Alcohol causes loss of libido, impotence, and sterility in males.
Direct damage to testicular cells and impairment of control centers in
the brain may help explain the sexual dysfunction.
The association between alcohol abuse and reproductive dysfunction has
long been recognized. For example,
the Greeks proscribed the use of alcohol on the day of matrimony.
Signs and symptoms of inadequate sexual function (hypogonadism)
associated with alcohol abuse include testicular atrophy (shrinkage),
sterility, impotence, loss of libido, reduction in size of the
prostate gland, and decreased sperm production.
Hypogonadism may be caused by direct effects of alcohol on the testis;
it can also be caused by effects of
alcohol on parts of the brain that regulate gonadal function. These
parts of the brain include the hypothalamus, located approximately in
the center of the brain, and the pituitary gland, located at the base
of the brain just below the hypothalamus. The term "hypothalamic-
pituitary-gonadal (HPG) axis" refers to the interaction of these three
levels of control of testicular function.
Alcohol, Sexual Function, And The Liver
Because hypogonadism was first reported in alcoholic men with
cirrhosis of the liver (Table 1), alcohol-induced sexual dysfunction
was initially attributed to liver disease. As reliable methods of
quantifying sex hormones became available, levels of the male sex
hormone testosterone were measured in the blood of cirrhotic men.
Subjects with alcohol-induced liver disease were found to have
markedly reduced testosterone levels, while those with advanced liver
disease due to other causes often had normal testosterone levels
Direct Effects of Alcohol on the Testis
When assessing testicular failure, the two functions of the testis--
sperm production and testosterone production--must be examined
independently.The cells responsible for sperm production occupy 95
percent of the testicular volume. Therefore, failure of
spermatogenesis (sperm production) may be characterized by testicular
atrophy associated with oligospermia (decreased sperm production) or
azoospermia (absence of sperm). In contrast, decreased production of
steriod sex hormones (principally testosterone) is characterized by a
loss of male secondary sex characteristics, impotence, diminished
libido, and other symptoms, but usually not by an obvious reduction in
testicular size.
With respect to spermatogenesis, the testes of both alcoholic men and
rats fed alcohol chronically show advanced injury to the germ cells of
the seminiferous tubules, the site of sperm production within the
testis (Gavaler and Van Thiel 1987).
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