Dependence on alcohol and sexual dysfunction

Alcohol dependence syndrome (alcoholism) is a chronic progressive disease, the development and clinical manifestations of which are influenced by genetic, psychosocial factors and environmental conditions. Alcoholism is manifested by a loss of self-control, unstoppable alcohol abuse, continued alcohol abuse, despite adverse health, social status, family and marital relations, as well as cognitive impairment (from denying an obvious alcohol addiction to the development of gross intellectual-mental disorders and degradation personality).

Alcohol dependence syndrome is characterized by the presence of 3 or more of the following signs: a) a strong need or need to take alcohol; b) a violation of the ability to control alcohol intake (the beginning of use, its termination and the amount of alcohol consumed); c) the state of abolition (alcohol withdrawal), which is characterized by a complex with a mate of autonomic and mental disorders, in order to facilitate or prevent which the subject resorts to the next intake of alcohol; d) development of tolerance, which is manifested by an increase in the amount of alcohol consumed, necessary to achieve a state of intoxication, previously caused by lower doses; e) progressive neglect of former interests in favor of alcohol use, as well as an increase in the time spent on the acquisition and reception of alcohol, or recovery after the end of its action; f) continued use of alcohol despite the obvious harmful effects (liver damage, depressive states, cognitive decline, etc.).

Alcohol dependence is most common in men who start to drink early, with the rapid development of tolerance, physical dependence with the formation of withdrawal states, demonstrating anti-social behavior in childhood and adolescence.

Alcohol abuse is an extremely serious medical and social problem. The likelihood of developing alcohol abuse during life is 10 – 15%. The number of persons suffering from alcoholism in Germany is about 2 million people, in the United States – over 10.5 million men and women, and 7.2 million Americans systematically abuse alcohol, without showing signs of dependence. In 2005, more than 167 thousand people with alcohol dependence were registered in drug treatment facilities in Belarus.

From 20 to 40% of the total bed capacity in hospitals in Europe is occupied by patients with alcoholism and persons whose condition has become heavier due to the abuse of alcoholic beverages. The average life expectancy of patients with alcoholism is reduced by about 10 years. The presence of psychosomatic disorders in the family, and the neuroticism of the non-drinker spouse are found with a high frequency in the families of alcoholics. In women with alcohol dependence, continuing to drink alcohol during pregnancy, fetal alcohol syndrome is observed. Children are born with gross morphological disorders: irregular head sizes and ratios of the head, body, limbs, facial and brain parts of the skull; spherical or deep-set eyes, broad bridge of nose, sunken base of the nose, underdevelopment of the jaw bones, etc.

Children of alcohol-abusing parents often suffer from congenital cerebral insufficiency (excessive mobility, lack of concentration, desire for destruction, aggressiveness), they slow down or prove to be unsatisfactory motor and mental development, mastering practical skills. In all cases of parental drunkenness, children grow up in a psycho-traumatic environment, revealing signs of neuroticism (logoneurosis, enuresis, night terrors), behavioral disorders (stubbornness, aggressiveness, runaways from home) and emotions (anxiety, depression, suicidal attempts); their mental development is impaired, there are difficulties in learning and contacts with peers.

The frequency of sexual disorders in people with long-term alcohol dependence, according to various data can reach 55 – 83%. Erectile disorders, accelerated ejaculation, less often – decreased libido and sharpness of orgasmic sensations predominate among male sexual disorders. Sexual dysfunction in patients with alcoholism can develop as a result of a number of reasons: disorders of the neuroendocrine regulation of reproductive organs, lesions innervatornyh structures of the penis with alcoholic neuropathy, hyperestrogenia with alcoholic hepatitis and liver cirrhosis (occurs enhanced biotransformation of androgens into estrogens), the deterioration of the relationship with the partner, due to degradation of the personality, etc. In any clinical variant, sexual dysfunction in men suffering from alcoholism is The result of a complex interaction of constitutional and personal factors, peculiarities of partnerships, concomitant diseases that negatively affect the sexual sphere, as well as the intensity and duration of alcohol intoxication.

Sexual disorders in women with alcoholism in some cases are the result of alcohol intoxication and manifest sexual hypo-or hyperfunction, in others – are the result of lack of awareness of the psycho-hygiene of sexual life and increasing social and psychological maladjustment.

Most women at the initial stage of the formation of alcohol dependence sexual function does not undergo significant changes. In some cases, already existing violations of the sexual sphere (hypolibidemia, hypoorgasmia) are aggravated. Sexual hyperfunction may be observed, which is manifested by an increase in sexual desire and sensitivity of erogenous zones, as well as multiorganism. The main mechanisms for the development of such hypersexuality are the defeat of the hypothalamic region as a result of chronic alcohol intoxication and the moral and ethical decline of the personality, accompanied by sexual disability. The decline in sexual function in women in the late stages of alcoholism is due to violations of the neuroendocrine and mental regulation of it and depends on the duration and severity of the course of alcoholism, and on the type of their sexual constitution. Disorders of sexual function in women develop in parallel with the development of alcoholism and are most often manifested by alibidemia and / or anorgasmia.

According to the data, in husbands of women with alcoholism, due to the paired nature of sexual function, sexual disorders are often noted, manifested in decreased libido, deterioration in the quality of erections, premature ejaculation, psychological and sexual aversion, and in 22% of cases there is a complete rejection of sexual activity with the spouse , which ceases to cause any sexual desires, or the man has an overwhelming loathing for intimate contact with her. However, alcoholism in her husband (even in the absence of pronounced violations of potency) also has a very negative effect on the quality of sexual life in marriage, since the majority of women have a very negative attitude towards sexual intimacy with a drunken spouse.

It should be noted that sexual dysfunction in one of the partners, his systematic abnormal behavior during intimate intimacy leads to frequent sexual frustrations and an increase in emotional and physical discomfort in another partner, who can relieve the latter by regularly drinking alcohol. Some men systematically resort to alcohol before intimacy, using it to lengthen intercourse. In some cases, alcohol acts as a means of stimulating sexual activity (usually in anxious, insecure individuals). This practice often turns into alcohol abuse and can lead to the development of alcohol dependence. The occurrence or aggravation of disorders of the sexual sphere in patients with alcoholism requires the combined treatment of both alcohol dependence and associated sexual dysfunctions.

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