Many men wonder whether specific alcoholic drinks, such as tequila, might contribute to erectile dysfunction. Whilst alcohol consumption can indeed affect sexual performance, the type of spirit consumed is less important than the total amount of alcohol and drinking patterns. Tequila contains ethanol—the same active ingredient found in all alcoholic beverages—and affects erectile function in the same manner as beer, wine, or other spirits. Understanding the relationship between alcohol and sexual health, recognising safe drinking limits, and knowing when to seek medical advice are essential for maintaining both general wellbeing and sexual function. This article examines the evidence surrounding alcohol, tequila, and erectile dysfunction within the context of UK clinical guidance.

How Alcohol Affects Erectile Function

Alcohol consumption has a complex relationship with sexual function, acting as both a central nervous system depressant and a vascular modifier. When consumed, ethanol interferes with the neurological pathways responsible for sexual arousal and the physiological mechanisms required for achieving and maintaining an erection. The process of obtaining an erection depends on a coordinated sequence of events involving the brain, nervous system, hormones, and blood vessels—all of which can be disrupted by alcohol.

Acute effects of alcohol on erectile function include:

• Impaired nerve signal transmission between the brain and penis

• Reduced sensitivity and delayed response to sexual stimulation

• Decreased blood flow to the penile tissues due to central nervous system depression

• Slowed reaction times and diminished response to sexual stimuli

In the short term, even moderate alcohol intake can cause temporary erectile difficulties. Alcohol depresses the central nervous system, impairing the neurovascular signalling essential for erection. Whilst alcohol may initially cause vasodilation, it subsequently disrupts the body's ability to coordinate and maintain the increased blood flow necessary for a firm erection. The depressant effects slow reaction times and diminish the brain's ability to respond to sexual stimuli, creating a disconnect between psychological arousal and physical response.

Chronic heavy drinking presents more serious concerns. Long-term excessive alcohol consumption can lead to permanent damage to blood vessels and nerves, endothelial dysfunction, hormonal imbalances including reduced testosterone levels, and psychological factors such as anxiety and depression—all recognised risk factors for persistent erectile dysfunction. Research demonstrates a clear dose-dependent relationship between alcohol consumption and erectile dysfunction prevalence, with heavy drinkers experiencing significantly higher rates of sexual dysfunction compared to moderate drinkers or abstainers. The NHS and UK Chief Medical Officers' guidance emphasise that reducing alcohol intake can improve various aspects of health, including sexual function.

Does Tequila Cause Erectile Dysfunction?

Tequila itself does not possess unique properties that specifically cause erectile dysfunction beyond the effects of its alcohol content. The active ingredient in tequila—ethanol—is identical to that found in beer, wine, whisky, or any other alcoholic beverage. What matters for erectile function is the total amount of pure alcohol consumed, not the type of drink. In the UK, one unit of alcohol equals 10 millilitres (approximately 8 grams) of pure ethanol. A standard 25ml measure of tequila at 40% ABV contains one unit of alcohol and will affect the body in the same manner as any other drink containing the same alcohol quantity.

The misconception that tequila might have distinct effects on sexual function may stem from several factors. Tequila is often consumed as shots, which can lead to rapid alcohol intake and higher blood alcohol concentrations in a shorter timeframe compared to sipping wine or beer. This pattern of consumption may result in more pronounced acute effects on erectile function. Additionally, tequila is frequently associated with party environments where multiple drinks are consumed quickly, potentially leading to excessive intake.

There is no evidence linking tequila specifically to erectile dysfunction that differs from other alcoholic beverages. NHS and UK Chief Medical Officers' guidance on alcohol and sexual health makes no distinction between types of alcoholic drinks—the focus remains on total alcohol consumption measured in units. Some individuals may report subjective differences in how various drinks affect them, but these experiences likely relate to drinking patterns, the rate of consumption, mixer choices, or psychological expectations rather than any inherent property of tequila itself.

What remains clinically significant is the volume and frequency of alcohol consumption overall. Whether someone drinks tequila, gin, or lager, exceeding recommended limits regularly increases the risk of both temporary and long-term erectile difficulties.

Safe Drinking Limits and Sexual Health

The UK Chief Medical Officers recommend that both men and women should not regularly drink more than 14 units of alcohol per week to keep health risks low. For context, 14 units equates to approximately six pints of average-strength beer or six medium glasses of wine. To minimise risks to sexual health and overall wellbeing, these units should be spread evenly over three or more days, with several alcohol-free days each week.

From a sexual health perspective, moderate alcohol consumption—defined as staying within these guidelines—appears to have minimal long-term impact on erectile function for most men. Some observational research has suggested an association between light to moderate drinking and slightly reduced erectile dysfunction risk compared to heavy drinking, though this relationship is complex and likely influenced by confounding lifestyle and health factors. It is important to note that no level of regular drinking is without risk, and people should not start drinking alcohol for perceived health benefits. The key distinction lies between occasional, controlled drinking within guidelines and regular excessive consumption.

Practical guidance for protecting sexual health includes:

• Limiting alcohol intake to no more than 14 units weekly

• Spreading your drinking over three or more days if you drink up to 14 units per week

• Having several alcohol-free days each week

• Avoiding binge drinking—typically defined as consuming more than eight units in a single session for men

• Staying hydrated by drinking water alongside alcoholic beverages

• Being aware that alcohol can interact with medications for erectile dysfunction

• Recognising that alcohol may mask underlying sexual health concerns

Binge drinking poses particular risks for acute erectile dysfunction. The NHS advises that if you regularly exceed recommended limits, reducing alcohol consumption can improve various aspects of health, including sexual function. Men experiencing erectile difficulties should consider their alcohol intake as part of a broader assessment of modifiable lifestyle factors, alongside smoking status, physical activity levels, diet, and stress management. If you are concerned about your drinking, NHS alcohol support services can provide confidential advice and assistance.

When to Seek Medical Advice for Erectile Dysfunction

Erectile dysfunction is defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Occasional difficulties are common and not necessarily cause for concern, particularly when associated with identifiable factors such as stress, fatigue, or alcohol consumption. However, when erectile problems become frequent or persistent—generally defined as occurring in more than 50% of attempts over a period of three months or more—medical evaluation is warranted.

You should contact your GP if:

• Erectile difficulties persist for more than a few weeks

• The problem is causing significant distress or relationship difficulties

• You experience other symptoms such as reduced libido, testicular pain, or urinary problems

• You have cardiovascular risk factors (high blood pressure, diabetes, high cholesterol, obesity)

• You are taking medications that might contribute to erectile dysfunction

• You have concerns about alcohol or substance use

Seek urgent medical attention if you experience:

• Chest pain or breathlessness during sexual activity or exertion

• Sudden onset of erectile dysfunction following pelvic or perineal trauma

• Severe penile pain or curvature

• New neurological symptoms such as weakness, numbness, or loss of bladder or bowel control

Erectile dysfunction can be an early warning sign of underlying cardiovascular disease. The blood vessels supplying the penis are smaller than those serving the heart, so vascular problems often manifest as erectile difficulties before causing cardiac symptoms. NICE guidance emphasises that men presenting with erectile dysfunction should receive cardiovascular risk assessment, as this represents an opportunity for early intervention and prevention of more serious conditions.

Your GP will typically conduct a thorough assessment including medical history, medication review, physical examination, and blood tests. Standard investigations include morning total testosterone (repeated if low), sex hormone-binding globulin (SHBG), HbA1c (to screen for diabetes), lipid profile, liver function tests (particularly important if heavy alcohol use is suspected), renal function, and thyroid function. If testosterone is low or you have symptoms such as reduced libido or galactorrhoea, additional tests including luteinising hormone (LH), follicle-stimulating hormone (FSH), and prolactin may be arranged. This evaluation helps identify any underlying causes—whether physical, psychological, or lifestyle-related—and guides appropriate management. It is important to be honest about alcohol consumption during this consultation, as this information is essential for accurate diagnosis and treatment planning. All discussions with healthcare professionals are confidential, and erectile dysfunction is a common condition that GPs manage regularly.

Treatment Options Available in the UK

Treatment for erectile dysfunction in the UK follows a stepped approach, beginning with lifestyle modifications and progressing to medical interventions when necessary. NICE Clinical Knowledge Summaries (CKS) on erectile dysfunction recommend that management should address underlying causes, modifiable risk factors, and patient preferences whilst considering any contraindications to specific treatments.

Lifestyle modifications form the foundation of treatment and include:

• Reducing alcohol consumption to within recommended limits (no more than 14 units per week, spread over three or more days)

• Smoking cessation

• Increasing physical activity (at least 150 minutes of moderate-intensity exercise weekly)

• Achieving and maintaining a healthy weight

• Managing stress and improving sleep quality

• Addressing relationship issues through counselling if appropriate

For many men, particularly those whose erectile dysfunction is related to excessive alcohol consumption, lifestyle changes alone can produce significant improvement. Studies demonstrate that weight loss, increased exercise, and reduced alcohol intake can restore erectile function in a substantial proportion of affected men, particularly when implemented early.

Pharmacological treatments are widely available when lifestyle measures prove insufficient. Phosphodiesterase type 5 (PDE5) inhibitors—including sildenafil (Viagra), tadalafil (Cialis), vardenafil, and avanafil—represent first-line medical therapy. These medications work by enhancing the natural erectile response to sexual stimulation by increasing blood flow to the penis. Generic sildenafil is generally available on NHS prescription for men with erectile dysfunction, though some other PDE5 inhibitors may be subject to Selected List Scheme (SLS) restrictions. Private prescriptions are also available. Sildenafil 50mg (Viagra Connect) is available over the counter from pharmacies following a suitability assessment by a pharmacist.

Important safety information for PDE5 inhibitors:

• Absolute contraindications: Do not use PDE5 inhibitors if you are taking nitrates (for angina) or riociguat (for pulmonary hypertension), as this combination can cause a dangerous drop in blood pressure.

• Caution required: Use with care if you are taking alpha-blockers (for high blood pressure or prostate problems); your doctor will advise on timing and dosing.

• Cardiovascular assessment: Men with significant cardiovascular disease should have their fitness for sexual activity assessed before starting treatment.

• Alcohol: Limit alcohol consumption when using PDE5 inhibitors, as the combination may increase the risk of dizziness, headache, and low blood pressure. Follow the specific advice in the patient information leaflet for your medication.

If you experience side effects from any erectile dysfunction medicine, you should report them via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk or by searching for 'MHRA Yellow Card' in the Google Play or Apple App Store.

For men with confirmed testosterone deficiency (hypogonadism), testosterone replacement therapy may be considered alongside treatment for erectile dysfunction, following specialist assessment.

Alternative treatments include vacuum erection devices, intracavernosal injections of alprostadil, intraurethral alprostadil, and penile implants for cases resistant to other interventions. Psychological therapy, either alone or in combination with medical treatment, benefits men whose erectile dysfunction has psychological components such as performance anxiety or relationship difficulties. Your GP can refer you to specialist services including urology or psychosexual medicine when appropriate. The key message is that effective treatments exist, and seeking help early improves outcomes whilst potentially identifying important underlying health conditions.

Frequently Asked Questions