Masters and Johnson, identified alcohol as a common factor in impotence in their monumental work on human sexual inadequacy. Alcohol damages the central nervous system and destroys brain cells, and if the damage is prolonged enough, it can result in irreversible sexual impotence even while a person is sober. Alcohol is also a factor in loss of sexual control or premature ejaculation. Even a couple of beers before sex can spoil a man's erection and ruin his ejaculatory control. Up to 80 percent of men who drink heavily are believed to have serious sexual side effects, including impotence, sterility, or loss of sexual desire. Heavy drinking over a long period of time can irreversibly destroy testicular cells, leaving men with shrunken testicles. Both sexual drive and sexual capacity can be damaged. Alcohol also suppresses testosterone levels even in social drinkers by suppressing the secretory activity of the Leydig cells (Flatto, 1990).

Alcohol and High-Risk Sexual Behaviors

A history of heavy alcohol use has been correlated with a lifetime tendency toward high-risk sexual behaviors, including multiple sex partners, unprotected intercourse, sex with high-risk partners (e.g., injection drug users, prostitutes), and the exchange of sex for money or drugs (Windle,M.,1997). There may be many reasons for this association. For example, alcohol can act directly on the brain to reduce inhibitions and diminish risk perception (MacDonald,T.K.,2000).

However, expectations about alcohol’s effects may exert a more powerful influence on alcohol-involved sexual behavior. Studies consistently demonstrate that people who strongly believe that alcohol enhances sexual arousal and performance are more likely to practice risky sex after drinking (Cooper,M.L.,2002). Some people report deliberately using alcohol during sexual encounters to provide an excuse for socially unacceptable behavior or to reduce their conscious awareness of risk (Derman,K.H.,1998). According to McKirnan and colleagues (McKiran,D.J.,2001), this practice may be especially common among men who have sex with men. This finding is consistent with the observation that men who drink prior to or during homosexual contact are more likely than heterosexuals to engage in high-risk sexual practices (Avins,A.L.,1994).

Alcohol and AIDS

People with alcohol use disorders are more likely than the general population to contract HIV (human immunodeficiency virus) - the agent that causes acquired immunodeficiency syndrome (AIDS). Similarly, people with HIV are more likely to abuse alcohol at some time during their lives (Petray,N.M.,1999). Alcohol use is associated with high-risk sexual behaviors and injection drug use, two major modes of HIV transmission.

What are signs of problem drinking?