Alcoholism, marital problems and sexual dysfunction

Alcohol produces psychological effects of expectation and pharmacological effects on sexual performance. In low doses it may have a disinhibiting effect and enhance sexuality, however in increasing doses it impairs arousal and ejaculation. In women the physiological changes are similar to those in men, however they may report a positive subjective effect. Alcoholism may severely damage relationships and sexuality in both sexes. Alcohol affects the hypo-thalamic-pituitary axis causing features of hypogonadism and low serum testosterone levels. The peripheral metabolism of testosterone and sex-steroid binding globulin is also affected. Other factors which may play a detrimental role on libido and sexual function are liver function abnormalities, higher serum oestrogen levels, associated polyneuropathy and interpersonal and marital problems. Alcoholism can have a wide range of disruptive effects on family systems. Major issues include financial and job related problems, marital discord, isolation from the community, emotional and medical problems, disruption of family rituals and sexual and physical abuse.