Ever wondered how much alcohol it takes to cause "Whisky Dick"? In this video, wDr. Rena Malik discusses the science behind ...

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Drunk and 🍆 Dysfunctional? Urologist Explains How Much Alcohol Causes Whiskey Dick

is whiskey dick for real I'm Dr Reina Malik urologist and pelvic surgeon and today we're going to talk about does alcohol affect erections so what is whiskey dick well technically it's defined as the temporary inability to sustain or achieve an erection after drinking too much alcohol now it's not specifically just whiskey it can be any alcohol at all so I wanted to look at some data in terms of how much alcohol generally is going to cause you to have issues with erections and at what point should you be worried now what we know about alcohol is that it depresses the central nervous system which can then put you at risk for erectile dysfunction we also know that when you're using alcohol chronically it can absolutely lead to issues with erections and this is for a couple reasons one is because it affects what we know as the hypothalamic pituitary gonadal axis so this is the part of our brain that sends signals to the testicles to produce testosterone so what happens when there's damage to that that signaling pathway is that you can ultimately cause decreased testosterone and even smaller testicles or what's called testicular atrophy you can also see sometimes increased estrogen levels which then feed back to that access and cause decreased testosterone as well it can also affect blood flow because it causes an increase in something called acetal dhide and this is a metabolite of alcohol now this metabolite prevents nitric oxide formation in the blood vessels now if you're new here nitric oxide is the ignition for erections so when you don't have nitric oxide you're not going to get erections so this is more common when you have alcohol dependence now what is alcohol dependence well it's a chronic disease where a person craves alcoholic beverages and is unable to control their drinking because of it they may also notice that when they abstain from alcohol they get symptoms of withdrawal and they may need to drink more and more alcohol to get the same effect that they're trying to get now there's no specific number of drinks that will get you to alcohol dependence but there is a risk so for women if you're having four or more drinks a day or eight or more drinks a week you're at higher risk for men that number grows to five or more drinks a day or 15 or more drinks per week and when we have these issues it will put you at difficulty achieving and maintaining erections in anywhere from 14 to 20% of men who have alcohol dependence what if you're just drinking it occasionally so the initial studies that were done on alcohol were done in the 1970s and they basically found that high doses of alcohol made it more difficult to have an erection and since then however the Studies have shown us something different and so studies after that found that there was actually no different in terms of erection quality with alcohol intake and this might be because those initial studies didn't take into account a number of things first off they didn't look at if the person was where they were in terms of intoxication was their blood alcohol content rising or was it coming down and does that make a difference secondly when they told them to get AR Rouse they typically used the same cue meaning that if you were sober they gave you a cue to get an erection and then when you were intoxicated they gave you the same q and so you can develop a habituation to that stimuli and it actually may be less you know responsive when you're intoxicated the other factor is that people may believe that when they're intoxicated they're not supposed to have good erections and your brain is really powerful so if you think that you're not going to have a good erection when you're intoxicated you won't and so these sorts of things were not taken into account in 1990 so 20 years later they wanted to look at the effects of acute alcohol on the actual tissues and how to messent or how hard or firm the erection gets in young men and dogs but we're going to focus on the young men so they recruited 11 subjects and these 11 subjects were Baseline called light to moderate drinkers but this was defined as 7 to 21 drinks a week at Baseline they were on average 24 years of age and they then monitored them over three consecutive nights and they wore these uh devices that would measure the expansion of their penis over the course of the night time and they measured their nocturnal penal tessin or the erections at night and so they did this over three nights the first two nights were without any alcohol so normal activities normal soberness and then on the third night they gave them a fixed amount of alcohol and how much was that fixed amount well it wasn't a specific number of drinks but they wanted to elevate the blood alcohol content to a level of 0.12 G per 100 milliliters and that's significantly higher than our current legal limit of your blood alcohol content if you were going to drive a car and so generally people are having slurred speech maybe their cognition is a little slowed so we know that they're definitely having an impact of the alcohol on their body and the way your body responds to alcohol is different from person to person so for an average person it might take five or six drinks to get to that blood Al alcoholic content but someone who metabolizes alcohol more slowly or is a little smaller it may take a little less and someone who's bigger or metabolizes faster it may take more and so in the study the first four subjects who got to that blood alcohol content and were followed at that night notice that they didn't see any difference in terms of erection quality on the night after consuming alcohol so for the rest of the seven subjects they increased the blood alcohol content to19 G per 100 m and so when those patients had that high level of alcohol they found no impact on the amount of sleep the person got the number of erections they got the increase in Penal circumference and the maximum penal circumference so ultimately no difference even though these people were very inebriated now this is just during sleep right they didn't look at them during awake and having an response to an erotic stimuli so then in 2006 another group wanted to look at really high alcohol blood alcohol levels in awake patients so for this study they recruited 65 men who were already moderate Drinkers and this was on average 17 drinks a week and all the participants were shown a 2 and 1 half minute documentary about birds to start off with followed by two different erotic films and they then measured arousal using penal plethysmography and that's essentially a measurement of the pen circumference again and girth enhancement during an erection and they then asked them questions as well about their self-reported rating of arousal and they measured these men they wanted them to reach a blood alcohol content of 0.1 and so they did that they measured every 3 minutes to make sure they were getting them as their blood alcohol content was rising and not coming down and in this study they found that the men who did have the higher blood alcohol content of 0.1 did reach a a lower Peak circumference of their erection so they did notice that they didn't get as firm as it does without the alcohol now there was no difference on self-reported arousal so while they found the erection didn't achieve maximal girth it still didn't feel less arousing to the individual so they also did a second arm of the study and in this study they went to a lower blood alcohol content of 0.8% so these guys were also Young on average 25 years old it was 60 men and at Baseline these guys drank about 14 drinks per week and ultimately they found that there was no significant effects at that 008 target blood alcohol content when comparing the sober group to the intoxicated group now moving on in 2007 they did a metaanalysis so a meta analysis is combining a bunch of studies and these were populationbased studies so looking at people who were drinking alcohol of a certain amount and seeing if that correlated with erectile dysfunction not specifically erectile dysfunction in the moment of drinking so it's not the exact same question but nonetheless it's helpful right if somebody was drinking pretty moderately and they often had issues with erections they would probably say yes I do have erectile dysfunction so they had 11 studies some of them they asked the participants did you use alcohol yes or no in other studies they looked at how much and they categorize them as having less than one drink one to seven drinks a week week or eight or more drinks per week in terms of how much alcohol they consumed over the course of the week and what they found was that men who had regular alcohol consumption or had an average of eight or more drinks per week were not associated with erectile dysfunction now very specifically they point out a couple studies the largest study looking at lifestyle factors and the correlation with erectile dysfunction is called the health professionals follow-up study and this followed about 31,00 ,000 men between the ages of 53 and 90 and what they found was that erectile dysfunction was decreased in men who had moderate levels of alcohol intake now again this is correlation not causation but they did adjust for things like medication smoking physical activity and body mass index again another sign that maybe alcohol is not problematic in another large cohort study called the Massachusetts male aging study this was smaller it looked at about 500 men without erectile dysfunction at Baseline and they categorize men in terms of how much they drank and so if they drank one drink one to three drinks greater than four drinks a day the incidence of erectile dysfunction remained relatively stable so from this study they basically said alcohol consumption is not related to erectile dysfunction and it may follow what's called a j-shape so at lower moderate amounts of alcohol you're not seeing a negative impact but once you get to those higher levels as I mentioned earlier in the video you're going to start seeing detriment in terms of erectile function because of the long-term effects on testosterone and as well as nitric oxide production now there's some limitations in all of these studies right one if you're looking at populationbased studies the people who choose to not drink alcohol may already have erectile dysfunction and they may say you know what I don't want to deal with the issues of drinking alcohol and having issues with my erections and these studies were not only in the US they were in South America Europe Africa Asia and Japan so these studies may not be generalizable to individuals in the United States bottom line I think the point of this is that yeah whiskey dick can occur probably when you're really really intoxicated or if you're a chronic Drinker however if you're drinking casually or moderately it's probably not a huge issue now I will never encourage anyone to drink I don't think it has any protective health benefits based on the new data and in fact has some correlation with cancer and so there's really no safe amount of alcohol consumption but if you are going to consume consume safely try to stay within the limits as recommended which would be less than two drinks a day for men and less than one drink a day for women but I would say ideally as minimal as possible try to stick to two drinks or less a week if you can and I hope you you guys found this helpful if you did please let me know in the comments below and as always remember to take care of yourself because you are worth it

Dr.

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