How Alcohol Can Affect Men’s Sexual Function

If you’ve ever tried to head to the bedroom after having a few drinks, you may have found that you couldn’t perform as expected, like having trouble getting or keeping an erection or finishing in a timely fashion, among other possibilities.

You’re certainly not alone in these issues. But why do they happen? Urologist Neel Parekh, MD, explains how alcohol can lead to sexual dysfunction in men in both the short and the long term.

What happens to men when they drink alcohol?

Yes, the term “whiskey dick” is crass. But it refers to the very real way that alcohol — not just whiskey — can affect your ability to get or stay hard (aka erect). Alcohol can also cause ejaculation issues, trouble orgasming and low libido (sex drive).

It does this, in part, by:

• Slowing activity in your central nervous system, your brain’s processing center
• Decreasing blood flow to your penis
• Disrupting hormone levels, including testosterone, cortisol and prolactin
• Alters neurotransmitters in your brain, like GABA and glutamate

All of these bodily effects can spell trouble for your attempts at getting busy.

Erection issues

“Alcohol dampens sexual arousal by interfering with the brain signals that are needed to initiate and maintain an erection,” Dr. Parekh explains. “Specifically, it inhibits the parasympathetic nervous system, which is responsible for the relaxation of smooth muscle in the penis.”

Alcohol also affects the blood flow to your penis, which can keep you from getting or staying erect. During an erection, blood flow to your penis increases, causing it to become hard and stand upright. But alcohol widens (dilates) your blood vessels, which can cause a temporary drop in blood pressure that prevents your blood from flowing as it normally does.

“Blood flow is an important component of erections,” he reiterates, “but alcohol can impair the ability to maintain sufficient blood flow to the penis.” And little or no blood flow to your penis means little or no ability to get an erection.

Ejaculation and orgasm problems

Drinking can cause delayed ejaculation, meaning it takes 30 minutes or longer to ejaculate. It can also lead to anorgasmia, which is when having an orgasm takes a long time, is unsatisfying or doesn’t happen at all.

Why? Blame it on changes in your neurotransmitters, the chemical messengers that send communications between your brain and the rest of your body — including your penis. “Alcohol alters neurotransmitter activity in the brain,” Dr. Parekh explains, “which can ultimately delay ejaculation or make it difficult to reach orgasm.”

On the other hand, studies show that alcohol can also lead to premature ejaculation, or ejaculating too soon. And while it’s true that these two conditions are polar opposites, the reality is that alcohol can have a variety of effects and may impact different people in different ways.

Lower sex drive

A drink or two might loosen your sexual inhibitions and get you in the mood for sex. But any more than that can have the opposite effect.

Because it’s a depressant, alcohol can reduce your sensitivity to touch, which can make it more difficult for you to get aroused. Heavy drinking also affects your testosterone levels, which plays a role in both sexual function and libido.

Risky behaviors

In addition to its physical effects, drinking a lot of alcohol can wreak havoc on your cognition and judgment, which can play out in your sex life. Studies show that drinking may make men more likely to engage in risky behaviors related to sex, including having unprotected sex, which is a risk factor for contracting sexually transmitted infections (STIs, formerly known as STDs).

Can heavy drinking cause chronic erectile dysfunction?

The occasional night out can cause sexual performance issues that disappear once you’ve sobered up. But heavy drinking can lead to chronic sexual dysfunction — and the more you drink, the more likely you are to experience it.

One study found that in men with alcohol use disorder, more than 67% experienced some type of sexual dysfunction. The top effects were premature ejaculation, low libido and erectile dysfunction (ED).

Dr. Parekh explains some of the ways heavy drinking can cause these issues.

• Lower testosterone. Long-term alcohol use is associated with hypogonadism, which can lead to persistent ED.
• High prolactin levels. Alcohol dependence can also increase a hormone called prolactin. “High prolactin levels further suppress testosterone production and sexual function,” he says.
• Hardened arteries. Chronic drinking increases the risk of atherosclerosis, or a hardening of the arteries, which can reduce blood flow to your penis.
• High blood pressure. “Alcohol use disorder contributes to high blood pressure, which is a known risk factor for erectile dysfunction,” Dr. Parekh notes.
• Vitamin deficiencies. Heavy drinking can lead to deficits in vitamins like thiamine (B1), which can affect the nerves responsible for penile sensation.
• Mental health issues. “Alcohol use disorder is linked to depression and anxiety, both of which can worsen erectile dysfunction,” he says. One review of studies found that the risk of erectile dysfunction increases by 39% in men with depression.

Finally, Dr. Parekh notes that alcohol dependence can affect your relationships with the people closest to you, which can impair sexual activity.

How can alcohol withdrawal cause erectile dysfunction?

Getting treatment for alcohol use disorder can help you regain sexual function. But for a few reasons, going through alcohol withdrawal can temporarily make ED worse.

• Changes in neurotransmitter activity. “During alcohol withdrawal, the brain downregulates GABA receptors and increases excitatory neurotransmitter activity,” Dr. Parekh explains. “This imbalance leads to heightened sympathetic nervous system activity, which can impair erections.”
• Temporary surges in cortisol. High levels of cortisol, sometimes called the stress hormone, can impact erections and reduce testosterone.
• Sleep disruptions. Insomnia can reduce nocturnal erections and testosterone production.

But stick with it. As the other effects of alcohol withdrawal pass, your erectile dysfunction likely will, too. One study found that after three months of abstaining from alcohol, 88% of participants saw improvement in their ED.

A final word on alcohol and sexual dysfunction

It’s normal to experience ED or other sexual dysfunction every now and then, particularly if you’ve had a few drinks. But if you seem to have trouble getting or keeping an erection when you haven’t been drinking, or if you’re experiencing other sexual dysfunction issues, it’s time to make an appointment with a healthcare provider.

“A urologist can help you get to the bottom of whatever issues you’re having,” Dr. Parkeh reassures. “And if you need help addressing alcohol use disorder, a healthcare provider can certainly help you find the right resources and treatments for that, as well.”