How does alcohol affect reproductive health?

Mina Draskovic, B.Psy., reviewed this content for accuracy on February 5th, 2024

Heavy drinking has been scientifically linked to reproductive health issues in both genders. For both sexes, excessive alcohol consumption has been linked to reduced fertility, sexual dysfunction, and increased risks during pregnancy.

A 2017 cohort survey study revealed that women who drank heavily were more likely to seek fertility treatment.

A 2023 Vietnamese study found that alcohol consumption leads to lower testosterone, sperm count, and motility in men. In women, it adversely affects menstrual cycles, egg implantation, and fetal development, leading to compromised fertility and pregnancy.

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How does alcohol affect hormones in men?

One of the main reasons why alcohol is detrimental to health is because of its negative effects on hormones. Chronic heavy drinking can disrupt the hypothalamic-pituitary-gonadal (HPG) axis, which regulates the production of key male sex hormones.

The HPG axis is a complex three-tiered interaction between the hypothalamus, pituitary gland, and gonads that controls human development, reproduction, and aging. The hypothalamus produces a gonadotropin-releasing hormone that signals the pituitary gland to release luteinizing hormone and follicle-stimulating hormone, which then act on the gonads (testes in men) to stimulate production of sex hormones.

According to Emanuele and Emanuele, alcohol affects the HPG axis and male sex hormones in the following ways:

Alcohol decreases testosterone. Testosterone is crucial for male sexual development and functioning, muscle growth, bone density, and red blood cell production. Chronic heavy consumption of alcohol can damage Leydig cells in the testes, which directly disrupts testosterone synthesis. This can lead to the shrinking of the testes and lower sperm quality and count. (Heavy drinking also impacts the liver, which helps regulate circulating levels of hormones, such as testosterone.)
Alcohol abuse can suppress the release of luteinizing hormone (LH). LH signals the testes to produce testosterone. Reducing LH levels leads to less testosterone production by the testes.
Heavy drinking reduces the levels of follicle-stimulating hormone (FSH). FSH works closely with LH to stimulate sperm production. FSH levels often fall with chronic heavy drinking.
Alcohol lowers estrogen. Estrogen is a female hormone, but men also produce it naturally, although in smaller amounts than women. Heavy drinking triggers increased conversion of testosterone to estrogen via an enzyme called aromatase. Emanuele and Emanuele found that “this increased conversion may account for the elevated estrogen levels and abnormal breast enlargement observed in some heavy drinkers.”
Alcohol suppresses male growth hormone production. Growth hormone promotes muscle and bone growth. Levels tend to be abnormally low in chronic heavy drinkers, contributing to reductions in muscle mass and bone mineral density.

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The effects of alcohol on men’s vital hormones contribute to adverse effects on their physical and sexual health. Before we talk more about men’s sexual and reproductive function, let’s discuss the ladies’ side.

(Spoiler alert: it’s bad.)

How does alcohol affect hormones in women?

Alcohol consumption can significantly impact female hormone levels. Research has shown that alcohol raises endogenous hormones, which can affect the growth of breast tissues and increase the risk of breast cancer. This leads to a disrupted menstrual cycle and an imbalance in reproductive, liver, weight, and body fat composition-related hormones in women.

Here’s what female hormones are affected by alcohol and binge drinking:

Alcohol increases estrogen levels in the blood. In women, estrogen promotes egg maturation and regulates fertility by controlling ovulation. Even moderate alcohol consumption can interfere with estrogen breakdown and clearance from the body. Researchers from Cleveland, Ohio, found that “alcoholism is also associated with liver dysfunction, which can result in hormonal disturbances due to the inability to metabolize estrogens.”
Heavy drinking affects progesterone. Progesterone is the hormone that helps prepare and maintain the uterus for pregnancy. Alcohol reduces progesterone synthesis in the ovaries and enhances progesterone metabolism and excretion in the liver. Lower progesterone can lead to menstrual irregularities and difficulty sustaining pregnancies.
Alcohol suppresses LH in women. Luteinizing hormone is essential for stimulating ovulation and normal menstrual cycle function. Alcohol suppresses the pulsatile secretion of LH from the pituitary gland.
Chronic heavy drinking elevates blood FSH levels in women. Elevated FSH indicates problems with the functioning of the ovaries and reduced female fertility.
Heavy drinking boosts prolactin. Prolactin is the hormone primarily responsible for milk production (lactation) in women after childbirth by stimulating the mammary glands. Excessive alcohol can lead to a condition called hyperprolactinemia, where prolactin levels significantly rise in the blood in women. Hyperprolactinemia may cause infertility, irregular menstrual cycles, and impaired production of breast milk in non-pregnant or nursing women.

Regardless of the amounts you consume (short-term binging or chronic heavy drinking), alcohol disrupts these major reproductive hormones in women. In general, alcohol’s deleterious effects on overall health have been associated with increased risks of mortality, liver disease, breast cancer, psychiatric problems, heart failure, and obesity.

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Read more about the health risks of too much drinking for women.

How does alcohol affect men’s reproductive systems?

Alcohol takes a heavy toll on the male reproductive system, leading to sexual problems, infertility issues, and even generational impacts. Research in both animals and humans has shown that alcohol consumption negatively affects sperm and testosterone levels, suggesting detrimental impacts on the hypothalamic-pituitary-gonadal axis as well as direct testicular damage.

Alcohol impairs sexual function

Alcohol can sabotage a man’s sexual functioning and enjoyment. A few drinks too many can often make it harder for a guy to get aroused. This happens because alcohol is a central nervous system depressant that dulls the key brain chemicals needed to spark sexual excitement and response. Over time, heavy alcohol use also slowly damages the sensitive nerve networks and blood vessels involved in healthy erections.

Chronic and persistent alcohol use is known to induce sexual dysfunction, leading to interpersonal difficulties and distress. This, in turn, is known to worsen alcohol abuse. A 2007 study found that 72% of alcoholic men in treatment had one or more sexual dysfunctions, with the most common being premature ejaculation, low sexual desire, and erectile dysfunction.

Heavy drinking lowers fertility in men

Alcohol abuse severely reduces male fertility. A 2021 Australian article suggested that chronic alcohol use can lead to sexual dysfunction, impotence, and reduced libido in men, further impacting male fertility.

Drinking lowers testosterone levels critical for sperm maturation and directly damages sperm-producing testicular tissue, shriveling the testes. Heavy alcohol consumption can lead to reduced sperm concentrations, motility, and sperm DNA integrity, as well as an increase in sperm DNA fragmentation and chromatin abnormalities.

Italian researchers revealed that 73% of heavy drinkers exhibited oligozoospermia, a condition characterized by abnormally low sperm count, compared to 13% of non-drinkers. Their study points to “the association between chronic alcohol consumption and poor semen quality, mainly due to the development of oxidative stress, as well as its genotoxic impact on hormonal regulation and DNA integrity, affecting the offspring’s health.”

Heavy drinking has negative effects on offspring

Bad news for young men who dream of healthy offspring: research shows that paternal alcohol consumption around the time of conception can have significant negative effects on the fetus.

Back in 1994, researchers investigated the teratogenic effects of paternal alcohol: the harmful impacts on offspring development when the father consumes alcohol around the time of conception. They found that “male offspring of alcoholic fathers have behavioral problems and impaired intellectual skills as well as hormonal and nervous system anomalies.”

A 2022 study published in Scientific Reports confirmed that preconceptional alcohol consumption in men was associated with an increased risk of child behavioral problems. These findings imply that the preconception period may be a critical window for offspring development.

The aforementioned Italian study also found that paternal drinking impacts the male fertility potential of offspring, altering sperm composition, failing to eliminate alcohol-damaged sperm, and inducing genetic mutations in sperm DNA.

Alcohol damages DNA, increasing the risk of cancer mutations. Macke and Petrosyan found that heavy alcohol and binge drinking are positively associated with an increased risk of developing prostate cancer.

Since alcohol is a known carcinogen, the best prevention against reproductive cancers and improving sexual health is for men to quit drinking alcohol altogether.

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What are the effects of alcohol on women’s reproductive health?

Alcohol takes a major toll on the entire female reproductive system, interfering with critical processes from menstruation to conception to pregnancy. A Journal of General Internal Medicine study found that “the highest rate of reported infertility (30%) was among women who drank 6 or more drinks at least five times a week.”

At the heart of it all is estrogen—alcohol throws off this delicate hormone underlying feminine sexual and reproductive functions. Emanuele, et. al. found that “mild-to-moderate alcohol use has numerous negative consequences for female reproductive function” and that heavy drinking has been found to “disrupt normal menstrual cycling in female humans and animals and to affect hormonal levels in postmenopausal women.”

Here’s how.

Alcohol disrupts menstruation

Alcohol interferes with maturation and release of eggs from the ovaries. This happens because drinking suppresses FSH and LH signals from the pituitary gland. Without these cues, the uterine lining doesn’t develop properly, impairing hormonal shifts in the ovaries.

A recent study in developing Rhesus monkeys has demonstrated detrimental effects of alcohol on the activation of hormone secretion that accompanies female puberty… the interval between subsequent menstruations was lengthened, showing that alcohol affected the development of a regular monthly pattern of menstruation. (Emanuele, et. al.)

The results are irregular cycles and abnormal bleeding which suggest that the womb lacks a healthy foundation for embryo implantation and supporting early pregnancy.

Heavy drinking leads to higher infertility rates

Heavy drinking leads to higher infertility rates because alcohol toxicity damages the cervix and fallopian tubes, which are needed to transport sperm and ovulated eggs. Alcohol also reduces ovarian reserve prematurely by destroying egg-containing follicles. It seems that drinking creates a uterus environment that is hostile and inadequate for implantation, with insufficient blood flow (estrogen-driven) and nutrient transfer capacity to sustain a pregnancy.

A Danish cohort study found that compared to women who did not drink at all, those who reported having 1-5 alcoholic drinks per week had 39% lower odds of getting pregnant. Additionally, women who drank over 10 drinks per week had a 66% reduction in their chances of achieving pregnancy compared to non-drinkers.

A 2004 Swedish study found that Swedish women who consumed more alcohol than average were more likely to seek fertility treatment, whereas those who drank less had a lower likelihood of pursuing such treatment.

Alcohol increases the risk of pregnancy complications

Alcohol use during pregnancy can lead to a range of complications that not only affect the developing fetus but also pose risks to the pregnant woman. Research from the March of Dimes indicates that alcohol consumption during pregnancy increases the likelihood of premature birth, birth defects, and fetal alcohol spectrum disorders.

Alcohol use during pregnancy can lead to:

Preterm birth. Women who consume alcohol during pregnancy are at an increased risk of delivering their babies prematurely. Preterm birth can lead to respiratory distress syndrome, infections, developmental challenges, and other health issues for the newborn.
Low birth weight. Alcohol use during pregnancy can also contribute to low birth weight in newborns. Babies born with low birth weight are more susceptible to health problems and developmental delays.
Stillbirth. Heavy alcohol consumption during pregnancy may increase the risk of stillbirth.
Miscarriage. Alcohol use during pregnancy has been associated with an elevated risk of miscarriage, particularly during the first trimester.
Placental abruption. Alcohol can interfere with the proper functioning of the placenta, increasing the risk of placental abruption. This is a serious condition where the placenta detaches from the uterine wall prematurely, potentially leading to severe bleeding and endangering both the mother and the fetus.
Fetal alcohol spectrum disorders (FASD). As mentioned earlier, heavy alcohol consumption during pregnancy can result in FASD. This involves a range of physical, cognitive, and behavioral impairments in the child that may cause lifelong disabilities and impose emotional and financial burdens on the family.

The Centers for Disease Control and Prevention (CDC) shows evidence that there is no known safe amount of alcohol to drink while pregnant. It is safest to avoid alcohol use altogether during pregnancy.

How does alcohol affect the reproductive organs?

Alcohol can have detrimental effects on both male and female reproductive organs, disrupting their normal functioning and potentially leading to a range of reproductive health issues. Here’s how alcohol negatively affects both the male and female reproductive organs.

Alcohol can lead to testicular atrophy, reducing the size and function of the testes. This can decrease sperm production and lower sperm quality.
Chronic alcohol use may contribute to prostate problems, potentially affecting semen quality and overall reproductive health.
Alcohol can impair blood flow to the penis, leading to erectile dysfunction (ED) and making it difficult for men to achieve and maintain erections.
Alcohol can disrupt ovarian function, causing irregular ovulation and hormonal imbalances, which can hinder fertility.
Chronic alcohol consumption can impact the uterine lining, making it less receptive to embryo implantation. This can seriously hinder achieving and maintaining pregnancies.
Alcohol can damage the cervix and fallopian tubes in women, impairing their ability to facilitate the passage of sperm and eggs for fertilization.
Alcohol can disrupt the hormonal balance necessary for the proper functioning of the female reproductive system, affecting menstruation and overall reproductive health.

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Alcohol and reproductive health FAQ

How long after quitting drinking will sperm improve?

Sperm quality can show improvement within a few months of quitting drinking. The level of improvement may vary among individuals, and factors like blood pressure and hormone levels can influence this process.

Is wine bad for fertility?

Excessive consumption of alcoholic beverages, including wine, can negatively affect fertility in women. It can disrupt hormone levels and blood pressure, potentially impacting fertility. While some suggest that moderate levels of alcohol per week may be safe for those trying to conceive, we suggest abstaining to maximize fertility.

Can drinking alcohol every day cause infertility?

Consistent daily alcohol consumption can lead to negative impacts on fertility, both in men and women. Excessive drinking can affect hormone levels, such as testosterone in men, and can contribute to alcohol use disorder (AUD), potentially causing fertility issues.

How many drinks are okay when trying to conceive?

When trying to conceive, it’s advisable to limit alcohol consumption to moderate amounts, taking into consideration units per week. Excessive drinking, especially during the critical follicular and luteal phases of the menstrual cycle, can affect hormone levels and blood pressure, potentially impacting fertility.

What if I drank heavily before I knew I was pregnant?

If you consumed excessive amounts of alcohol before realizing you were pregnant, it’s crucial to seek prenatal care immediately to assess the potential risks to the development of the fetus. Heavy drinking can lead to issues such as abnormal sperm morphology and hormone imbalances.

Can you drink during the 2-week wait (during the luteal phase)?

During the 2-week wait (luteal phase), it’s best to avoid alcohol, as it can negatively affect reproductive health. Blood alcohol concentration, hormone levels, and sperm motility can be influenced by drinking patterns, potentially impacting the development of offspring.

Does alcohol in sperm affect the baby in the womb?

While research on this topic is limited, it is possible that alcohol in sperm may have negative effects on the developing fetus in the womb. Alcohol content and blood pressure can play a role in such effects. Therefore, moderation in alcohol consumption is recommended for prospective fathers.

Does alcohol affect egg quality in IVF?

Alcohol consumption can have effects on egg quality in the context of In Vitro Fertilization (IVF). It’s advisable for individuals undergoing IVF to avoid excessive alcohol intake to optimize their chances of success. Alcohol can affect the hormonal and endocrine functions necessary for reproduction.

Resources

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Macke, A. J., & Petrosyan, A. (2022). Alcohol and Prostate Cancer: Time to Draw Conclusions. Biomolecules, 12(3). https://doi.org/10.3390/biom12030375

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