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Emma Schmidt, a clinical sexologist in Cincinnati, has lost track of the number of clients she’s seen for low libido and problems orgasming after they’ve first visited a doctor who advised them to “Just relax and have a glass of wine.”
That type of suggestion is not just dismissive, Dr. Schmidt said, but it highlights the gaps in our collective understanding about the interplay between alcohol and sex.
After years of contradictory findings, recent research has made it clear that even moderate drinking poses risks to your overall health. But the question of how alcohol affects sexual health — specifically, orgasms — can be a bit fuzzier.
“Society has long depicted alcohol as a crucial ingredient for romantic encounters,” said Catalina Lawsin, a clinical psychologist who specializes in sexuality. She added that people often mix sex and alcohol because it relaxes them and offers a sense of escapism — and because of a widely held belief that alcohol “elevates sexual prowess and pleasure.”
But the reality, she said, is much more complex.
What happens when you mix alcohol and sex?
“Essentially, there’s no research,” said Dr. Lauren Streicher, a clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine whose work focuses on sexual dysfunction in women.
The data that does exist — much of it from rat studies or small, qualitative investigations — suggests a pattern: Small amounts of alcohol seem to enhance arousal and decrease sexual inhibitions, Dr. Streicher said, but large amounts can suppress arousal and delay or prevent orgasm.
To understand why, it helps to look at the specific processes happening in your brain when you drink.
Alcohol releases dopamine, said Dr. Regina Krel, an assistant professor of neurology with Hackensack Meridian School of Medicine, who described it as “the feel good neurotransmitter.” Researchers believe it helps control desire.
At the same time, alcohol enhances the effects of gamma-aminobutyric acid, or GABA, a chemical messenger that inhibits impulses between nerve cells, essentially slowing the brain down and making a person feel more relaxed.
“It does make you think, ‘Oh, I feel hornier!’” because it lowers inhibitions, said Laurie Mintz, an emeritus professor of psychology at the University of Florida who focuses on human sexuality. “But the irony is that, in fact, it’s a central nervous system depressant.”
That means that alcohol has a dampening effect throughout the brain, Dr. Krel said, including in the prefrontal cortex (which is responsible for things like weighing consequences), the cerebellum (which controls coordination) and the autonomic nervous system (which regulates functions like heart rate and breathing).
Alcohol can hinder the brain’s ability to process sexual stimuli and coordinate muscle contractions, which are central to the orgasmic response, Dr. Lawsin added. “While it may contribute to relaxation and inhibition reduction initially, excessive consumption can interfere with the intricate processes that lead to the intense pleasure and satisfaction of orgasm.”
How much you drink matters.
The experts said that moderate drinking before having sex is usually OK. However, they also stressed that knowing whether alcohol will help lead to orgasm by reducing stress and inhibitions, or get in the way of orgasm by suppressing basic functions, has a lot to do with how often you drink and how much you drink on any given occasion.
Moderate drinking is usually defined in the United States as no more than two drinks a day for men or one drink a day for women. But the way alcohol affects you is determined by a host of factors, including genes, body size and composition, and your history with drinking.
Chronic, heavy use of alcohol has been linked to erectile dysfunction and premature ejaculation in men, Dr. Mintz said. Research has also connected alcohol consumption to sexual dysfunction (persistent problems with sexual response, desire and orgasm) in women.
“There isn’t a magic number of drinks that applies to everyone,” Dr. Lawsin said, adding that excessive alcohol use can hamper the connection between partners, as well as impair decision making and the ability to consent to sex.
How to find help with orgasm issues.
If you are experiencing anorgasmia (which is delayed or infrequent orgasms, or no orgasms at all), your first step should be to reach out to a primary care physician or sex therapist who can help determine the root cause or causes and connect you to the right type of specialist or treatment, Dr. Schmidt said.
There could be one or a number of underlying issues affecting your ability to orgasm, including certain health conditions or medications, relationship problems and trauma, as well as your alcohol consumption.
Many primary care doctors, and even some gynecologists and urologists, do not have a specific background in sex medicine, so it can help to ask if they do, she said, and if they have any experience working with patients with anorgasmia.
If alcohol seems to be hampering your orgasms, ask yourself how and why you use alcohol around sex, Dr. Schmidt said, noting that mental health professionals and sex therapists can be a valuable resource.
Do you often or always drink beforehand?
“If someone is using alcohol as a way to be able to have sex,” she said, “or if they feel scared, ashamed or vulnerable having sex without alcohol, then we might want to explore more.”
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