In regard to circulation, alcohol causes the blood vessels to dilate, which influences the way the blood moves in and out of the penis. A good blood flow regulates the relaxation and contraction of the penis, so it can get and maintain an erection. Without it, no matter how much you may want it to happen differently, your penis will simply remain flaccid.
Fully restoring sexual health with treatment of a medical condition (such as high blood pressure with diet and/or exercise or by controlling diabetes or other chronic diseases) may not be possible. Identification and treatment of these conditions may prevent the progression of ED and affect the success of various ED therapies. Nutritional states, including malnutrition, obesity, and zinc deficiency, may be associated with erectile dysfunction, and dietary changes may prove a sufficient treatment. Masturbation and excessive masturbation are not felt to cause ED, however, if one notes weak erections with masturbation, this may be a sign of ED. Some men who masturbate frequently may have troubles with achieving the same degree of stimulation from their partner, but this is not ED.
Erectile dysfunction is a condition in which a man is unable to achieve an erection sufficient for sexual intercourse. In some cases the man is able to achieve an erection but unable to maintain it long enough to complete the sex act. Most men experience erectile difficulties at some point in their lives, but this is different from ED. According to the Mayo Clinic, those with ED will fail to achieve an erection at least 25 percent of the time. ED has several causes and alcohol consumption can be one of them.
Failure to achieve an erection is not uncommon for most men and may be considered normal even if it happens as often as 20 percent of the time. There is a wide range of normal when it comes to sexual functioning and sexual relationships. "Generally if a couple feels comfortable with their sex life and they enjoy intimacy together, erectile dysfunction may not be much of an issue. But if erectile dysfunction is causing stress in a relationship, then help is available," says Feloney.
The initial step in evaluating ED is a thorough sexual history and physical exam. The history can help in distinguishing between the primary and psychogenic causes. It is important to explore the onset, progression, and duration of the problem. If a man gives a history of “no sexual problems until one night,” the problem is most likely related to performance anxiety, disaffection, or an emotional problem. Aside from these causes, only radical prostatectomy or other overt genital tract trauma causes a sudden loss of male sexual function.
Alcohol consumption is a common behavior in social circumstances worldwide. Epidemiological studies have suggested that moderate alcohol consumption reduces cardiovascular morbidity and mortality. The cardiovascular protective effects of alcohol may be attributed to its antioxidant, vasorelaxant, and antithrombotic properties, elevation of high-density lipoprotein or increase of nitric oxide production. Erectile dysfunction (ED) is a harbinger of cardiovascular diseases. Most epidemiological studies have also found that alcohol consumption, like its relationship with coronary artery disease, is related to ED in a J-shaped manner, with moderate consumption conferring the highest protection and higher consumption less benefits. In epidemio-logical studies, it is difficult to distinguish the ethanol effects from those of associated confounding factors. Meanwhile, long-term alcohol users, especially in those with alcohol liver disease, are highly associated with ED. More research is needed to investigate the true effects of alcohol consumption on cardiovascular diseases or ED.
Other hormone levels: Measurement of other hormones beside testosterone (luteinizing hormone [LH], prolactin level, and cortisol level) may provide clues to other underlying causes of testosterone deficiency and erectile problems, such as pituitary disease or adrenal gland abnormalities. Doctors may check thyroid levels in some individuals as both hypothyroidism (low thyroid function) and hyperthyroidism (overactive thyroid function) can contribute to erectile dysfunction.
Yes, excessive alcohol intake can affect sexual function. Erectile dysfunction is more common in people who abuse drugs and alcohol. Lifestyle changes such as drinking less alcohol and quitting smoking may help improve sexual function. Chronic heavy alcohol consumption can affect erectile ability through altered hormone metabolism and nervous system involvement.
When these drugs don't work, there are other options. Medications that dilate blood vessels, such as alprostadil, can be injected or deposited in the penis; they work in more than 80 percent of men with diabetes. Beyond that, penile implants can be an effective surgical solution. Implants are either malleable rods, which can be manually adjusted to the desired position, or inflatable cylinders that fill with fluid when a pump under the skin of the scrotum is pressed.

“Although having sex at 70 is not the same as having sex at 20, erectile dysfunction is not a normal part of aging,” according to Michael Feloney, MD, urologic surgeon and expert on sexual dysfunction issues at the Nebraska Medical Center in Omaha. “You should still be able to have a satisfying sex life as you age." If you are experiencing erectile dysfunction, these 10 dos and don'ts may help.

 Other treatment options such as penile self-injection therapy, external vacuum pumps and the medicated urethral system for erection are on rare occasions an effective long-term treatment. A very small percentage of men will continue with these treatments as evidenced by a very high drop out rate and a very low refill rate for these treatments. These procedures require extensive planning which interfere with sexual spontaneity and are really not a realistic long-term treatment for young patients with permanent ED. 
Schiavi et al.[12] failed to find any difference in sexual dysfunction in alcoholics abstinent for 2-3 months in comparison with a nonalcoholic control group, speculating that alcohol-induced sexual dysfunction was reversible with abstinence. The aim of the present study was to estimate the prevalence of sexual dysfunction in males with alcohol dependence. We specifically assessed male subjects admitted to a treatment center with a diagnosis of alcohol dependence syndrome, without obvious hepatic cirrhosis or other co-morbidity. Female patients were excluded from the study as the number of women who use alcohol in India are few and the number of female alcoholics who avail of treatment centers are too few to contribute to significant statistical power. Also, the spectrum of sexual dysfunction is different in the female from the male.
3. Are there physical causes of erectile dysfunction? Erectile dysfunction may be a symptom of underlying medical conditions, which if not detected may cause further medical problems. A prior history of cigarette smoking, heart attacks, strokes, and poor circulation in the extremities (for example, intermittent claudication or cramping in your leg[s] when you walk) suggest atherosclerosis as the cause of the erectile dysfunction. Loss of sexual desire and drive, lack of sexual fantasies, gynecomastia (enlargement of breasts), and diminished facial hair suggest low testosterone levels. A prior history of pelvic surgery or radiation and trauma to the penis/pelvis/perineum can cause problems with the nerves and blood vessels. Symptoms of intermittent claudication of the lower extremities with exercise may suggest a vascular problem as a cause of the erectile dysfunction.
Capogrosso, P., Colicchia, M., Ventimiglia, E., Castagna, G., Clementi, M. C., Suardi, N., … Salonia, A. (2013, May 7). One patient out four with newly diagnosed erectile dysfunction is a young man - worrisome picture from the everyday clinical practice [Abstract]. Journal of Sexual Medicine, 10(7),1833-41. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23651423
The liver is the largest gland and organ in the body. There are a variety of liver diseases caused by liver inflammation, scarring of the liver, infection of the liver, gallstones, cancer, toxins, genetic diseases, and blood flow problems. Symptoms of liver disease generally do not occur until the liver disease is advanced. Some symptoms of liver disease include jaundice, nausea and vomiting, easy bruising, bleeding excessively, fatigue, weakness, weight loss, shortness of breath, leg swelling, impotence, and confusion. Treatment of diseases of the liver depends on the cause.
While these are the two most comparable datasets on this subject, there’s a problem with both of these studies, which is that they don’t tell us anything about the severity of the difficulties experienced. Having erectile “difficulty” doesn’t necessarily mean that these guys can’t get an erection at all or that they have problems every time and with every partner. Also, we don’t know whether guys who had very mild problems answered these questions consistently (e.g., if it only happened once or you didn’t think it was a big deal, would you still report it as a problem?).
Similar to the general population (58), in subjects consulting for sexual dysfunction, T deficiency is progressively more prevalent as a function of age (50). In a series of 4,890 subjects consulting our Sexual Medicine and Andrology Unit for sexual dysfunction, one in five (19.6%) and one in three (29.4%) patients have total T below 10.4 and 12 nmol/L, respectively (60). Clinical correlates of T deficiency show different figures according to patient’s age. In fact, we previously demonstrated that in the youngest quartile (17–42 years old), but not in the oldest one (62–88 years old), severity of reported ED and penile blood flow impairment (dynamic peak systolic velocity) were not associated to decreasing testosterone levels (50). It is possible to speculate that, in young individuals, intercourse-related penile erection is such a complex phenomenon that other determinants (i.e., intrapsychic or relational) might mask its androgen regulation and that T deficiency produces greater sexual disturbances in subjects with greater frailty, such as older individuals. However, reported frequency of spontaneous erection and sexual thoughts were significantly decreased as a function of T decline even in younger subjects (50). Moreover, in young individuals low T was associated with a worse metabolic profile, including hypertriglyceridemia and increased waist circumference (50). Accordingly, the prevalence of MetS in the youngest quartile was clearly associated with T deficiency, as it was in the older quartiles (50). Therefore, T deficiency must be accurately verified in all subjects consulting for sexual dysfunction, even in the youngest ones.
"The good news is, our study also found that a large proportion of men were naturally overcoming erectile dysfunction issues. The remission rate of those with erectile dysfunction was 29%, which is very high. This shows that many of these factors affecting men are modifiable, offering them an opportunity to do something about their condition," Professor Wittert says.
Like all diabetic complications, ED can occur even when you have followed your doctor’s advice and carefully managed your diabetes. Also like all diabetes complications, ED is less likely to occur with good blood sugar control. Poorly controlled diabetes and high cholesterol increase the chances of vascular complications, which may lead to ED or other circulatory problems. In addition, regular smoking and alcohol use can contribute to ED.
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