Alcohol and Erectile Dysfunction: What’s the Link?

Erectile dysfunction (ED) is an inability to get or maintain an erection firm enough for sexual activity.

The process of getting an erection is complex and involves your:

• brain
• hormones
• blood vessels
• nerves

Consuming alcohol can affect all of these parts of your body and can contribute to the development of ED.

Consuming a large amount of alcohol in a short period of time, such as a single evening, can cause changes that make it more difficult to get an erection. These changes can occur in your:

• nervous system
• hormone levels
• circulation

Chronic (long-term) overconsumption of alcohol can cause permanent damage to your blood vessels and nerves.

Read on as we take a deeper look at how alcohol contributes to ED.

Getting an erection is a complex process, and ED can occur if there’s a problem during any step.

Sexual thoughts or stimulation of the penis activate the parasympathetic nervous system and the release of neurotransmitters from nerves in the penis. These neurotransmitters relax the muscles in the arteries of the penis, which increases blood flow by 20 to 40 times.

Short-term causes of ED

A temporary inability to get an erection can happen after consuming any type of alcohol.

According to a 2018 study, short-term consumption of alcohol depresses your central nervous system and slows down the transmission of information between your brain and penis. This can lead to decreased sensitivity of the penis.

Alcohol is a diuretic, meaning it’s dehydrating and increases urination. Dehydration can lead to increased levels of the hormone angiotensin, which narrows blood vessels. Angiotensin can limit blood flow to the penis.

According to older 1998 research and more recent animal studies, alcohol can also lead to a drop in circulating levels of testosterone. Testosterone deficiency limits nitric oxide production, which is the key molecule that relaxes the blood vessels in your penis.

Chronic effects of alcohol

Chronically consuming large amounts of alcohol can damage your nerves, raise your risk of cardiovascular disease, and damage blood vessels, all of which can impact your ability to get an erection.

A 2021 review of studies found a significant relationship between regular alcohol consumption and ED.

Nervous system dysfunction

According to a 2020 review, anywhere from 16 to 73 percent of chronic heavy alcohol users experience dysfunction of the autonomic nervous system. The most common symptom is ED. Your autonomic nervous system largely controls functions that are unconscious.

Cardiovascular disease and blood vessel damage

It’s well established that ED is closely related to cardiovascular disease.

According to a 2018 review, light to moderate drinking is associated with a lower risk of cardiovascular disease, while heavy consumption is associated with increased cardiovascular mortality.

A 2018 study found that heavy alcohol consumption increases your risk of developing high blood pressure. High blood pressure is a risk factor for sexual dysfunction.

Results from human and animal studies suggest that binge drinking is associated with blood vessel damage.

Alcohol withdrawal syndrome develops when a person who drinks heavily suddenly stops drinking. It’s been linked to cardiovascular symptoms such as high blood pressure that could potentially interfere with the ability to get an erection.

Other common withdrawal symptoms include:

• tremors
• anxiety
• nausea
• vomiting
• headaches
• high blood pressure
• irritability
• confusion

Symptoms usually start 6 to 12 hours after your last drink and are usually most severe after 48 to 72 hours.

Although reducing your alcohol intake may cause short-term symptoms that contribute to ED, it will likely improve your sexual health in the long run.

In a 2022 studyof 104 people with alcohol use disorder and ED, 88.5 percent showed improvements in ED after 3 months of not consuming alcohol.

Alcohol can affect sexual function in people of all genders in a variety of ways.

A 2021 study in India included 100 participants who were categorized as males with alcohol dependence syndrome. The researchers found that 48 participants had sexual dysfunction. Of those 48:

• 87.5 percent reported lower sex drive
• 79.1 percent had dysfunction of sexual arousal
• 58 percent had ED
• 54 percent reported difficulty reaching orgasm

Alcohol consumption may also:

• delay ejaculation
• increase sex drive with moderate amounts of alcohol, but lower sex drive with high amounts of alcohol

In people assigned female at birth, alcohol may:

• lead to vaginal dryness
• make it more difficult to orgasm
• increase sexual desire with small amounts of alcohol but decrease sexual arousal with large amounts of alcohol

Experiencing ED occasionally is normal and no reason for concern. It can occur if you’ve been drinking or feeling stressed or anxious.

However, it’s a good idea to see a doctor if it becomes a regular problem. Sometimes ED can be a sign of an underlying health condition like high blood pressure.

It’s also a good idea to see a doctor if you think you may have a problem with alcohol. Signs of alcohol use disorder include:

• drinking alone and in secrecy
• losing interest in activities other than drinking
• craving alcohol
• experiencing withdrawal symptoms
• making drinking a priority over other responsibilities
• drinking in the morning
• inability to control the amount of alcohol you consume
• alcohol contributing to financial or family problems

Consuming alcohol can contribute to the development of ED by:

• slowing down your central nervous system
• causing dehydration
• lowering your testosterone levels

Long-term consumption of alcohol can lead to damage to your blood vessels and nerves.

It’s normal to experience ED every now and then, especially when you’re drinking.

If you regularly have trouble maintaining an erection when you’re sober or after only drinking small amounts of alcohol, it’s a good idea to visit a doctor to rule out an underlying health condition.

Alcohol and Erectile Dysfunction: What’s the Link?

Erectile dysfunction (ED) is an inability to get or maintain an erection firm enough for sexual activity.

The process of getting an erection is complex and involves your:

• brain
• hormones
• blood vessels
• nerves

Consuming alcohol can affect all of these parts of your body and can contribute to the development of ED.

Consuming a large amount of alcohol in a short period of time, such as a single evening, can cause changes that make it more difficult to get an erection. These changes can occur in your:

• nervous system
• hormone levels
• circulation

Chronic (long-term) overconsumption of alcohol can cause permanent damage to your blood vessels and nerves.

Read on as we take a deeper look at how alcohol contributes to ED.

Getting an erection is a complex process, and ED can occur if there’s a problem during any step.

Sexual thoughts or stimulation of the penis activate the parasympathetic nervous system and the release of neurotransmitters from nerves in the penis. These neurotransmitters relax the muscles in the arteries of the penis, which increases blood flow by 20 to 40 times.

Short-term causes of ED

A temporary inability to get an erection can happen after consuming any type of alcohol.

According to a 2018 study, short-term consumption of alcohol depresses your central nervous system and slows down the transmission of information between your brain and penis. This can lead to decreased sensitivity of the penis.

Alcohol is a diuretic, meaning it’s dehydrating and increases urination. Dehydration can lead to increased levels of the hormone angiotensin, which narrows blood vessels. Angiotensin can limit blood flow to the penis.

According to older 1998 research and more recent animal studies, alcohol can also lead to a drop in circulating levels of testosterone. Testosterone deficiency limits nitric oxide production, which is the key molecule that relaxes the blood vessels in your penis.

Chronic effects of alcohol

Chronically consuming large amounts of alcohol can damage your nerves, raise your risk of cardiovascular disease, and damage blood vessels, all of which can impact your ability to get an erection.

A 2021 review of studies found a significant relationship between regular alcohol consumption and ED.

Nervous system dysfunction

According to a 2020 review, anywhere from 16 to 73 percent of chronic heavy alcohol users experience dysfunction of the autonomic nervous system. The most common symptom is ED. Your autonomic nervous system largely controls functions that are unconscious.

Cardiovascular disease and blood vessel damage

It’s well established that ED is closely related to cardiovascular disease.

According to a 2018 review, light to moderate drinking is associated with a lower risk of cardiovascular disease, while heavy consumption is associated with increased cardiovascular mortality.

A 2018 study found that heavy alcohol consumption increases your risk of developing high blood pressure. High blood pressure is a risk factor for sexual dysfunction.

Results from human and animal studies suggest that binge drinking is associated with blood vessel damage.

Alcohol withdrawal syndrome develops when a person who drinks heavily suddenly stops drinking. It’s been linked to cardiovascular symptoms such as high blood pressure that could potentially interfere with the ability to get an erection.

Other common withdrawal symptoms include:

• tremors
• anxiety
• nausea
• vomiting
• headaches
• high blood pressure
• irritability
• confusion

Symptoms usually start 6 to 12 hours after your last drink and are usually most severe after 48 to 72 hours.

Although reducing your alcohol intake may cause short-term symptoms that contribute to ED, it will likely improve your sexual health in the long run.

In a 2022 studyof 104 people with alcohol use disorder and ED, 88.5 percent showed improvements in ED after 3 months of not consuming alcohol.

Alcohol can affect sexual function in people of all genders in a variety of ways.

A 2021 study in India included 100 participants who were categorized as males with alcohol dependence syndrome. The researchers found that 48 participants had sexual dysfunction. Of those 48:

• 87.5 percent reported lower sex drive
• 79.1 percent had dysfunction of sexual arousal
• 58 percent had ED
• 54 percent reported difficulty reaching orgasm

Alcohol consumption may also:

• delay ejaculation
• increase sex drive with moderate amounts of alcohol, but lower sex drive with high amounts of alcohol

In people assigned female at birth, alcohol may:

• lead to vaginal dryness
• make it more difficult to orgasm
• increase sexual desire with small amounts of alcohol but decrease sexual arousal with large amounts of alcohol

Experiencing ED occasionally is normal and no reason for concern. It can occur if you’ve been drinking or feeling stressed or anxious.

However, it’s a good idea to see a doctor if it becomes a regular problem. Sometimes ED can be a sign of an underlying health condition like high blood pressure.

It’s also a good idea to see a doctor if you think you may have a problem with alcohol. Signs of alcohol use disorder include:

• drinking alone and in secrecy
• losing interest in activities other than drinking
• craving alcohol
• experiencing withdrawal symptoms
• making drinking a priority over other responsibilities
• drinking in the morning
• inability to control the amount of alcohol you consume
• alcohol contributing to financial or family problems

Consuming alcohol can contribute to the development of ED by:

• slowing down your central nervous system
• causing dehydration
• lowering your testosterone levels

Long-term consumption of alcohol can lead to damage to your blood vessels and nerves.

It’s normal to experience ED every now and then, especially when you’re drinking.

If you regularly have trouble maintaining an erection when you’re sober or after only drinking small amounts of alcohol, it’s a good idea to visit a doctor to rule out an underlying health condition.

the role of thioctic acid in complex treatment uMEDp

The article substantiates the need for taking antioxidants (eg, thioctic acid) to prevent and treat conditions accompanied by the development of oxidative stress, including alcoholic neuropathy and erectile dysfunction.

Erection is a complex neuro-humor-vascular phenomenon, the quality of which depends on the psycho-emotional status, functional state of the vascular wall (endothelium), conductive nerve fibers and afferent adrenergic endings (adequate activity of neurogenic nitric oxide synthase (NO-synthase)) [1] . It should be emphasized the importance of the functional state of the nervous system in the occurrence of erection [1]. As you know, an erection occurs during sexual stimulation (which distinguishes a true erection, say, from nocturnal tumescences), which entirely depends on the state of the hypothalamic system and the androgenic status of a man. As a result, the nerve impulse propagates along the conduction system of the spinal cord to the pelvic nerve plexus, after which the neurogenic NO-synthase of peripheral (cavernous) adrenergic presynaptic endings is activated, which is accompanied by an additional release of NO (neuromuscular impulse transmission) and leads to an instant additional NO- dependent vasodilation of cavernous arteries against the background of basic activity of endothelial NO-synthase (androgen-dependent process).

Depending on disorders in a particular body system, men distinguish between vasculogenic, dyshormonal, psychogenic and neurogenic erectile dysfunction (ED), however, in clinical practice, in the vast majority of cases, a combination of these causes prevails. The generally accepted strategy for treating ED with type 5 phosphodiesterase (PDE) inhibitor drugs is justified due to the high efficacy of this class of drugs. However, monotherapy with PDE-5 inhibitors cannot comprehensively affect all factors of the pathogenesis of ED, therefore, it has an inferior therapeutic effect, which weakens over time if pathogenetic treatment is not carried out [2]. In this regard, the method of determining the hormonal status of a man (especially androgen deficiency and hyperprolactinemia) seems promising and promising. Correction of hormonal disorders greatly increases the effectiveness of “traditional” therapy for ED due to a potentiating effect on the synthesis of nitric oxide through the expression of the NO-synthase gene in endotheliocytes and adrenergic nerve endings, activation of lipolysis, elimination of insulin resistance, hyperinsulinemia and prevention of neuropathy. The pathogenesis of neuropathies is different: they distinguish toxic, alcoholic, diabetic, immunological, infectious, hereditary, traumatic, iatrogenic neuropathies, etc. In clinical practice, doctors are mainly engaged in the detection and treatment of exclusively diabetic neuropathy [3], while the prevalence of dyshormonal (age-associated) and alcoholic neuropathy is no less [4, 5]. Regardless of the pathogenesis of neuropathy, the pathophysiological mechanisms of its development are the same and are reduced to a violation of energy metabolism and activation of oxidative stress in the cells of the nervous tissue.

The energy substrate for all cells of the nervous tissue is glucose, which is included in the tricarboxylic acid cycle (Krebs cycle), oxidized to form CO2, H2O and adenosine triphosphate (ATP). The functioning of the Krebs cycle involves various enzyme complexes that provide sequential reactions accompanied by the formation of ATP. The key importance of two reactions catalyzed by pyruvate and alpha-ketoglutarate dehydrogenase complexes has been experimentally established. The complexes consist of several enzymes, coenzymes and cofactors, among the latter one can single out, for example, Mg+. Replenishment of Mg + deficiency is necessary if it is intensively consumed during overloads in the work of the nervous system, under conditions of chronic stress. The coenzymes in these complexes are vitamins B1, B6, pantothenic acid, nicotinamide and alpha-lipoic (thioctic) acid (ALA). It is the deficiency of these coenzymes that leads to the “stopping” of the Krebs cycle [5, 6]. It should be noted that enzymes and coenzymes in chemical processes affect the rate of the reactions they catalyze without being consumed themselves. Consequently, the deficit of coenzymes occurs under the condition of their increased consumption in third-party processes with insufficient renewal of their supply in vivo.

Conditions associated with B vitamin deficiencies include nutritional deficiencies (now a very rare disease, beriberi disease) and alcohol abuse, which leads to an increased consumption of B vitamins against the background of nutritional deficiency and oxidative stress. Given the excessive consumption of alcohol in our country, the problem of eliminating the consequences of alcoholism and related complications is very relevant. If both medicinal and dietary recommendations are used to correct hypovitaminosis B, then the situation is much more complicated with regard to oxidative stress.

There is the concept of “RedOx-status” (reduction-oxidation – oxidation-reduction), meaning the ratio of oxidative and reduction reactions in the body. Normally, the balance between these processes is maintained in the body at an optimal level as carefully as the pH of the blood or the activity of the coagulation and anticoagulation systems. However, with an increased intake or formation of free radicals in vivo, a deficiency of antioxidant systems, or oxidative stress, occurs. The most common conditions associated with the development of oxidative stress are obesity, diabetes, and alcoholism. Moreover, with alcohol abuse, due to thiamine deficiency, the synthesis of myelin sheaths of nerve cells is disrupted, and the toxic effect of ethanol and its metabolites leads to axonopathy. The maximum allowable safe dose of alcohol for the nervous system corresponds to 40 ml of vodka / 180 ml of dry wine / 300 ml of beer. In the current reality, it is advisable to introduce adequate measures to prevent oxidative stress, especially for urban residents who experience additional oxidative stress due to air pollution, smoking, etc.

The leading role in the antioxidant defense system belongs to vitamins E and A, which are restored by the thiol system. Vitamin E recycling is impossible without the participation of ALA, which reduces thiols and has its own antioxidant activity. ALA, a fatty acid containing 8 carbon atoms and two sulfur atoms [6], is a necessary component of the enzyme complexes of the Krebs cycle and the antioxidant system. Unfortunately, the endogenous synthesis of ALA is minimal and does not meet the needs of a modern person living in the city, especially if he smokes, abuses alcohol, is obese or has diabetes. There is no possibility to eliminate ALA deficiency by alimentary means. The daily prophylactic dose for a healthy person, according to various estimates, is 100-600 mg / day.

Experience with the use of ALA in cases of poisoning with toadstool venom and phosgene (nerve agents), in the treatment of radiation sickness and leukemia in children after the Chernobyl tragedy, use in sports medicine, as well as data from large randomized clinical trials substantiate the possibility of prescribing ALA drugs in everyday life. practice. ALA can be used to prevent and treat conditions associated with oxidative stress, including alcoholic neuropathy and ED.

Tablet and parenteral forms of ALA with predicted bioavailability are now available, such as Espalipon. Our own experience allows us to recommend a daily intake of 300 mg of Espa-Lipon 1 r / day in the morning at least 30 minutes before meals. At the beginning of treatment, it is advisable to conduct courses of infusion therapy with ALA solution 600–1200 mg/day IV No. 12–14. This approach significantly increases the effectiveness of ED therapy and reduces the financial burden on the patient. It should be noted another very important effect of the regular intake of Espa-Lipon: normalization of hepatic function (normalization of transaminase levels) and a unique effect on the structure of the hepatic lobules, expressed in the normalization of the histological structure of the liver. It is no coincidence that ALC therapy is included in the standard treatment for hepatitis of any etiology, liver cirrhosis, and non-alcoholic steatohepatosis [4, 6].

In conclusion, we can formulate the main expected therapeutic effects from the continuous use of Espa-Lipon at a dose of 300 mg / day: prevention and treatment of ED, alcoholic and non-alcoholic steatohepatosis, diabetic neuropathy, insulin resistance, autonomic neuropathy. The accumulated scientific, experimental data and our own experience allow us to recommend the regular intake of Espalipon at a dose of 300 mg / day, if necessary, in combination with IV infusions.

Alcohol and sexual dysfunctions. Clinic Andros

Moderate amounts of alcohol are said to stimulate libido and improve a person’s sexual performance.

Is it really?

This is true when it comes to small doses of alcohol that are taken infrequently or “on occasion”. If alcohol is consumed regularly and in large enough doses, the effect is completely opposite. Among those who regularly take alcohol, there is a decrease in sexual desire and a weakening of erection twice as often as among non-drinkers. If among non-drinkers sexual dysfunctions occur in about 10-15% of cases, then people who regularly drink alcohol report problems in the sexual sphere with a frequency of up to 58%.

What role does frequent alcohol consumption play in the structure of causes of erectile dysfunction (impotence) in men?

In countries where the amount of alcohol consumed per capita is significantly higher than the world average (Russia is one of them), alcoholism is the cause of at least 5-10% of cases of impotence. Sexual partners of alcoholics note in almost 100% of cases that their men had significantly harder and longer erections before they started drinking alcohol.

What changes that affect sexual function does alcohol cause in a man’s body?

Regular alcohol consumption, especially in combination with malnutrition, leads to a significant deterioration in liver function. This negatively affects the functioning of the organs regulating sexual function, which leads to a decrease in the concentration of the male sex hormone testosterone in the body, and hence to a decrease in sexual desire and impotence. Alcohol also has a direct toxic effect on the testicles and leads to their atrophy. And this, in addition to the above problems, also leads to infertility. In addition, alcohol affects the central and peripheral nervous system, which negatively affects both the quality of erection and the fullness of sensations during intercourse and orgasm. Alcohol causes atrophy of the gray matter of the cortical and frontal lobes of the brain, which play an important role in sexual function.

How successful is the treatment of alcohol-related sexual disorders in men?

In some cases, the cessation or a significant reduction in the amount of alcohol consumed leads to a complete restoration of impaired sexual function.