Factors underlying infertility in the alcoholic.

In an effort to identify the factor(s) contributing to loss in sexual competence in alcoholics, a pilot study was made of the interrelationships of hepatic disease, plasma hormone levels and importnce in 35 male patients in an alcohol unit. Contrary to previous reports, impotence was not a direct concomitant of hepatic disease, elevated sex hormone-binding globulin capacity or hyperestrinism. The most significant aberration found was a nearly 30% lower mean free testosterone concentration which appeared to be secondary to a mean total testosterone concentration 20% below that of the subjects with normal sexual function. We conclude from this that impotence results from testicular secretion impaired by the action of alcohol or its metabolite, acetaldehyde.