Considerations:
(1) acute vs chronic alcohol use
(2) long term complications of alcohol abuse
(3) concomitant factors
The acute effects of acute alcohol use are dose-dependent. At low doses alcohol may exert beneficial effects (increased libido, increased sense of prowess, vasodilation, decreased anxiety, decreased inhibitions) but at higher doses it can result in sedation and impaired control, which can lead to premature ejaculation or other forms of sexual dysfunction.
Long term complications may contribute to sexual dysfunction:
(1) hypogonadism with decreased serum testosterone levels
(2) feminization from relative excess of estrogens
(3) diabetes mellitus
(4) neuropathy
(5) cirrhosis
Concomitant factors:
(1) underlying anxiety and depression
(2) risk factors for atherosclerosis
(3) medications (include Antabuse, spironolactone)
