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  • Writer's pictureisaacmathu

Low Testosterone and Shrunken Testes: How Alcohol Affects Male Fertility and Reproductive Health

As most men can attest, knocking back one too many drinks can tank your performance in bed. You may have heard of it being referred to as ‘whiskey dick’. But the effects of alcohol go beyond the bedroom. 

Excessive and chronic alcohol consumption has been proven to negatively affect male fertility and overall reproductive health. It lowers sperm count, reduces testosterone and can even cause shrunken balls. 

In this post, we dive deep into the link between alcohol and the male reproductive system. We discuss the risks of alcohol consumption for men and whether there is a safe limit. 

This is the first of several articles that examines how different factors and lifestyles can affect male reproductive health. Over the next several posts, we are going to look at the link between mens’ sexual health and obesity, exercise, smoking, diet, stress and sleep. So, stick around. 

A Finely Tuned System

Male reproduction is a complex and finely tuned system that can easily get disrupted by many factors. Three main parts — the hypothalamus in your brain, the anterior pituitary gland at the base of the brain and the testes — control various hormones and processes essential to sex and making babies. 

Any disruption to the function of one or all of these organs also disrupts male reproduction. It can cause infertility (because of reduced sperm production/sperm quality), impotence (erectile dysfunction) and loss of libido. 

Your ability to enjoy sex and procreate are not the only things you need to worry about. Anything that lowers your T levels also causes other health problems like fatigue, increased stress, muscle loss, and osteoporosis. 

So even if you are not that concerned about your fertility or libido, there are plenty of other reasons to be wary of anything that threatens your testosterone levels such as alcohol, stress and sleep deprivation. 

4 Ways Alcohol Harms Male Reproductive Health 

There is no debate on whether alcohol, particularly heavy and chronic alcohol consumption, is bad for men’s sexual wellness. That’s settled science. Numerous studies have found that excessive intake of alcohol has negative short and long term effects including reduced sperm count, loss of libido and erectile dysfunction (ED). 

Not only that, chronic alcohol use also significantly increases the risk of testicular cancer, a condition that can also cause infertility, loss of interest in sex and ED. 

The only debate right now is whether there is a safe alcohol consumption limit. We are going to discuss that shortly. For now, let’s look at the 4 main ways alcohol affects the male reproductive system. 

1. Alcohol Damages Leydig Cells (Testosterone-producing Cells) and Germ Cells

Excessive alcohol consumption damages Leydig cells, which are responsible for producing testosterone. When they get damaged T-levels go down.  This drop in testosterone comes with a whole lot of sexual and health problems including low libido, loss of lean muscle and fatigue. 

Researchers are not sure exactly how alcohol damages Leydig cells. It could be via inflammation or some other mechanism. 

Lower testosterone is already bad news for sperm count. Testosterone is essential in sperm production (that’s one of the reasons T levels are a lot higher in the testes than in the blood). 

But the effects of alcohol don’t stop there. It also goes directly for the sperm. Excessive alcohol damages germ cells. These are the cells that develop into sperm. Combine this with the reduced testosterone production and it’s easy to see why low sperm count is one of the biggest consequences of alcoholism. 

And we are not even done yet. Alcohol also affects other organs outside the testes that are important for testosterone and sperm production.

By the way, the damage to Leydig and Germ cells is one of the causes of testicular atrophy (shrinkage) that’s common in heavy alcohol users.  

Here’s some sobering research. There is a possibility that alcohol-induced testicular damage is irreversible. One study on rats that were given alcohol showed some signs of cell and tissue regeneration after total alcohol absence. But they did not show complete reversal in damage. 

2. Alcohol Kills Sertoli Cells (Responsible for Sperm Maturation) 

In addition to damaging and killing germ cells, alcohol also affects the development and maturation of the sperm cells that survive. 

Sertoli cells are essential in sperm maturation. They support, protect and nourish sperm cells. 

In one study, researchers examined sperm of alcoholics who hadn’t yet developed liver disease (liver disease can affect male fertility). 

Researchers found that about 45% of alcoholics in the study had sperm with abnormal shapes, meaning they hadn’t matured normally. 40% of the alcoholics also had reduced sperm count and 50% had abnormal sperm motility (meaning their sperm didn’t move properly, which lowers fertility). 

Damage to sertoli cells was likely responsible for the abnormal shapes and movement of the sperm. 

As with Leydig cells, researchers don’t know how alcohol damages sertoli cells. One theory is that alcohol damages proteins in sertoli cells that are necessary for sperm maturation.

3. Alcohol Lowers Production of LH and FSH Hormones 

Alcohol’s harmful effect on male reproduction is not limited to the testes. It also affects the other two organs involved in the reproductive system — the anterior pituitary gland and the hypothalamus. 

In the anterior pituitary gland, alcohol causes a drop in the production of luteinizing hormone (LH) and follicle stimulating hormone (FSH).

LH and FSH are important regulatory hormones. LH triggers the Leydig cells to make more testosterone. FSH is responsible for the development of sertoli cells, which in turn ensure sperm maturation. FSH also stimulates the production of sperm cells. 

Researchers have discovered that alcohol acts directly on the pituitary gland to reduce the production and secretion of LH and FSH hormones. And with lower levels of these hormones in the blood, it leads to a subsequent drop in testosterone and sperm production. 

4. Alcohol Affects the Production and Function of GnRH (Gonadotropin-releasing Hormone)

Not content with damaging the testes and the pituitary gland, alcohol also goes for the master control unit of male reproduction — the hypothalamus. 

The hypothalamus produces and releases Gonadotropin-releasing Hormone (GnRH) into the anterior pituitary gland. GnRH stimulates the pituitary gland to release LH and FSH.

Currently, researchers don’t think alcohol affects the production of GnRH. Instead, they suspect it interferes with the secretion/release and action of GnRH. 

Either way, this affects the production and secretion of LH and FSH in the anterior pituitary gland, which as we have discussed, consequently lowers sperm count and T levels. 

Overall, alcohol has two major effects in moderate and heavy alcohol users.

One, alcohol individually affects the function of each major organ involved in male reproduction — the hypothalamus, the anterior pituitary gland and the testes. 

Secondly, alcohol causes cascading damage that begins in the hypothalamus and consequently affects the function of the other organs. 

Other Effects of Alcohol On Male Sexual Health

In addition to altering how the three main organs of male reproduction work, alcohol has other damaging effects on male reproductive health.  

  • Alcohol disrupts communication between your penis and the brain. This reduces blood flow to the penis and can also reduce sensitivity. Both of these can lead to temporary erectile dysfunction. 

  • Chronic alcohol consumption damages blood vessels (due to high blood pressure), leading to long term erectile dysfunction. 

  • Long term alcohol use also damages nerves, leading to alcohol neuropathy. This can cause permanent erectile dysfunction. 

  • Alcohol lowers libido, primarily by reducing sexual stimulation and lowering testosterone levels. 

  • High consumption of alcohol can lead to other health conditions like obesity, heart disease and hypertension that affect male reproductive health. 

Is There a Safe Amount of Alcohol?

This is where the debate is. In most of the studies we have referenced above, researchers found that moderate and heavy drinkers experienced the most harm from alcohol consumption. But what counts as low, moderate or heavy alcohol consumption?

What matters is the amount of pure alcohol in a drink, not the type of drink. So someone who drinks spirits is not necessarily a heavier drinker than someone who drinks wine or beer. 

Generally, an alcohol consumption under 30-40g each day is considered low. For women, it’s even lower — about 20-30g. 40g of alcohol is about 34 ounces of 5% beer, 14 ounces of 12% wine (roughly one glass of wine) and 4.2 ounces of 40% liquor or spirits (a little less than 3 shots). 

In the US, the recommended max alcohol consumption per day is 2 standard drinks for men (28g) and one for women (14g). 

A daily intake of more than 30-40g of alcohol is considered moderate and an intake of over 80g is heavy. 

Men who are moderate or heavy drinkers have the highest risks of developing alcohol-related problems with their reproductive system. 

That said, many experts say there is no safe amount of alcohol. For one, we don't have a clear idea of what long term alcohol intake, even if it’s low, has on male fertility and reproduction. 

Secondly, alcohol in whatever amount is associated with many other health risks beyond impaired fertility. It increases risk of cancer and other health complications. 

The bottom line is: if you are already a drinker, reduce your alcohol consumption to under 30g or eliminate alcohol altogether. If you are a non-drinker there’s no reason at all to start drinking. 

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