Alcohol Can Lead to Erectile Dysfunction — and the Effects Usually Outlast the Buzz

In his play “The Tragedie of Macbeth” Shakespeare wrote that drinking alcohol “provokes the desire, but it takes away the performance.” People have known for a long time that a little alcohol can be relaxing. But drinking too much can have unexpected sexual side effects — both in the moment, and over time. How exactly does alcohol affect erections? 

How alcohol affects erections

Many body systems must work together to get and keep an erection. 

When your penis won’t get hard or stay hard long enough for sex, it’s called erectile dysfunction (ED). Some causes of ED are temporary, while others are chronic. Some men only have trouble with erections every now and then. For others, it’s a common concern.

Alcohol can lead to both temporary and chronic causes of ED. To understand how, let’s look at the body functions involved in erections: 

• Central nervous system: This includes your brain and spinal cord. Your brain processes messages about sexual arousal. But it also deals with stress, anxiety, and other emotions or distractions. These can affect both sexual desire and performance. The nerves of your spinal cord send information back and forth between your brain and your penis.

• Peripheral nerves: Sensations like touch and pressure are processed in peripheral nerves. These nerves signal blood vessels and muscles around your penis about what needs to happen next.

• Blood vessels: An erection happens when your penis fills with blood. Some blood vessels relax to allow more blood in, while others contract to keep it there.

• Hormones: Chemical messengers like testosterone play a key role in erections. But other hormones are also involved in erections.

• Muscles: Most of the muscles involved in erections work without you noticing. But they need the right nerve input and blood flow to work correctly.

Let’s take a look at how alcohol affects each of these body systems. We’ll explain how alcohol can impact your ability to have an erection both in the moment and over time.

Short-term effects

Some effects of alcohol can show up right away. These include:

• Slower nerve function: Alcohol slows down nerve signals to blood vessels and muscles in and around your penis. This can make it harder to get an erection. If you’re able to get one one, the quality and timing of your erection may not be what you’d expect. 

• Dehydration: Alcohol is a diuretic, which is why you pee more when you drink. Even mild dehydration means there’s less blood volume available for your penis. So, you may not have an erection firm enough to have sex.

• Changes in mood: For some people, a drink or two may take the edge off of worries or anxiety. That may help increase sexual desire. But alcohol can also make feelings of sadness or depression worse. This can have the opposite effect on erectile function.

Long-term effects

Heavy alcohol consumption over time can also increase your risk of chronic ED.

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• Can you cure erectile dysfunction? Some causes of ED are treatable, while others aren’t. No matter the cause, there are things you can do to help.

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• Does alcohol affect male fertility? If you’re in the midst of family planning, learn how alcohol impacts sperm count and quality.

Some of the long-term effects of too much alcohol include:

• Less hormone production: Less testosterone can affect your ability to have an erection. It also decreases sexual desire and leads to smaller testicle size.

• Weight gain: The extra calories in alcohol can lead to weight gain. More body fat can increase estrogen levels. In males, this is a risk factor for ED. 

• Chronic diseases: Extra weight also increases your risk for Type 2 diabetes, high blood pressure, and cardiovascular disease. All of these are associated with ED.

• Blood vessel damage: Long-term alcohol use can damage small blood vessels. This reduces blood flow to your penis. 

• Nerve damage: Chronic alcohol use damages nerves that send messages to the blood vessels and muscles in your penis.

How much alcohol is bad for erectile function?

When it comes to the health effects of alcohol, the less you drink is generally better. Most experts recommend that men should limit their intake to two drinks or less per day. They should also avoid binge drinking, which is about 5 drinks in a 2-hour period (for men). 

The risk of erectile dysfunction increases with about this amount of alcohol. But your individual risk will depend on factors like your age, other health conditions, and how your body processes alcohol. For some people, even a little alcohol can affect sexual performance.

Other ways alcohol affects your sexual health

ED is one of the more common sexual side effects of alcohol. But alcohol can affect your sex life in other ways, too. Drinking too much alcohol can lead to:

• Risky sexual behaviors

• Premature ejaculation (coming too fast)

• Decreased fertility

• Stress between you and your partner 

• Challenges with emotional and physical intimacy

Can you reverse alcohol-induced erectile dysfunction?

For younger men without other health conditions, ED caused by alcohol often goes away once the alcohol wears off. But reversing longer-term alcohol-induced ED depends on other factors like:

• Age

• Other alcohol-related conditions, like liver or heart disease

• How much alcohol is consumed daily

• How many years you’ve been drinking

There are many options for treating erectile dysfunction. But alcohol can interfere with common ED medications like Viagra or Cialis. Alcohol may reduce their effectiveness and increase side effects like headache. 

Why trust our experts?

Written by:

Anne Jacobson, MD, MPH

Anne Jacobson, MD, MPH has been a board-certified family physician since 1999. She worked as a full-scope family physician (inpatient, outpatient, obstetrics, and office procedures) in the Cook County Ambulatory Health Network for 15 years.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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