Does Drinking Alcohol Affect Testosterone?

Alcohol consumption, particularly alcohol misuse, is a topic of interest due to alcohol’s widespread effects on overall health. About 17% of adults binge drink, and 7% are heavy drinkers (15 or more drinks weekly for men and 8 or more for women). Alcohol can influence hormone balance, particularly testosterone, which plays an important role in male and female health.

This article explores the potential impact alcohol may have on overall testosterone balance and ways to adopt healthy habits that support hormone health.

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What Is Testosterone?

Testosterone is a sex hormone that plays a key role in bone density, muscle mass, sexual function, mood, reproduction, sex drive, and overall well-being in men and women. While both men and women produce testosterone, men have much higher levels.

Does Drinking Alcohol Affect Testosterone?

Drinking alcohol may influence testosterone levels in various ways.

Immediate Effects of Alcohol on Testosterone Levels

Alcohol consumption can cause fluctuations in testosterone measurements, but these effects appear to be dose-dependent. 

• Findings from a review suggest that acute low-to-moderate alcohol consumption may temporarily increase testosterone, while ingesting large amounts of alcohol could reduce blood testosterone concentrations in men. 
• Another study found similar results: heavy acute alcohol consumption may decrease testosterone in men, while lower alcohol doses (0.5 grams per kilogram of body weight) might increase testosterone in men and women. 
• A third study also indicated that drinking large amounts of alcohol can disrupt hormone balance.
• Research suggests that both acute and chronic alcohol consumption is linked to lower testosterone levels in alcoholic men. 

Mechanisms involved in alcohol-induced lower testosterone may include increased hypothalamic-pituitary-adrenal axis activity, oxidative stress, and inflammation.

Long-Term Consequences of Regular Alcohol Consumption

Chronic high intake of alcohol is linked to lower testosterone in men. Long-term alcohol consumption (chronic use or misuse) may contribute to sustained lower testosterone levels. This could be due, in part, to damage to Leydig cells in the testes that are responsible for testosterone production. 

Specific Effects of Alcohol on Men's Health

Alcohol can play a role in men's overall health and well-being.

Alcohol and Male Reproductive Health

High quantities of alcohol may directly affect male reproductive capabilities. 

• Research demonstrates that heavy alcohol intake (more than seven drinks weekly) may reduce semen volume, antioxidant enzymes in semen, testosterone, follicular stimulating hormone, and luteinizing hormone while increasing estrogen. However, a moderate alcohol intake (less than 7 units per week) showed no changes.
• Another review found similar results: chronic alcohol consumption is associated with poor semen quality because of its impacts on oxidative stress, hormone regulation, and DNA integrity.
• A third study suggested that alcohol may affect fertility in men by impairing Sertoli cells, which play a role in sperm maturation. 
• Researchers found that alcoholic men had significantly lower levels of sperm counts, semen volume, motility, and numbers of healthy sperm.
• Alcohol may also affect fertility in men by increasing the risk of erectile dysfunction (ED). 

However,  low to moderate alcohol intake may not negatively affect semen quality or testosterone levels in men. 

Systemic Effects of Lowered Testosterone in Men

Additional health issues men may face because of alcohol-related low testosterone (less than 300 ng/dL) may include:

• Muscle atrophy
• Reduced bone density
• Mood changes
• Depression
• Low sex drive
• Fatigue
• Irritability
• Erectile dysfunction (ED)
• Smaller testes
• Reduced body hair
• Difficulty sleeping 
• Problems with concentration or memory
• Muscle weakness 
• Lower endurance
• Infertility

Adopting healthy habits, such as avoiding alcohol or drinking it in moderation, eating healthy foods, getting regular exercise and enough sleep, minimizing stress, and maintaining an ideal body weight may help support healthy testosterone levels. 

Alcohol And Testosterone Levels in Women

Alcohol intake may also affect testosterone levels in women.

Testosterone's Role in Female Health

Testosterone plays a vital role in women’s health, though women have lower natural levels of testosterone than men. Their bodies can convert testosterone (made in the ovaries) to estrogen.

Testosterone in women is also critical for bone health, sex drive, muscle health, mood, menstruation, and fertility.

Impact of Alcohol on Women's Hormonal Balance

Alcohol seems to affect women differently than men. Studies show that alcohol use in young adult women is associated with higher testosterone levels. It may cause hormone imbalance and affect conditions like polycystic ovary syndrome (PCOS), potentially worsening its symptoms (excess facial or body hair, acne, obesity, infertility, thinning hair, irregular periods, etc.). 

Another study found that 45 and 90 minutes after drinking 0.5 grams of alcohol per kilogram of body weight, testosterone levels were higher in premenopausal women.

Recovering Testosterone Levels After Reducing Alcohol Intake

All isn’t lost after heavy alcohol use, as lasting recovery and improved health and well-being are often within reach. 

Potential for Hormonal Recovery

There’s a possibility of hormone recovery after reducing or ceasing alcohol intake, but it may take some time for the body to adjust. It can take several months, up to a year or longer, to correct health issues caused by heavy drinking. 

However, individualized recovery results vary based on the amount of alcohol an individual drank, their medical history, and their current lifestyle habits. Not everyone can fully restore their health, however, as alcohol misuse can cause lasting effects on the liver and other organs. It may lead to cancer, brain damage, dementia, liver disease, or other chronic conditions.

Supporting Recovery

Making lifestyle adjustments or undergoing medical intervention may support the recovery of hormonal health after alcohol misuse. Examples include:

• Eat a nutritious diet rich in whole (non-processed) foods
• Avoid highly processed foods like fried foods, refined grains, and processed meats
• Minimize or eliminate added sugar
• Avoid smoking
• Exercise regularly
• Routinely check hormone levels  
• Take any medications as directed
• Get plenty of sleep
• Minimize stress
• Consider counseling if necessary 
• Drink plenty of water
• See a healthcare provider routinely for follow-up visits

Testosterone replacement therapy (TRT) may be an option for patients with low testosterone, regardless of what has caused it.

When to Seek Medical Advice

Individuals should seek medical advice if they experience symptoms suggesting alcohol-related hormonal imbalance or alcohol misuse. Examples include:

• Low libido
• Reduced lean body mass
• Muscle weakness
• Increased body fat
• Weight gain
• Fatigue
• Erectile dysfunction (ED)
• Infertility
• Signs of alcohol-related liver problems (drowsiness, lower limb and abdominal swelling, easy bruising, loss of appetite, jaundice, confusion, feeling sick, etc.)

These or other unusual symptoms, particularly among heavy drinkers, warrant a professional evaluation. 

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Key Takeaways

• Alcohol use, particularly heavy or chronic consumption, may negatively affect testosterone, increasing the risk of low T and the often bothersome side effects this condition may cause. 

• While low to moderate drinking on occasion may not be problematic and could even temporarily increase testosterone, alcohol misuse is associated with hormone imbalance and physical and mental health problems.

• Consider alcohol consumption in the context of long-term hormonal health and consult with a healthcare provider for personalized advice regarding a safe (if any) amount of alcohol.