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Who Answers?For decades, research has tried to examine the complexities of how alcohol impacts sexuality and reproductive health. Research has found connections between alcohol and pregnancy, sexual behavior, and fertility.1
Alcohol and Sex
Research has shown alcohol can have an impact on the engagement of certain sexual behaviors, which have been linked to increased risks of sexually transmitted infections, unplanned pregnancy, and other unplanned outcomes.2
Behaviors that studies show occur more often when using alcohol include a higher occurrence rate of:3
- Sexual activities at an earlier age
- Unprotected sex
- Sex with multiple partners
- Casual sex, or sex with a partner one does not know well and/or is not in a committed relationship with
- Sex while under the influence of drugs or alcohol
Research also shows that the consumption of alcohol can:2
- Increase sexual activity
- Heighten sexual arousal
- Increase the likelihood of engaging in sexual behaviors outside of your personal norm
Alcohol use can restrict and impair cognitive abilities so when individuals are under the influence, they are less able to attend to and process information.4 It is likely that reduced ability to process information impacts judgment and risk assessment, which may explain why individuals participate in certain activities under the influence that they do not participate in while sober.5
Additionally, in studies, individuals who had consumed alcohol were less likely to be able or willing to communicate sexual desires and negotiate sexual expectations between partners.2 While the study did not draw conclusions based on this data, it is possible that a reduced ability to communicate boundaries and expectations can significantly contribute to issues of coercion and consent when either party uses alcohol, which could damage relationships or cause lasting trauma.
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Help is standing by 24 hours a day, 7 days a week.Who Answers?Alcohol and Fertility
Limited research has been conducted on the impact of alcohol on fertility.6 However, some studies suggest alcohol negatively impacts reproductive systems.6 Notably, researchers suggest the occasional use of alcohol does not appear to have an impact, but heavier and longer-term alcohol use may.6
Individuals assigned female at birth who misuse alcohol have been shown to have reduced fertility and an increase in menstrual disorders.1 One study found that heavy alcohol consumption resulted in a reduced likelihood of pregnancy of up to 13%.7 Heavy alcohol use can also diminish ovarian reserves, in other words reduce the number of eggs retained in the ovaries.7
Alcohol misuse in individuals assigned male at birth may lead to:7
- Reduced gonadotropin release, which affects testosterone production
- Atrophy of the testicles
- Decreased testosterone and sperm production
- Sexual dysfunction, including decreased libido, erectile disfunction, or ejaculatory disfunction
Alcohol and Pregnancy
In a 2014 study, approximately 10.2% of pregnant persons in the U.S. reported alcohol use at some level while pregnant.1 The use of alcohol while pregnant can pose a significant risk to the developing fetus.
Given that not all pregnancies are intentional or known immediately upon conception, it is possible a fetus can be exposed to alcohol unintentionally. This exposure may pose less risk. However, there is no known safe level of alcohol use while pregnant.1 Alcohol can pass through the placenta to the fetus, meaning it can potentially affect development and fetal growth at any time during pregnancy.1
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Help is standing by 24 hours a day, 7 days a week.Who Answers?Health effects associated with alcohol use during pregnancy include:1
- Miscarriage
- Intrauterine growth restriction, which can result in lower birth weight
- Pre-term labor
- Stillbirth
Prenatal exposure to alcohol can disrupt normal fetal development in several ways:1
- Gene issues
- Changes in cellular function
- Damage to the growth factor signaling that allows the fetus to develop normally
- Altered placental function (e.g., reduced oxygenation and perfusion)
Prenatal exposure to alcohol can impair the structural development of the fetus, which can present as abnormalities of the:1
- Heart
- Liver and kidneys
- Brain
- Bones
- Head and face
In utero exposure to alcohol can also potentially lead to Fetal Alcohol Spectrum Disorders (FASD). The Center for Disease Control (CDC) and studies estimate for every 1,000 live births, 0.2 to 7 of those births will be affected by FASD.1
Research suggests up to approximately 1 in every 13 pregnant persons who consume alcohol while pregnant give birth to a child who will suffer from FASD.6 Symptoms of FASD include:1
- Vision and/or hearing problems
- Poor coordination
- Small head size
- Abnormal facial features (e.g., smooth philtrum)
- Low body weight
- Shorter-than-average height
- Sleeping and feeding problems as an infant
- Hyperactive behavior
- Difficulty with attention
- Poor memory
- Learning disabilities
- Difficulties in school, math in particular
- Intellectual disabilities or low intelligence
- Poor judgment skills
- Poor reasoning skills
- Delays in speech and language abilities
Fetal Alcohol Syndrome (FAS) is considered to be the most common nonhereditary disorder.1 At present, there are no cures for FASD, and symptoms do not appear to be reversible.1
Children who were exposed to alcohol in utero but do not meet full criteria for FASD may be diagnosed with Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE).1 Children diagnosed with ND-PAE may exhibit symptoms of:1
- Memory and thinking difficulties
- Problematic behaviors
- Difficulties with activities of daily living
It is also not clear how much alcohol, the frequency or pattern of consumption, and during which trimester prenatal exposure to alcohol can cause harm to the developing fetus.6
Alcohol Use and Breastfeeding
Alcohol can pass through the placenta to the fetus, but it can also pass through breast milk to the baby.1 The use of alcohol may also impact hormone production, which may potentially decrease one’s ability to breastfeed.1
Alcohol can have a detrimental impact on your body, brain, and reproductive health.
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Resources
- Dejong, K., Olyaei, A., & Lo, J. (2019). Alcohol use in pregnancy. Clinical Obstetrics & Gynecology, 62(1), 142-155.
- Scott-Sheldon, L., Carey, K., Cunningham, K., Johnson, B., & Carey, M. (2015, June 15). Alcohol use predicts sexual decision-making: A systematic review and meta-analysis of the experimental literature. AIDS and Behavior, 20(S1), 19-39.
- Egervari, G., Siciliano, C., Whiteley, E., & Ron, D. (2021, October 23). Alcohol and the brain: From genes to circuits. Trends In Neurosciences, 44(12), 1004-1015.
- Rao, R., & Topiwala, A. (2020, February 28). Alcohol use disorders and the brain. Addiction, 115(8), 1580-1589.
- Wang, S., Lui, J., Vega, G., Waldrop, M., & Garris, J. (2018). The moderating effect of alcohol use on protective and risky sex behaviors among college students in the Southeast United States. Journal of American College Health, 66(7), 546-552.
- Lim, A., Van Schalkwyk, M., Maani Hessari, N., & Petticrew, M. (2019). Pregnancy, fertility, breastfeeding, and alcohol consumption: An analysis of framing and completeness of information disseminated by alcohol industry–funded organizations. Journal of Studies on Alcohol and Drugs, 80(5), 524-533.
- Van Heertum, K. & Rossi, B. (2017, July 10). Alcohol and fertility: how much is too much? Fertility Research and Practice, 3(1).