Alcohol interferes with gonadal function even in the absence of cirrhosis by inhibiting normal testicular, pituitary, and hypothalamic function. Testicular atrophy, low testosterone levels, decreased beard growth, diminished sperm count, and a loss of libido result. However, testicular atrophy does not occur in all male alcoholics but is associated with alcohol dehydrogenase polymorphism in the testes, as reflected by the genetic variant of an increased frequency of the ADH21 allele (Yanauchi et al., 2001).
Thyroid dysfunction is common in alcoholics. Consistent findings indicate reduced thyroxine, and total and free triodothyronine concentrations in early abstinence. A blunted thyroid stimulation test is found in one-third of alcoholics during detoxification and into the early weeks of abstinence. A direct toxic effect of alcohol on the thyroid is likely, which in turn induces a compensatory activation of the hypothalamic-pituitary (HP) axis (Hermann, Heinz, & Mann, 2002).
Alcohol intoxication activates the HP axis and results in elevated gluco-corticoid levels. Elevated levels of these stress hormones may contribute to alcohol's pleasurable effects. With chronic alcohol consumption, however, tolerance may develop to alcohol's HP axis-activating effects. Chronic alcohol consumption, as well as chronic glucocorticoid exposure, can result in premature aging (Spencer & Hutchison, 1999).
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