Sexual dysfunction refers to impairment in sexual desire, arousal, or orgasm, or presence of pain associated with intercourse as a result of alcohol use. Alcohol-induced sexual dysfunction differs from a primary sexual disorder in that improvement would be expected with abstinence from alcohol.
Alcohol consumption has been found to have a negative relationship to physiological arousal in women. Although women state that they felt more aroused, the physical responses tend to be depressed when alcohol is consumed. Inhibition of ovulation, decrease in gonadal mass, and infertility may follow chronic heavy alcohol use.
In males, erectile dysfunction may occur transiently with alcohol use, especially at blood alcohol levels above 50 mg/100 ml. Decreased libido, erectile dysfunction, and gonadal atrophy are reported in chronic alcoholics (Adler, 1992).
Chronic male alcoholics, even without liver dysfunction, commonly demonstrate primary hypogonadism, as evidenced by decreased sperm count and motility, and altered sperm morphology. Increases in luteinizing hormone and a decrease in the free androgen index were reported in noncirrhotic males and related to lifetime quantity of ethanol intake (Villalta et al., 1977).
However, a controlled study of abstinent alcohol males selected for absence of physical illness and use of medications found that sexual dysfunction, level of lutenizing hormone, and level of bioavailable testosterone did not differ between the controls and the alcoholics (Schiave, Stimmel, Mandeli, & White, 1995).
Normal sexual functioning in abstinent alcoholic men can be expected in the absence of sexually impairing medications (e.g., disulfiram), liver disease, or gonadal failure.
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