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Reviewed by Dr John Dean, specialist in sexual medicine
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Alcoholism will inevitably lead to sexual problems in a relationship. For men, this most often means problems getting and sustaining an erection, even when sober.
How does alcoholism cause sexual problems?
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| Alcoholism can adversely affect
libido and cause erection
difficulties. |
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Defining what constitutes alcoholism is not easy, because it has to cover several related factors.
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There are the toxic effects of too much alcohol consumed over the short and long term on many body tissues – particularly the liver, brain and nervous system.
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There are also the social consequences of alcoholism to consider.
For many alcoholics, the disruption of their personal lives can be more immediately obvious and important than the chemical changes occurring inside them.
If either partner in a relationship is an alcoholic, then sexual difficulties will almost certainly be one of the consequences of the problem.
For men, this most commonly manifests itself as erectile dysfunction (ED), which can be present even when you are sober.
Alcoholism also has an adverse effect upon libido: long-standing alcoholism is accompanied by various hormone problems, among which is a fall in testosterone output.
Sex is unlikely to be an attractive activity for anyone with an inebriated partner and is just one aspect of the relationship problems that alcoholism brings.
Alcoholism and psychiatric illness
In addition to the direct effects of excess alcohol, many alcoholics also have significant psychiatric illness, the most common being depression.
Many depressed people also turn to drinking to give short-term relief of depression, only to find that alcohol doesn’t help - but the consumption can rapidly get out of control.
The elderly are a section of the population that is growing in numbers, but in whom loneliness and depression are common and often not recognised.
Increasing age and the presence of depression are both strongly associated with erectile dysfunction.
How does having a problem with alcohol affect treatment?
Like alcoholism, ED in general is under-reported and concealed. Exactly how many people there are with both problems is therefore unknown.
Treatment cannot start until all problems are recognised. The treatment of ED associated with alcoholism clearly has to emphasise the need to control the drinking and preferably stop it completely, but chronic alcoholism is a very difficult condition to treat successfully.
Any associated depression also needs to be detected and effectively treated. In some people, this is the key to stopping the alcohol abuse.
Although the common treatments for erectile dysfunction such as drug therapy and mechanical aids are likely to work in an alcoholic man as far as obtaining an erection is concerned, they will do nothing to repair a relationship damaged from alcohol abuse.
Marital therapy can be an essential part of a couple regaining any form of sexual relationship.
Where to get help
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Your GP
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Alcoholics Anonymous
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Relate
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BASRT - the national specialist charity for sex and relationship therapy
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British Association for Counselling and Psychotherapy: http://www.bacp.co.uk
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Sexual Dysfunction Association
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Based on a text by Christine Webber, psychotherapist and Dr David Delvin, GP and family planning specialist
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Last updated 31.07.2006
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