Most medical experts agree that that men who consume alcohol on a regular basis are more likely to experience temporary or lasting impotence as a result. Alcohol and impotence are not necessarily always linked, but most research indicates that there is a connection, particularly among men who drink heavily and men who are over 50. Alcohol damages the nervous system and reduces the production of testosterone and other hormones necessary for sexual arousal. Long-term alcohol abuse can lead to irreversible erectile dysfunction (ED), in which a man cannot get or maintain an erection long enough to have sex. To avoid this condition and other health problems that indirectly cause impotence, medical experts usually recommend that people limit their alcohol intake to one or two "standard drinks" a day.
Hormonal Role in Arousal
Sexual arousal can be a complicated thing, but it’s usually driven by hormones and nerve synapses that originate in the brain and travel throughout the body to end up in the genital region. The term “impotence” is usually understood to relate only to male arousal, specifically with penile erection. A man is usually deemed impotent if he cannot maintain an erection long enough to complete the sex act.
For a man to get an erection, nerve cells must send a message from the hypothalamus to the anterior pituitary gland to the penis communicating that more blood should flow into the penis, making it larger and stiffer. Alcohol generally slows down communication between nerve cells, which can interfere with the delivery of this message. The more a man drinks, the slower that response time may be. Impotence isn’t usually an immediate effect, but it can and often does happen over time.
Alcohol’s Effects
Alcohol can act as both a stimulant and a suppressant, depending on how much is consumed. Many men find that a drink or two will lower their inhibitions and can actually facilitate sexual activity, but in most cases this is strictly a short-term effect — and it’s usually also driven by quantity. One or two drinks can fuel sex, but more than that can often serve to slow it down.
For most men, the key is moderation. Consuming several alcoholic drinks over the course of one evening is unlikely to have any profound effect. Having those same drinks in quick succession, however, or repeating the pattern for many nights in a row, can cause temporary impotence because it can slow down the functioning of the nervous system.
Problems With Long-Term Abuse
Long-term alcohol abuse can adversely affect every step of a man's sexual functioning. It can prevent a man from feeling much sexual desire at all, in part because it reduces the production of the hormone testosterone; and, even if sexual desire remains, alcohol-damaged nerve cells may be unable to communicate with the penis. Supposing the penis does receive the "erection" message, alcohol-damaged blood vessels inside the penis might still be unable to fill up normally.
Defining “Problem” Drinking
Alcohol is generally understood to be a toxin, but there is some debate in the literature when it comes to whether or not the substance is necessarily harmful in small quantities. Some experts actually recommend moderate drinking. Heavy consumption is almost universally acknowledged as harmful, though, and abuse is usually pretty easy to define. In most cases, alcohol abuse is defined as more than three standard drinks a day, or drinking to the point of intoxication as a pattern of ordinary behavior. This sort of activity usually has the most profound link to impotence.
A “standard” drink is usually defined as one 12-ounce (350 mL) can of beer, 4 ounces (120 mL) of wine, 1.5 ounces (45 mL) of 80-proof spirits, or 1 ounce (30 mL) of 100-proof spirits. The popular 40-ounce (1.2 liter) bottle of beer contains more than three standard drinks, so finishing just one of them in an evening is usually thought to be too much. According to many doctors and researchers, men who limit their alcohol intake to just one or two standard drinks or less in a day have the best chance of avoiding the connection between alcohol and impotence.
Even non-abusive drinking can lead to problems with impotence, though. So-called “binge drinking,” which is a period of excessive alcohol consumption typically followed by one or more days of no drinking, does not necessarily prevent sexual dysfunction. Some of this has to do with individual body chemistry. Usually, though, any amount of heavy drinking can, over time, lead to issues.
Treatment Options
Alcohol-induced erectile dysfunction is often irreversible, but treatments sometimes succeed at curing, or at least reducing, the frequency of the problem. Treatment options include vacuum devices, hormone replacement, and prescription drugs. It’s important to note, though, that some possibilities may be restricted by other alcohol-induced health conditions. For example, alcohol abuse can damage the heart, and many erection-inducing pharmaceuticals cannot be used on men with heart problems. Most aren’t recommended for men who drink regularly, either.