Alcohol and Sex

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David Fawcett PhD, LCSW

In Act II, Scene III of Macbeth, William Shakespeare comments on alcohol and its impact on sex, writing, “It provokes the desire, but it takes away the performance.” One must assume the Bard’s statement was based on either personal or anecdotal experience rather than scientific research, but there is no arguing his accuracy. Almost all of the research into alcohol and its impact on sex finds the following to be true:

  • Small amounts of alcohol tend to increase sexual desire in both men and women.
  • Larger amounts of alcohol tend to decrease both sexual performance and sexual enjoyment in both men and women (though the overall impact is more varied in women).

When one understands that alcohol is a depressant – a drug that causes the body’s systems to slow down – these findings are not surprising. Like other depressant drugs, alcohol initially reduces stress and creates a sense of happiness and wellbeing. With this change comes a reduction in social inhibitions, including sexual inhibitions. As we consume more alcohol, however, balance, coordination, and the ability to experience physical sensations, including the pleasures of sex, are diminished.

Alcohol and Sex: Men

Consuming relatively small amounts of alcohol (one or two drinks at most) tends to increase sexual desire and physical sexual arousal in males. This may be linked to a decrease in sexual inhibitions, or it may be something of a self-fulfilling prophecy, where males expect to be sexual in drinking settings and act accordingly. Probably it’s a bit of both.

Consumption of higher levels of alcohol, however, can decrease sexual desire, sexual arousal, sexual performance, and sexual pleasure. This is caused, at least in part, by the metabolism of alcohol, which reduces the NAD+/NADH ratio in both the liver and the testes.[i] NAD+ is an enzyme that is essential to the production of testosterone – a critical element of male sexual desire and performance.

In addition to issues with NAD+ and testosterone, alcohol has the following effects:

  • It decreases blood flow to extremities, including the genitals.
  • It depresses the central nervous system.

Both of these issues can impact a male’s ability to achieve and maintain an erection, and to reach and enjoy orgasm.

Many heavy drinkers (daily drinkers, binge drinkers, and alcoholics) suffer from Erectile Dysfunction (ED). Based on this, many people theorize a direct link between heavy drinking and ED, though research is somewhat inconclusive on this front.[ii] What is more clear is the impact that alcohol has on a male’s ability to achieve and enjoy orgasm, with alcohol consumption beyond one or two drinks leading to delayed ejaculation and, at times, a complete inability to reach orgasm.[iii]

Alcohol and Sex: Women

Alcohol impacts women differently than men. For the most part, this is related to the fact that men tend to have more muscle tissue, and women tend to have more fat tissue (usually gynoid fat in their breasts and hips). Basically, because alcohol is water-soluble, it is diffused out of the bloodstream into muscle tissue (which is water-soluble) but not fat tissue (which is not water-soluble). As a result, alcohol tends to remain in women’s bloodstreams at higher levels for longer periods of time. So, if a man and a woman weigh the same and drink the same amount of alcohol, the woman will probably have a higher blood alcohol content and be more impacted for a longer period of time. As with a man, this can negatively impact both her desire for and her ability to enjoy sex.[iv]

As for female sexual desire, a drink or two is likely to increase libido. As with men, this may be linked to a decrease in sexual inhibitions, or it may be something of a self-fulfilling prophecy, where females also expect to be sexual in drinking settings and act accordingly.

With heavier drinking, especially if a woman reaches the point of intoxication, the impact on sexual desire in females is less predictable. Many women find their sexual desire suppressed, though others continue to experience higher levels of desire.

In general, however, as with men, alcohol consumption in women:

  • Decreases blood flow to extremities, including the genitals.
  • Depresses the central nervous system.

These issues may impact a woman’s ability to naturally lubricate for sex, to reach orgasm, and to fully enjoy an orgasm. However, these effects are more sporadic with women than with men. Basically, research shows that for many women alcohol consumption is associated with taking longer to reach orgasm and decreased intensity of orgasm, although the opposite is true for a significant number of other women.[v]

Alcohol and Sex: Risk-Taking

Numerous studies show a link between alcohol and casual sex, with increased alcohol consumption heightening the likelihood of such sex in every age group, though especially in teens and young adults. Other studies show that alcohol consumption is linked with sexual risk-taking, including unprotected sex, sex with people who might be dangerous, sex in locations that might be dangerous, etc.[vi] It is unclear whether alcohol’s disinhibiting properties are the cause, or if people who drink alcohol as part of their sexual behavior patterns are more tolerant to risk in general. Either way, alcohol is linked with risky sexual activity, potentially leading to a variety of unwanted outcomes – date rape, unwanted pregnancy, STIs, and more.[vii]

Individuals, both males and females, who consistently link alcohol and sexual behaviors, regardless of whether they are addicted to alcohol, sex, or both, are likely to be negatively impacted over time. They are more likely to engage in promiscuous behaviors and to experience the negative consequences that eventually accompany such activities, and they are less likely to fully enjoy the sexual experiences they have. Though small amounts of alcohol are likely to increase both desire and enjoyment, the men and women who consistently link alcohol and sex tend to not drink in small amounts. And when they get beyond the one or two drink threshold, they are almost certain to be deleteriously impacted.

References

[i] Frias, J., Torres, J. M., Miranda, M. T., Ruiz, E., & Ortega, E. (2002). Effects of acute alcohol intoxication on pituitary–gonadal axis hormones, pituitary–adrenal axis hormones, β-endorphin and prolactin in human adults of both sexes. Alcohol and Alcoholism37(2), 169-173; Mendelson, J. H., Ellingboe, J., Mello, N. K., & Kuehnle, J. (1978). Effects of alcohol on plasma testosterone and luteinizing hormone levels. Alcoholism: Clinical and Experimental Research2(3), 255-258; and (among other studies) Mendelson, J. H., Mello, N. K., & Ellingboe, J. (1977). Effects of acute alcohol intake on pituitary-gonadal hormones in normal human males. Journal of Pharmacology and Experimental Therapeutics202(3), 676-682.

[ii] Cheng, J. Y. W., Ng, E. M. L., Chen, R. Y. L., & Ko, J. S. N. (2007). Alcohol consumption and erectile dysfunction: meta-analysis of population-based studies. International Journal of Impotence Research, 19(4), 343-352.

[iii] Farkas, G. M., & Rosen, R. C. (1976). Effect of alcohol on elicited male sexual response. Journal of Studies on Alcohol37(3), 265-272.

[iv] Crowe, L. C., & George, W. H. (1989). Alcohol and human sexuality: review and integration. Psychological Bulletin, 105(3), 374.

[v] Beckman, L. J., & Ackerman, K. T. (2002). Women, alcohol, and sexuality. In Recent developments in alcoholism (pp. 267-285). Springer, Boston, MA.

[vi] Halpern-Felsher, B. L., Millstein, S. G., & Ellen, J. M. (1996). Relationship of alcohol use and risky sexual behavior: a review and analysis of findings. Journal of Adolescent Health19(5), 331-336.

[vii] Hanson, G., Venturelli, P., & Fleckenstein, A. (2011). Drugs and society. Jones & Bartlett Publishers.