The most succinct summary of alcohol’s impact on sex was penned 400 years ago by William Shakespeare in Macbeth: “It provokesthe desire, but takes away the performance.” That’s close to the truth, but a recent review of the huge literature on alcohol and sex by a University of Washington psychologist shows that the subject is more nuanced than the man from Stratford-on-Avon imagined. The Washington researcher analyzed 128 mostly experimental studies. Here’s what he found. 

Note: One “drink” contains roughly 14 grams of pure alcohol, the amount found in: 12 ounces ofbeer, 5 ounces of wine (a standard wine glass about half full), or 1.5 ounces of distilled spirits (one shot).

Impact on Men

• Increases men’s sexual desire and arousal—up to a point. Shakespeare was right. One drink provokes desire. Many studies show that after one drink—or two in men who weigh more than around 190 pounds—modest consumption up to a blood-alcohol level of around 0.08 percent, the legal definition of intoxication while driving, is associated with greater libido and more sexual activity. But at higher doses, alcohol becomes a powerful central nervous system depressant that torpedoes desire, especially among men who binge periodically, drink heavily regularly, or become alcohol-dependent or alcoholic. 

In addition, the combination of alcohol and sex creates a self-fulfilling prophesy. Men who expect to drink become hornier than men who don’t, whether or not they actually imbibe anything. Alcohol is part of partying, and people who party often become sexually aroused. Men associate drinking with getting turned on, so many become aroused in social situations that involve alcohol, even if they don’t drink. 

• Has dose-related impact on men’s erection function. The myth is that any alcohol impairs erections. In fact, impairment is a function of dose. At low doses, up to one drink a day, alcohol actually offers some protection against erectile dysfunction, just as one drink a day helps prevent heart disease. But a great deal of research agrees that higher doses of alcohol—for most men, two or more drinks in an hour or so—wreaks havoc on erections. Among men with erection issues, sex therapists generally recommend refraining from drinking or limiting consumption to just one drink within an hour or two before sex.

In addition, the erection-impairing impact of several drinks compromises erection function for up to several hours after drinking has ceased and the man no longer feels tipsy or tests as intoxicated. Apparently, the penis gets hung over before the rest of the body.

• Usually doesn’t interfere with erection medications. Alcohol and erection drugs are often used simultaneously. The research is sparse, but the few studies show that drinking doesn’t compromise erection-drug effectiveness unless men binge or are alcohol abusers or alcoholic.

• Has dose-related affects on men’s orgasms/ejaculation function. For most men, one drink has little, if any impact on orgasm/ejaculation. But at higher doses, alcohol is associated with both premature ejaculation (PE) and difficulty ejaculating at all. Sex therapists often recommend that men with PE or orgasm/ejaculation difficulties refrain from drinking or limit consumption to a single drink during the hour or two before sex.

Impact on Women

• Affects women somewhat differently than men. Alcohol intoxication depends on weight. If a couple consumes the same amount of alcohol and the woman weighs less than the man, she’s likely to become more intoxicated. In addition, body composition differs by gender. Men tend to have more muscle tissue, women more fat, for example, in their breasts and hips (gynoid fat). Alcohol is water-soluble. It diffuses out of the blood stream into muscle tissue, which reduces the amount that gets into the brain. But fat tissue is not water-soluble. Compared with men of the same weight, more alcohol remains in women’s bloodstreams and gets into the brain where it increases women’s intoxication. In other words, when men and women drink the same amount, women often become more intoxicated, which has implications for sexual interest, consent, and function.

• Increases women’s sexual desire and arousal—up to a point. Alcohol affects women’s libido and arousal in much the same way it impacts men’s. One drink usually increases desire and the likelihood of sexual activity. Thirteen of 16 studies show that as women become intoxicated, they report increasing sexual arousal. But high doses—stumbling drunkenness—suppress arousal.

Like men, women also experience the self-fulfilling prophesy of alcohol-expectancy. They anticipate feeling aroused by situations that include alcohol, and tend to become aroused around alcohol—whether or not they drink. 

• May or may not impair women’s genital sensitivity. Unlike men, modest intoxication in women—blood levels of 0.08 to 0.10—seems to have less genital impact. Six of 11 studies show that mild intoxication does not diminish women’s sexual arousal. Five of 11 show that it does. It appears that women’s genital reactions to alcohol are more individual than men’s.

• Impairs women’s orgasms. Like some men, many women have difficulty working up to orgasm after drinking. Intoxication delays orgasm in many women, and in some precludes it.

Casual Sex and Possibly Serious Risks

• Associated with casual sex. Twenty-nine studies have addressed the link between alcohol and casual sex. Almost all show a positive association. Booze is integral to casual sex in every age group, especially among teens and young adults.

• Associated with sexual risk-taking. More than three dozen studies show that alcohol intoxication is strongly associated with sexual risk-taking. Compared with couples who make love sober, those who mix drinking and sex are significantly less likely to discuss contraception and sexual infection prevention. They’re less likely to use condoms. And if they use condoms, they’re less likely to use them properly. 

• Associated with child sexual abuse. Alcohol is strongly associated with child sexual abuse. Many abusers drink before and during assaults. Some ply children with alcohol beforehand to reduce their resistance. 

• Associated with sexual assault and domestic violence. Many studies show a clear connection between alcohol and sexual assault and domestic violence. During assaults, most perpetrators and victims are intoxicated—often so drunk that afterward they have no clear recollection of what happened. During domestic violence, the women may or may not have consumed alcohol, but the men usually have.

Adding to the link between alcohol and rape, when women drink, many men believe they’re more sexually available. A recent study by Iowa State University researchers shows that compared with women who hold glasses of water, men believe that women who hold alcoholic beverages are more eager to get it on and less in need of assistance if things seem to be getting out of hand. 

• Linked to dissociation. During sex, women with histories of sexual trauma often “dissociate.” They emotionally disconnect from the experience so they don’t flash back to their abuse. Alcohol intoxication is emotionally numbing. Many women with histories of sexual trauma use it to increase dissociation. Many studies show that a history of sexual trauma is a key risk factor for problematic drinking and other drug problems in women. 

Drink Responsibly

I am not a prohibitionist. I’m not calling for any legal constraints on alcohol beyond current statutes. However, alcohol is a powerful drug with many sexual effects—some beneficial, many detrimental. If you're sexually active, drink responsibly. When people have sex drunk, sexual quality usually suffers and risks of harm soar.

George, W.H. “Alcohol and Sexual Health Behavior: What We Know and How We Know It,” Journal of Sex Research (2019) 56:409.

Reimer, A.R. et al. “She Looks Like She’d Be an Animal in Bed: Dehumanization of Drinking Women in Social Contexts,” Sex Roles (2019) 80:617.