Reproductiveand sexualhealth
Alcohol impacts women’s sexual and reproductive health
Alcohol and Pregnancy
No amount of alcohol nor any time during which it is consumed is without risk during pregnancy1,2. It is recommended that pregnant women avoid consuming alcohol throughout their entire pregnancy. In some cases of alcohol dependence, a gradual reduction in consumption or other treatment options may be initiated, as abrupt cessation can have serious health impacts. In all cases, it is important to consult a healthcare provider.
Exposure to alcohol during pregnancy can have several effects on the unborn child, including the risk of developing fetal alcohol spectrum disorder (FASD) 2. Alcohol consumption during pregnancy is associated with an increased risk of miscarriage, contractions, preterm labor, and other complications, including hypertensive pregnancy and placental abruption 1. After pregnancy, alcohol consumption can also reduce breast milk production, lead to early cessation of breastfeeding, or disrupt the infant’s sleep cycle1.
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Alcohol and Fertility
Existing studies cannot definitively conclude that alcohol has an effect on women’s fertility. However, liver diseases can impact a person’s reproductive functions. And while data on this topic is currently limited, it is likely that long-term alcohol consumption affects fertility, given that an individual’s lifestyle habits directly influence their health, which in turn affects fertility3.
Studies have shown that alcohol consumption impacts men’s fertility. Additionally, alcohol use in men may also play a role in the development of FASD . Indeed, sperm DNA can be affected by alcohol exposure, influencing the development of the child. The father’s lifestyle habits in the months leading up to conception, including heavy alcohol consumption , can impact his fertility and the development of the fetus. Therefore, alcohol consumption habits during conception are a shared responsibility4,5.
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Alcohol consumption and Sexuality
Alcohol consumption can affect sexual and reproductive health in both positive and negative ways. While alcohol consumption may reduce women’s sexual arousal 6, for others, it can facilitate physical intimacy7 and enhance sexual desire6,8.
Demystifying the role of alcohol in sexual contexts
Long-term alcohol consumption is associated with sexual dysfunction in both men and women. In women, these sexual dysfunctions are characterized by decreased lubrication, reduced sensitivity, and difficulty reaching orgasm9,10. As a central nervous system depressant, alcohol slows brain activity and blood circulation, which can affect various physical and psychological responses, such as physical sensitivity, alertness, and judgment. While many people report positive effects of alcohol on their sex lives, these are often related to social disinhibition rather than sexual response . For many, alcohol helps reduce shyness, facilitates intimacy, increases sexual desire, and encourages the exploration of new sexual practices9,10.
Sexual desire may seem to decrease when regular alcohol consumption is stopped. If you have any questions or concerns about this topic, check out the article from Club Sexu in collaboration with Sober Club!
Reducing the risks associated with alcohol consumption in intimate contexts
The most significant risks to women’s sexual health associated with alcohol consumption include the potential for contracting sexually transmitted infections (STIs) or blood-borne infections through unprotected sex, as well as experiencing violence, such as sexual violence6,8. Alcohol consumption influences disinhibition and vigilance, thus increasing the risk of finding oneself in such situations.
Several strategies can be considered to reduce the risks associated with alcohol use in sexual contexts. Here are some ways to lower these risks:
- Keep condoms on hand in case of sexual activity
- Try to reduce alcohol consumption when sexual activity might occur
- Prioritize sexual activity with people you know well in drinking contexts.
Alcohol consumption and sexual and gender diversity
Different factors11 can influence women’s alcohol consumption, including gender , as well as sexual orientation. Notably, an individual may find themselves at the intersection of various forms of discrimination that accumulate due to their social status (for example: gender, ethnicity, age, sexual orientation, etc.).
Scientific research shows that sexual and gender diverse individuals tend to engage in higher and riskier substance use, including alcohol, compared to their heterosexual peers12,13,15,16. This tendency is often linked to the prevalent festive culture within 2SLGBTQIA communities, but several factors, such as minority stress , also play a role in consumption habits13. Sexual and gender diverse individuals face higher levels of discrimination , which can influence their use of psychoactive substances, including alcohol13,14. The desire to connect with other people in the community, the way an individual expresses their gender identity, cultural expectations related to sexual orientation, and limited social spaces are also factors that may explain higher substance use within this population13,14.
Few studies have explored alcohol consumption among sexual and gender diverse individuals, and even fewer data are available on alcohol use among women in these communities. However, according to existing data, the 2SLGBTQIA+ subgroup with the highest alcohol consumption or the greatest risk of developing problematic substance use appears to be bisexual women12,14,15,16,17. Their consumption is characterized by more frequent episodes of heavy drinking , as well as polysubstance use 17,18.
There are few resources specifically dedicated to alcohol consumption among sexual and gender diverse women, but many community groups are working at other levels to support this population.
Check out the resources to learn more!
Quiz
True or False? Drinking just once during pregnancy can cause birth defects in the fetus.
True or False? Alcohol consumption increases genital arousal in women.
References
[1] Paradis C, Butt P, Shield K, et al. (2023) Repères canadiens sur l’alcool et la santé : rapport final, Centre canadien sur les dépendances et l’usage de substances.
[2] Cook JL, Green CR, Lilley CM, et al. (2016) Fetal alcohol spectrum disorder: a guideline for diagnosis across the lifespan. CMAJ Can Med Assoc J J Assoc Medicale Can 188: 191–197.
[3] De Angelis C, Nardone A, Garifalos F, et al. (2020) Smoke, alcohol and drug addiction and female fertility. Reprod Biol Endocrinol 18: 21.
[4] Bébé à naître : la consommation d’alcool du père a aussi des effets Available from: https://ici.radio-canada.ca/ohdio/premiere/emissions/penelope/segments/chronique/480996/sante-procreation-maladie-enfant-parentalite-pere-homme.
[5] Bendayan M, Alter L, Swierkowski-Blanchard N, et al. (2018) Toxiques, mode de vie, environnement : quels impacts sur la fertilité masculine ? Gynécologie Obstétrique Fertilité & Sénologie 46: 47–56.
[6] George WH (2019) Alcohol and Sexual Health Behavior: ‘What We Know and How We Know It’. J Sex Res 56: 409–424.
[7] Léger, Normandeau E (2023) Rapport de sondage préparé pour l’ASPQ: Alcool au féminin, 2023. Available from: https://aspq.org/app/uploads/2023/11/15667_054-rapport-aspq-alcool-au-feminin.pdf.
[8] Lewis D, Hutton HE, Agee TA, et al. (2015) Alcohol Use and Unintended Sexual Consequences among Women Attending an Urban Sexually Transmitted Infections Clinic. Womens Health Issues 25: 450–457.
[9] Salari N, Hasheminezhad R, Almasi A, et al. (2023) The risk of sexual dysfunction associated with alcohol consumption in women: a systematic review and meta-analysis. BMC Women’s Health 23: 213.
[10] Bn AK, M S, J SR, et al. (2017) Sexual dysfunction in women with alcohol dependence syndrome: A study from India. Asian Journal of Psychiatry 28: 9–14.
[11] Canada A de la santé publique du (2022) Comment intégrer la théorie de l’intersectionnalité dans les analyses quantitatives d’équité en santé, 2022. Available from: https://www.canada.ca/fr/sante-publique/services/publications/science-recherche-et-donnees/comment-integrer-theorie-intersectionnalite-analyses-quantitatives-equite-sante.html.
[12] A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, & Transgender (LGBT) Individuals | SAMHSA Publications and Digital Products Available from: https://store.samhsa.gov/product/providers-introduction-substance-abuse-treatment-lesbian-gay-bisexual-transgender-lgbt.
[13] Goldbach JT, Tanner-Smith EE, Bagwell M, et al. (2014) Minority Stress and Substance Use in Sexual Minority Adolescents: A Meta-analysis. Prev Sci 15: 350–363.
[14] Feinstein BA, Dyar C (2017) Bisexuality, Minority Stress, and Health. Curr Sex Health Rep 9: 42–49.
[15] Boyd CJ, Veliz PT, Stephenson R, et al. (2019) Severity of Alcohol, Tobacco, and Drug Use Disorders Among Sexual Minority Individuals and Their “Not Sure” Counterparts. LGBT Health 6: 15–22.
[16] Marshal MP, Friedman MS, Stall R, et al. (2008) Sexual orientation and adolescent substance use: a meta‐analysis and methodological review*. Addiction 103: 546–556.
[17] Shokoohi M, Kinitz DJ, Pinto D, et al. (2022) Disparities in alcohol use and heavy episodic drinking among bisexual people: A systematic review, meta-analysis, and meta-regression. Drug and Alcohol Dependence 235: 109433.
[18] McCabe SE, Engstrom CW, Kcomt L, et al. (2022) Trends in Binge Drinking, Marijuana Use, Illicit Drug Use, and Polysubstance use by Sexual Identity in the United States (2006–2017). Substance Abuse 43: 194–203.