Women are more affected by alcohol than men due to a number of factors, including having less water in their bodies to dilute the alcohol; fewer enzymes to digest the alcohol; usually smaller body size; and hormonal differences that may affect absorption. As women age, they metabolize alcohol less efficiently, so women tolerate alcohol less and less.

Alcohol’s Effects on the Body

• Weight gain. Drinking alcohol contributes to weight gain due to its low nutritional value and high caloric content.
• Breast cancer. Alcohol increases breast cancer risk, but we don’t yet know why.
• Heart disease. Having more than seven alcoholic drinks a week (one drink equals 12 oz of regular beer, 4 oz of wine, or 1 oz of liquor) may increase certain cardiovascular risks such as hypertension, stroke, and coronary artery disease.
• Insomnia. Alcohol use can cause insomnia, even when consumed throughout the day, not just near bedtime.
• Irregular menstruation. In premenopausal women, chronic alcohol exposure can result in irregular menstrual cycles, an occurrence that increases osteoporosis risk.
• Osteoporosis. Alcohol can also increase the risk of osteoporosis by increasing parathyroid hormone (PTH) levels, which disrupt the body’s calcium balance. In cases of chronic alcohol abuse, blood levels of PTH can remain elevated, resulting in a strain on the body’s calcium reserves. In alcoholics, continuous elevations in PTH can cause “secondary hyperparathyroidism,” which can further deplete calcium stores. Alcohol also inhibits the production of enzymes found in the liver and kidneys that convert the inactive form of vitamin D to its active form. This interference with the body’s vitamin D also affects calcium absorption.
• Imbalance. Alcohol can cause dizziness and loss of balance and judgment; this may lead to falls and fractures, not to mention car accidents.
• Esophageal cancer. Alcohol use leads to a greatly increased risk of mouth and esophageal cancers when combined with smoking.
• Skin and hair. Even with moderate use, alcohol causes a dull appearance in both the skin and hair and may worsen acne and dandruff.
• Depression. Any woman who finds herself drinking more than three drinks in one sitting or before noon, or just more and more, is advised to talk to a healthcare provider as drinking is often used to self-medicate for depression. And, drinking to excess makes depression worse.
• Hot flashes. Many women report that alcohol is a trigger for hot flashes, although research to prove a connection is lacking.

Think Ahead
While the results of mixing drinks with menopause are overwhelmingly negative, there are a few related benefits to consider. Studies have suggested that light alcohol use may lower a woman’s chances of fatal heart attacks, especially in women over age 50 who are at high risk for heart attack. Moderate alcohol intake may also decrease risk for hip fracture in women age 65 and above.

Understanding the impact that alcohol has on women’s bodies is important. While choosing to drink or not to drink alcoholic beverages is a woman’s decision, consuming alcohol should be done with care. Current recommendations for women include limiting intake to one drink or less per day with a maximum of seven drinks per week.