Picture this, ladies: you are getting ready at a friend’s place for a big night out. The music is loud, make-up is scattered across the dressing table and outfits are everywhere. The vibe is care-free. You and your friends are taking shots, laughing and posting stories on Insta before you even leave for the club. Fast forward a few hours, and the memories start to blur.
“I remember getting ready for the event […], and that was the last thing,” says Lia Morkel, a university student.
The next morning, your head is pounding, and your stomach turns as you try to piece together what happened. Did you use a condom? Did you give consent? Who took you home? Chronic alcohol use not only steals your memories; it can also leave scars on your body, your future health, and even delay or reduce your sexual pleasure.
Alcohol’s impact on young women’s sexual and reproductive health often carries a stigma, says Dr Obasanjo Bolarinwa. His research on South African women aged 15 to 24 shows that alcohol is one of the key factors putting them at risk of unplanned pregnancies and Sexually Transmitted Infections (STIs), yet women and girls are just not talking about it. We are definitely also not talking about pleasure.
“According to some studies, failure to achieve an orgasm is around 50% in women with alcohol dependence,” says Nelson Mandela Bay-based obstetrician and urogynaecologist Dr Quinton Blignaut.
Alcohol can reduce arousal, make it harder to enjoy sex and delay or prevent an orgasm.
“Young women with a history of smoking and alcohol consumption are at greater risk of experiencing sexual dysfunction,” says Blignaut.
Hidden effects
For some young women, alcohol is tied to ideas of emotional maturity, social acceptance and sexual confidence. It is often used to feel braver about talking to someone you like or going home with a partner. Risky behaviours tend to spike during weekends, grooves and celebrations at clubs, taverns and bars.
“Confused and embarrassed” is how Lia describes the feeling of not knowing how she got home. “[My friends] told me that I was completely fine, but they had to ask someone to help carry me.” She had not been with her friend for about 20 minutes.
Research in South Africa has found that young women who often drink in bars or shebeens are more likely to have unprotected sex, multiple partners and infections such as herpes simplex virus type 2 (HSV-2) and HIV. Alcohol can crank up risk-taking behaviours and contribute to you saying ‘yes’ to do things you would never agree to sober. And the cost is often higher for women from poorer communities.
Unequal sexual health
“Access to services is uneven, especially for adolescents, migrants and women with disabilities. Social stigma, healthcare provider bias and structural inequalities continue to hinder equitable outcomes,” says Bolarinwa, who is an expert in global and public health at York St John University.
Roughly put: The same young women who are dealing with poverty, toxic or unsafe relationships and long trips to the clinic are often the ones most exposed to heavy drinking and risky sex. When you do not have taxi money, or you are scared the clinic sister will judge you, you are much less likely to go for an STI test or treatment after a drunk hook-up.
With the business of everyday life, it is easy to brush off pain, discharge or discomfort after a drunk hook-up as something that will pass. Yet, ignoring these signs, especially when alcohol was involved, can allow infections to travel further up the reproductive tract.
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What you should know
Pain, burning, itching, discharge down there accompanied by flu-like symptoms? You could have herpes. Herpes is more common than many think. Some South African studies suggest that about one in five people carry the virus. Because of shame and stigma, a lot of women do not seek treatment early, especially if they feel clinic sisters will judge them. Many hope the symptoms will just go away. They will not. Herpes cannot be cured, but it can be treated with drugs like Acyclovir if you get it in time.
Fishy odour and itching could also be bacterial vaginosis (BV). BV itself is not classified as an STI, but it is strongly linked to sexual activity and to other infections. Women with BV are at higher risk of contracting STIs, and women living with HSV-2 are more likely to develop BV.
Condoms are still the most effective way to reduce the transmission of many STIs, but uncovered skin can still pass on HSV through bodily fluids and skin-to-skin contact.
An untreated infection like BV or chlamydia can develop into pelvic inflammatory disease (PID), which can interfere with fertility.
PID is a genital tract infection that damages the uterus, fallopian tubes and surrounding tissue. Studies show that women undergoing in vitro fertilisation (IVF) who also have BV may have a higher risk of fertility problems or difficulty conceiving.
Heavy binge drinkers are also more likely to have disrupted menstrual cycles or anovulation (cycles where no egg is released). When periods stop or become irregular, some girls panic and think they might be pregnant, even when that is not the cause.
Dr Blignaut confirms: “Chronic alcohol consumption …can lead to hormonal imbalances and reproductive health issues.”
Alcohol can also increase prolactin levels, which may add to fertility problems.
Safe fun
By now it is clear that the problem is not only one more drink for the road. Alcohol can sit right at the start of a chain: looser boundaries, condomless sex, infections like BV and herpes, menstrual changes and future fertility worries.
That does not mean you need to live like a nun. It does mean being honest about the risks and choosing how you drink and how you have sex with your future self in mind.
“Awareness of these risks remains low among the general public,” says Bolarinwa. Knowing the risks is only the beginning. Being educated and spreading awareness about these issues are ways you can protect your reproductive and sexual health.
Being mindful means:
- Set a limit on how much you drink on a night out.
- Make a pact with friends to look out for each other and leave together.
- Carry condoms and actually use them, even if you have been drinking.
- Go to a clinic for testing if something feels off, rather than waiting.
Your future self will thank you for staying informed, asking questions and making choices that protect both your pleasure and your health.
- This article was first published by Khulani!
