards for sparkling wine and indicate this on the label.

(In comments to the media)

We are aware of the Russian draft law on alcoholic and wine drinks. It will have a significant impact on wine exports. We will do whatever is necessary to express our disagreements and concerns about this project. We will do whatever is necessary to protect our rights and take the necessary steps if it comes into force.We will have to deal with the problems it will cause our wine exports.

(In the comments for the media)

This story with names is quite old, the story in many ways still came from Soviet times. […] The law has been passed, it must be followed. […] This is a difficult branch of the economy, this is not the place where fast money lives. Of course, the business process will be stretched: it is very complex technologically, it will take a long time, but nevertheless this industry is developing well and, of course, it must and will be supported in every possible way.

(On Twitter)

We are closely following the situation around the new Russian law on winemaking, we are in close contact with professionals and our partners. There can be no doubt: we will unconditionally support our manufacturers and high quality. Long live French champagne!

(In an interview with RIA Novosti)

We have decided that we need to revive our vineyards and protect our winemaking market.We have developed a law, set priorities. […] Everything related to the labeling of champagne, the corresponding genealogical tree of this champagne, the habitat of the vineyard, the variety and everything else – everything is spelled out. Our laws are not much different from theirs – they protect their producers, and nothing more.

Red iPhone caused violent controversy on the Internet – Russian newspaper

Apple has officially presented the red iPhone 7 and 7 Plus smartphones belonging to the (Product) RED series.Social media users expressed their opinion about the design: many liked the new color scheme, while others criticized the new product.

The release of the new iPhones in red cases was timed to coincide with the 10th anniversary of Apple’s collaboration with the RED program. As part of a charitable project, funds are collected for a fund to fight AIDS, tuberculosis and malaria.

I have been buying applications (red) in the AppStore for a long time, and people still think that the red iPhone 7 is the first charity event from Apple 🙁

– Boris Vedernikov (@VedernikovBoris) March 22, 2017

Those who call Tim Cook a greedy accountant forget that the red iPhone Product RED is an AIDS charity.

– Viktor Teplov (@vandesign) March 22, 2017

Red iPhone 7 have similar characteristics to other smartphones in this line.

Meet the Girls Only Red iPhone

– Lesaria Latova (@lesarianews) March 22, 2017

Now when I close my eyes, I see a red iPhone 7.Doctor, am I sick? # IPhone7RED

– Mikha Yakubenko (@yakubenko_m) March 22, 2017

Red iPhone is so beautiful !!!

– DzeTheBoss (@DzerassaBasaeva) March 22, 2017

– Hey Apple needs something new.
– Of course there is a red iPhone.
– But nothing has changed in him.
– It’s red!

– Oleg (@aka_Descure) March 22, 2017

just now noticed that the red #iPhone is sold with a white apron, but I think it looks better with a black apron than with a white pic.twitter.com/dsIUgXUIet

– Shurik (@tophackr_text) March 23, 2017

First, a red iPhone, and then an iPhone stylized as a Motorola

– Lenochka (@vellha_ne_volha) March 21, 2017

90,000 “I’m an alcoholic. With higher education and money “: how alcohol addicts live in Russia

In 2012, David Granovsky, together with other like-minded people, opened an outpatient care office, where people could receive information on how to act when there is a problem with alcohol or drugs at home, as well as psychological assistance (both relatives and addicts themselves).They hired psychologists, and they had to take a little money from the program participants in order to pay for the office and travel for specialists.

Over time, people began to ask for events at the school and other venues. According to Granovsky, people do not realize the scale of the problem, and there is still an opinion in society that alcoholism is not a disease, but a bad habit. Then the activists decided to conduct lectures for teachers, psychologists and social workers – all those who interact with a risk group, but do not always understand what they are really facing.For five years, Granovsky and his team traveled all over the country with such lectures. And in 2017, he decided to create the Bridge of Life foundation in order to be able to send people to rehabilitation centers and pay for treatment for those who do not have the funds.

The first thing that a person receives when seeking help from the “Bridge of Life” is a consultation with a psychologist. If the patients themselves seek help, the specialists develop a treatment program for them: for some it is an outpatient program, for others it is an inpatient program.The fund has an agreement with a rehabilitation center in Sevastopol, so most often patients are sent there.

When relatives of alcohol addicts seek help, psychotherapists first of all help them to cope with feelings of guilt, to get away from wrong decisions and actions in relation to their dependent relative.

Sometimes, after the first or second meeting, relatives “lure” the alcohol addicts themselves to the meeting. Since the fall of 2019, the foundation has launched a series of seminars for codependents, which, according to Granovsky, is receiving a tremendous response.

“At the very least, our state has opportunities to help people with alcoholism: rehabilitation centers, recovery programs from hard drinking, psychological methods,” says Granovsky. “But the problem is that after rehabilitation, where a person is undoubtedly going through the process of treatment, receives some tools for control, he again returns to ordinary life, where it is very easy to get alcohol. And if craving wins him at some point, he just needs to go to the store. ”

In 2019, the fund conducted 267 face-to-face consultations on drug and alcohol addicts, but only 47 of them agreed to targeted assistance, and only 18 to rehabilitation.

“Getting sober is not the most difficult task, we don’t know how to live sober,” says 36-year-old Elena. “Therefore, we need to revise our worldview.” She is a member of the fellowship of Alcoholics Anonymous (A.A.), it is there that she is helped not to break down for the third year.

Elena got drunk for the first time at the age of 13. She grew up in an ordinary, rather wealthy family, where alcohol was only on holidays. At the same time, she never had an understanding that this could be harmful. During her school and university life, she drank exclusively at holidays and parties.

The problem was that she never managed to stop: “I never had such a thing that I could have a glass to relax. I always drank in order to get drunk and change my mind, because this way I felt good, the whole world was open to me. ” When Elena got a job, she set herself a strict framework – you can only drink on weekends.

Then the girl decided to go to study at the second higher education – psychological – education.She began to delve deeper into herself and realized that alcohol was the cause of many problems in her life. After university, Lena did not drink at all for a year and tried to follow a healthy lifestyle. She recalls that during that period of her life she was very angry: “I constantly lectured everyone about the dangers of alcohol, watched who drinks how much, threatened that they would get drunk. At some point, people began to simply avoid communicating with me. ”

Once, on the eve of the New Year, the partners presented Lena with a box of expensive alcohol in honor of the closure of a large project.She brought it home to donate to relatives, and then thought that she could afford to drink a glass of champagne.

Alcohol experiment: the film “One More Each” was released in Russia

November 13, 2020, 07:47

On November 12, a new film with Mads Mikkelsen in the title role was released on wide screens. We have already watched the film “One More”, so we are sharing our impressions of the story, written and directed by Thomas Winterberg, about friends who drink daily supposedly for scientific purposes.

The pre-premiere screening of the Danish director Thomas Winterberg’s film “One More Each” (18+) took place in Nizhny Novgorod on Wednesday, November 11.

In the center of the plot are four school teachers (historian, psychologist, musician and physical education teacher) who are going through a crisis both at work and in their personal life.

One of them tells his colleagues about a pseudoscientific theory, according to which a person from birth does not have enough alcohol in his blood, which does not allow him to feel fully happy.And if you maintain its constant level (0.5 ppm), then everything around will change for the better.

Mired in a routine, the friends decide to risk their health and go for an experiment: drink only during working hours and watch how they will change, keeping “alcohol chronicles” so as “not to drink in vain,” as one of the comrades noted.

As a result, podshofe everything seems to be getting better. Winterberg’s heroes become confident, relaxed, joyful – they like to be drunk.

Gradually they increase the amount of alcohol consumed, but soon, as it becomes clear, the situation is getting out of control. After all, alcohol abuse is a dangerous thing, especially when you do not know the measure.

In his new film, well-known to the Russian audience in Hunting (with the same Mikkelsen in the title role – ed.) and Kursk, director Winterberg touches on a slippery topic – however, he did not set himself the goal of writing an ode to the green serpent, he wanted to show human capabilities against an alcoholic background.

Surely, many will consider that this problem is close to a Russian person – who, if not he, is well acquainted with drinking. However, it is not. Now Denmark, where Winterberg is from, is struggling with rising levels of alcoholism among the population. At the same time, the younger generation drinks the most – it is no coincidence that his film production begins with a youth game associated with running and drinking beer.

The tape balances between different genres. If at the beginning of the film we are shown a drama – the life of a sad historian and his colleagues experiencing apathy, then in the middle of the picture there are already comedic moments.

Having begun to use, the characters seem to come out of a deep sleep. For example, the protagonist begins to show creativity in his lessons (in one of them he arranged a presidential election, the results of which caused surprise and laughter among his students – they all voted for Hitler’s candidacy, without knowing it – ed.).

To enhance the fun component, the director also uses music, dances, funny inserts with famous politicians (in particular, many funny shots with a drunk Boris Yeltsin were shown – approx.ed.).

But the more comrades begin to drink, the faster their addiction develops, leading to a number of tragic episodes. This is where the downside of the frequent use of spirits comes into play.

It is also interesting that almost no attention is paid to hangovers here – a subtle hint that there are more serious consequences.

The movie turned out to be real not only because of the good script, but also thanks to the strong acting ensemble – Thomas Bo Larsen, Lars Rant, Maunus Millan and, of course, Mads Mikkelsen.All four won one award for all – the Silver Shell – in the Best Actor category at the 68th San Sebastian International Festival.

After watching the film, the viewer is unlikely to find a definite answer to the question: “To drink or not drink?”, But will definitely get acquainted with the positive and negative sides of alcohol. It is important to understand that alcohol is not in the foreground here, a well-thought-out story with unexpected twists, albeit predictable, is driven by its characters, whose drunken actions reveal the true nature and genuine emotions of people.

A chic ending with faith in a good future to the song of the Danish band Scarlet Pleasure (after What a Life you will want to listen to at every party – ed.) will cause a sincere desire to watch it again. The ending confirms that happiness is not stored at the bottom of the glass … It turns out that a person lacks love, and not 0.5 ppm of alcohol.

This Fall’s Potential Hit was released on November 12th. By the way, “One More Each” has already been awarded a number of prestigious awards, as well as the tape – a participant in the 73rd Cannes Film Festival, it is also included in the shortlist of candidates for the Oscar in the category “Best Foreign Language Film”.We wish you a pleasant viewing!

Author: Olga Kovaleva

Plushenko was called to the ring. The main freak fights in Russian history :: Martial arts :: RBC Sport

On Wednesday, the choreographer of the group of figure skating coach Eteri Tutberidze, Alexei Zheleznyakov, challenged two-time Olympic champion Evgeny Plushenko.RBC remembered past fights with the participation of non-professional fighters

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Photo: Oleg Bukharev / TASS

Alexander Orlov – Roman Chetin

November 10, 2017

Alexander Orlov became famous after he hit NTV correspondent Nikita Razvozzhaev on August 2, 2017, on Airborne Forces Day.In response to this, Perm journalist Roman Chetin called his colleague’s offender to a fight through social networks. In weight, the 111-kilogram Orlov outnumbered his opponent by more than 15 kg.
The fight was postponed several times. One of the reasons was Orlov’s alcohol dependence – he was “decoded”. As a result, the fight took place in November. The difference in weight affected the result: in the four-round match, Orlov won on points.

Vyacheslav Datsik – Artem Tarasov

April 15, 2019

This fight became the most memorable in Amiran Saradrov’s project “Battle for HYIP”.Datsik is an MMA fighter, criminal and nationalist. Tarasov is a well-known blogger in narrow circles who is fond of martial arts.

The fight was unusual even by the standards of this project, since the difference in weight between Datsik and Tarasov exceeded 70 kg. As a result, the fight was stopped a few seconds before the time expired. The 150-kilogram Datsik was disqualified for attacking a 75-kilogram opponent after the referee stopped the fight.

Oleg Mongol – Kirill Hands-bazookas Tereshin

19 October 2019

Oleg Mongol is a blogger from Khakassia, known for a video about the life of the Russian provinces.In his video blogs, he drinks alcohol or quarrels with his friends – Mad Pashka and Wild Irishka. His Instagram has almost 900 thousand subscribers, starred in music videos and participates in talk shows on Channel One. Recently, I decided to go in for sports and began to position myself as an MMA fighter. In this regard, he challenged Kirill Tereshin to a fight, who became famous for pumping synthol into the area of ​​the biceps. The fight took place in Abakan and ended with Mongol’s early victory a couple of minutes after the start of the battle.

Alexander Emelianenko – Mikhail Koklyaev

November 30, 2019

In the spring of 2019, Koklyaev, who is a powerlifter, not a representative of martial arts, spoke in a negative way regarding the mental abilities of MMA fighter Alexander Emelianenko, after which a conflict arose between them. As a result, the two athletes decided to sort things out in the boxing ring, and the fight was broadcast on one of the All-Russian channels.Emelianenko knocked out a 20 kg superior opponent in the first round.

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Vladislav Zhukov

90,000 Ambulance in Germany: to whom and how quickly does it arrive? | Culture and Lifestyle in Germany and Europe | DW

The Germans call an ambulance not so often in comparison with other European countries, since there are a lot of hospitals here – and not only in cities – and they are built so that it is not so far to get to them.But still, only in one federal state of Reiland-Palatinate (this is the latest data for the country), an ambulance was called in 2018 almost a million times. 73 thousand calls fell on reammobiles – the most equipped ambulances.

An emergency doctor in Germany is not just a doctor who is on duty in an ambulance. This is a profession that requires additional qualifications from those who have already received a medical degree and have work experience. The training lasts two years, of which six months – in the intensive care unit in the hospital, plus 80 hours – the intensive care course, plus anesthesiology, plus 50 ambulance shifts as an intern with an experienced doctor.After that, the appropriate exams are taken. There are about eight thousand such specialists in Germany. This is, on average, about one specially trained emergency doctor for every ten thousand inhabitants of the country. According to the online portal Statista, a total of 20,880 people work for the “rescue service” in Germany. For example, in the most populous land – North Rhine – Westphalia – just over four and a half thousand people are employed in this area of ​​health care.

Does an ambulance attendant need a doctor?

In some large German cities there are also special emergency doctors for children.In Munich, for example, they are constantly on duty in four city hospitals. At least one of them always has a specially equipped ambulance for children at the ready. By the way, parents can always accompany their children in it.

It should be noted that when an ambulance is called in Germany, a doctor does not necessarily come with it right away. Of the 12 million annual calls, only one in two is a very serious case, which deals with the threat to the patient’s life and other dangerous things.

Of course, if there is, for example, a suspicion of a heart attack, stroke, poisoning or, say, serious breathing problems, with the spine, if there are open wounds, severe pain, if the patient is unconscious, if an ambulance is called to the scene of a car accident or fire, if a child is injured, then the person on duty who receives the phone call immediately sends a doctor. But in other cases, two again specially trained paramedics of the rescue service arrive.

This is the most qualified medical specialty that does not require higher education.In Germany, the training of paramedics for the rescue service takes three years. More than half of the entire time of study, students spend not in theoretical studies, but at work, where they apply the knowledge gained in practice. After training, they take state exams. The seriousness of the training is evidenced by the fact that they include three written and three oral exams and four practical tests, during which orderlies must show in practice, in close to real conditions, whether they can save people.

By the way, during the training, future paramedics of the rescue service receive a salary: in the first year – about one thousand euros per month, in the second year – from one thousand to 1100 euros, in the last year of training – up to 1250 euros. The salary after completing their studies with them, say, in the federal state of North Rhine-Westphalia, ranges from two to three thousand euros per month, plus all kinds of allowances (for night duty, for work on weekends and holidays, work on a fire, etc.). ) is a few hundred more euros.

How quickly does an ambulance arrive in Germany?

But the profession, of course, is difficult, and the responsibility is very great. True, if an ambulance attendant has even the slightest doubt about the diagnosis, or he simply thinks that a doctor is needed, he immediately calls him. Usually the emergency doctor on duty arrives 10-15 minutes after the call, only in rural areas he may need a little more time. Therefore, by the way, there the doctor is more often than in the city, immediately sent along with the ambulance – but on it, but in his special car.By the way, the ambulance itself arrives even faster: according to statistics, on average, in eight and a half minutes.

It is probably worth mentioning how much it costs to call a medical ambulance. Usually from 100 (ambulance) to 300 euros (ambulance) per hour. An ambulance doctor costs about 200 euros. But it costs, like an ambulance, not to the patient, but to the health insurance company: it compensates for everything. The patient only pays a fee of a maximum of ten euros. Much more expensive than an ambulance is an ambulance helicopter.It is used, in particular, when it comes to very severe cases in difficult terrain, on a remote autobahn. An hour of a special helicopter costs about three and a half thousand. But this is also covered by health insurance in Germany.

See also:

  • How Germans Get Rid of Ailments

    Tea

    Before deciding what to do with a particular illness, it’s a good idea to have a cup of herbal tea. It can be bought in Germany not only in a pharmacy, but also in any store.Herbal teas have a beneficial effect. In addition, they perfectly raise the general tone and help to relax.

  • How Germans Get Rid of Ailments

    Licorice

    A well-known cough remedy – licorice, licorice or licorice root (Latin Glycyrrhiza glabra), is the basis of the “sticky” delicacy, beloved by the Germans. Regardless of the shape and degree of sweetness, licorice candy can do other wonders as well. A paste of crushed licorice lozenges and petroleum jelly helps to relieve calluses and horny skin on the feet.

  • How the Germans get rid of ailments

    Mustard

    Today, few people know about the benefits of mustard plasters in Germany. Also, rarely do Germans soar their feet with mustard powder. Mustard is better known here as a remedy for … heartburn! It sounds paradoxical, but a teaspoon of hot mustard, “taken” after a meal, soothes the stomach. The mustard oil contained in mustard improves the functioning of the gallbladder and liver, preventing the occurrence of heartburn.

  • How Germans Get Rid of Ailments

    Ginger

    In the Middle Ages, ginger imported from distant countries (lat.Zingiber officinale). Rich in vitamins and essential amino acids, the miracle root improves digestion and blood circulation. And ginger tea with lemon and honey is a universal antipyretic and anti-inflammatory agent.

  • How the Germans get rid of ailments

    Vodka

    The fact that a moderately “accepted” drink not only warms, but also relieves of various ailments has been known for a long time. Adherents of traditional medicine in Germany use vodka as a remedy for … excessive sweating of the feet and hands.To get rid of such a nuisance, it is recommended to wipe your hands and feet with gauze soaked in vodka twice a day.

  • How Germans Get Rid of Ailments

    Lard in German

    A slice of smoked bacon or “speck”, as the Germans call it, can save you from a toothache! Anyway, calm her down for a while until you get to the dentist. Do not rush to eat the whole piece at once – leave it behind your cheek, where the tooth hurts, and in 15-20 minutes you will feel better.The meat salt “draws” fluid from the swollen gums and acts as a mild pain reliever.

  • How Germans Get Rid of Ailments

    Olive Oil

    Due to its high content of oleic (monounsaturated) acid, olive oil is considered to be simply miraculous. It has healing properties. For example: to eliminate eczema, thoroughly rub oil into reddened areas of the skin. An excellent prophylactic agent against skin inflammations is a bath with the addition of 100 ml of oil and 500 ml of milk.

  • How Germans Get Rid of Ailments

    Cabbage

    Legends can be made about the benefits of white cabbage. In Germany, it is considered a migraine remedy. The juice of both fresh and sauerkraut is especially useful, according to traditional healers. A compress applied to the forehead of finely chopped cabbage leaves wrapped in a cotton towel also helps.

  • How Germans Get Rid of Ailments

    Cottage Cheese

    Instead of mustard plasters, cottage cheese is often used in Germany.Curd compress helps to get rid of annoying cough. To do this, the heated (not hot!) Curd mass is spread on a towel and placed alternately on the chest and back, covering the patient with a woolen blanket.

  • How Germans Get Rid of Ailments

    Black Pepper

    As you know, they knock out a wedge with a wedge, and hiccups with pepper! This physiological reaction of the body cannot be called dangerous, it usually goes away by itself. But sometimes the hiccups can be excruciatingly prolonged.In this case, it is recommended to sniff the ground black pepper. The alkaloid piperine contained in it will cause a “defensive reaction”, and the hiccuping sneeze will get rid of the hiccups.

  • How the Germans get rid of ailments

    Baking powder

    Artificial baking powder or just soda – the Germans resort to this “handy” remedy urgently in case of inflammation of the bladder. A pinch of baking soda or baking powder, dissolved in a glass of water, neutralizes the acidic environment, so favorable for the growth of bacteria, and turns it into an alkaline one.

  • How Germans Get Rid of Ailments

    Broth

    With a breakdown, flu and other ailments, the list of “healing” dishes in Germany is headed by chicken broth cooked over low heat. Spices are added to the broth: cloves, peppercorns, bay leaves, parsley roots, onions, and, if desired, a small piece of ginger. The favorite German chicken broth soup – with thin, homemade noodles.