Clinical evidence
Alcohol
CNS depressant·Recreational / illicit
Effect across the cycle
DesireBiphasic: Low-dose disinhibition raises psychological desire; expectancy effects are large.
ArousalBiphasic: Disinhibits subjective arousal at low dose; suppresses physiological genital response as BAC rises.
PerformanceInhibitory: Suppresses penile tumescence above low doses; chronic use drives erectile dysfunction.
ClimaxInhibitory: Increases ejaculatory latency; impairs orgasmic capacity at higher doses.
ExperienceBiphasic: Disinhibition and relaxation give way to sedation and numbing as dose climbs.
MemoryInhibitory: High doses fragment encoding; blackout at extreme intoxication.
Mechanism
Enhances GABA-A and inhibits NMDA transmission. Low doses disinhibit psychological arousal (part pharmacology, part learned expectancy); higher blood-alcohol levels suppress genital vasocongestion. Chronic use lowers testosterone and causes neuropathy and hypogonadism.
Sex differences & notes
Reduces vaginal lubrication and orgasmic function in women; suppresses tumescence and prolongs ejaculatory latency in men except at very low doses.
Key sources
- Rosen, experimental tumescence studies
- Briddell & Wilson 1976
- Int J Impot Res 2018 dose-response meta-analysis