Alcohol is the most common type of chemical dependency in the United States and western Europe; about one-third of American families have at least one problem drinker in the family, and alcohol is the third leading cause of death in the United States. Ethyl alcohol is a general nervous system depressant that has both long – and short-term effects on sexual functioning. It can impair spinal reflexes and decrease serum testosterone lev­els, which can lead to erectile dysfunction. Paradoxically, even as serum testosterone lev­els drop, luteinizing hormone (LH) levels can increase, leading to increased libido (George & Stoner, 2000).

Long-term alcohol abuse can have drastic consequences. Hyperestrogenemia (high – per-ess-troh-jen-EE-mee-uh) can result from the liver damage due to alcoholism, which, combined with lower testosterone levels, may cause feminization, gynecomastia (which we discussed in Chapter 5), testicular atrophy, sterility, ED, and the decreased libido seen in long-term alcoholic males. In women, liver disease can lead to decreased or absent menstrual flow, ovarian atrophy, loss of vaginal membranes, infertility, and miscarriages. Alcohol can affect almost every bodily system; after a while, the damage it causes, in­cluding the damage to sexual functioning, can be irreversible, even if the person never drinks alcohol again.

Alcoholism also has a dramatic impact on families. It often coexists with anger, re­sentment, depression, and other familial and relationship problems. Some people be­come abusive when drunk, whereas others may withdraw and become noncommunica­tive. For both sexes, problem drinking may lead them into a spiral of guilt, lowered self-esteem, and even to thoughts of suicide. Recovery is a long, often difficult process, and one’s body and sexuality need time to recover from periods of abuse.

| paraplegia

Paralysis of the legs and lower part of the body, affecting both sensation and motor response.