ERECTILE DYSFUNCTION: QUITTING ALCOHOL IS TOUGH BUT WORTH

UNHEALTHY LIFESTYLE factors such as alcohol consumption have major impact on the severity of erectile dysfunction in men. It is long regarded as a risk factor for erectile dysfunction. Alcohol consumption leads to marked distress and interpersonal difficulty in erectile deficient men. It has been found that 61% of patients dependent on alcohol suffer from sexual dysfunction, the most common being erectile dysfunction followed by reduced sexual desire. Erectile dysfunction and reduced sexual desire are frequently co-exist.

The scientific explanation is that alcohol is a central nervous system depressant. This causes impotence and other disturbances in sexual dysfunction. Erectile failure in alcoholic men is fairly a routine which is found to be higher in men consuming more than three standard units of alcohol (12 g ethanol) daily and in subjects smoking more than 10 cigarettes/day.

SYMPTOMS OF ALCOHOL-INDUCED ED

The symptoms of erectile dysfunction originated from alcohol consumption appeared accordingly with the amount of alcoholic beverage consumed. The chance of developing sexual dysfunction appears to increase with increasing quantity of alcohol consumed.

Higher levels of alcohol intake may result in greater neurotoxic effects. Heavy use of alcohol is also known to alter gonadal hormones (testosterone & follicle-stimulating hormone).

MECHANISM – BY WHICH ALCOHOL CAUSES ERECTILE DYSFUNCTION

In addition to the effect of alcohol on central nervous system receptors (as given above), alcohol also suppresses the release of gonadotropin and anti-diuretic hormone from the pituitary that may be associated with hypogonadism and hypovolemic shock in alcohol abusers. The chronic abuse of alcohol may cause testicular atrophy, inhibition of testosterone production and impairment of spermatogenesis, apart from its direct oxidative toxicity. These effects of alcohol cause erectile dysfunction because it directly affects the production of hormones responsible for erectile mechanism in males.

All this alcoholism effects are found to cause men to suffer from problems achieving and maintaining an erection, because alcohol can also prevent blood vessels in the penis from closing, inhibiting the ability of penis to remain erect. In a healthy, non-alcoholic man, the penis becomes erect when aroused because it fills with blood and the vessels close, preventing back-flow. Chronic consumption of alcohol damages blood vessels which cause problems in the heart and also in the penis.

EXAMINATION

Physical examination
Genitourinary examination
Attention to any endocrine (including testicular size and secondary sexual characteristics), neurological or vascular causes as appropriate, especially if indicated by the history.
Pulse (including peripheral pulses) and blood pressure. Because ED shares risk factors with CVD, a full cardiovascular assessment should be performed.
Rectal examination in patients over the age of 50 years.
Psychological counseling involving queries regarding stress, depression or alcohol consumption

Laboratory examination
Fasting glucose
HbA1c
lipid profile
Total testosterone
Follicle-stimulating hormone (FSH), luteinising hormone (LH), and prolactin when low testosterone is detected

MANAGEMENT OF ERECTILE DYSFUNCTION

When you drink heavily and frequently, your body becomes physically dependent on alcohol and goes through withdrawal if you suddenly stop drinking. The symptoms of alcohol withdrawal range from mild to severe, and include:

Headache
Shaking
Sweating
Nausea or vomiting
Anxiety and restlessness
Stomach cramps and diarrhea
Trouble sleeping or concentrating
Elevated heart rate and blood pressure

How to quit alcohol?

As mentioned here, alcohol consumption is the reason behind the risk of erectile dysfunction. Thus, primary treatment involves the inhibition of alcohol consumption which involves various strategies such as:

Avoid the things that trigger your urge to drink
Practice saying “no” to alcohol in social situations
Remind yourself of your reasons for not drinking
Evaluate the costs and benefits of drinking
Quit alcohol by diminishing the requirement day by day. Keep a “diary” of your drinking
Pick a day or two each week when you will not drink at all
When you’re struggling with alcohol cravings, try strategies such as talking to someone you trust, distracting yourself until the urge passes, accepting the urge and ride it out, instead of trying to fight it, etc.
Try to have exercise as more as possible and as much scheduled as possible.

Prescription for erectile dysfunction Phosphodiesterase inhibitors (sildenafil, tadalafil, vardenafil and avanafil) improve the relaxation of smooth muscle. Phosphodiesterase inhibitors are also contra-indicated in patients in whom vasodilation or sexual activity are inadvisable, and where there is previous history of non-arteritic anterior ischaemic optic neuropathy, hypotension.

Try herbal remedies which are devoid of side effects. These herbal remedies include ginseng, DHEA (Dehydroepiandrosterone), L-arginine, fenugreek, etc. Any prescription to be taken for erectile dysfunction should be after consultation with doctor because the dose and schedule of medicine depends upon the severity of the disease which can only be interpreted by the doctor specializing in that particular field.