Menopause and Alcohol

A handy cheat sheet

alcohol cheat sheet

Perimenopause and menopause bring significant changes to a woman’s body, affecting hormonal and overall health. Alcohol can worsen many menopausal symptoms and pose new risks.

 

Understanding these effects is essential for making informed decisions about alcohol consumption and your health Australia has updated its alcohol consumption guidelines to align with the latest research, which recommends minimising alcohol intake to reduce health risks.

 

While no amount of drinking is completely safe, the guidelines offer a framework for maintaining good health and protecting yourself and your family from alcohol-related harm. 

Australian guidelines recommend the following:
🍷 To minimise the risk of alcohol-related health issues or injury, healthy men and women should consume no more than 10 standard drinks per week and no more than 4 standard drinks on any given day.

🍷 Individuals under 18 years old should abstain from alcohol consumption to minimise the risk of injury and harm to the developing brain.
🍷 Women who are pregnant or breastfeeding should not consume alcohol to prevent harm to their baby.

Women Process Alcohol Differently Than Men

Women have less water in their blood than men, meaning the alcohol they drink becomes more concentrated. As a result, their brains and organs are exposed to alcohol for more extended periods. Even moderate alcohol consumption may increase the risk of neurodegeneration in women. Additionally, women have lower levels of key enzymes that metabolise alcohol, leading to it staying in their systems for longer. When you combine this with their smaller average body size, the same amount of alcohol has a more significant impact on them, ultimately leading to higher health risks for women when they drink compared to men.

Older Women Process Alcohol Differently Than Younger Women

Older women are likely to have less body water than younger women. That means drinking the same amount will result in a higher blood alcohol concentration for older women.

 

On top of that, older women are more likely to be taking prescription medications, which may magnify alcohol’s toxic effects on their organs.

Women Tend to Drink More as They Age

… and things can start to get a little dicey.

 

Despite the fact that age decreases our ability to tolerate alcohol, midlife and older women are drinking much more on average than previous generations — and having more health problems, including alcohol-related emergency room visits.

Plus, alcohol use can mask  –  and eventually worsen — other life challenges, such as stress and depression.  Women are also more likely than men to relapse to drinking alcohol in response to stress.

Alcohol Poses Body-Wide Negative Effects

In the past, the media often portrayed alcohol as part of a “heart-healthy” or “fun lifestyle,” even suggesting that red wine could have health benefits due to certain substances in grapes. However, recent research has debunked this belief. It is now clear that alcohol consumption, even at low levels, poses more risks than benefits, especially for women in midlife and beyond.

LOSS OF BRAIN FUNCTION

Moderate alcohol consumption may increase a woman’s risk of neurodegeneration.

WEIGHT GAIN & METABOLISM

Alcohol is high in calories, which can lead to weight gain, particularly central obesity, a risk factor for heart disease. Menopause may slow metabolism, making it harder to process alcohol and easier to gain weight.

HIGHER CANCER RISK

Alcohol use is linked to many types of cancer, including breast cancer and digestive cancers (e.g, esophageal cancers, gastric cancers, colorectal cancers).

MORE HOT FLUSHES

Alcohol may affect the vasomotor regulation which leads to hot flushes.

DISRUPTED HORMONES

Alcohol can disrupt the complex feedback loops that regulate sex hormones, potentially worsening other menopausal symptoms.

WEAKER BONES

Alcohol intake can lower bone mineral density, increasing a woman’s risk of fractures.

SLOWED EXERCISE RECOVERY

Drinking slows glycogen synthesis, which means women have less in the tank for their next workout after they drink. On top of that, their muscles don’t rehydrate as well, and cytokine signals that trigger post-workout muscle repair are altered.

FRAGMENTED SLEEP

Alcohol suppresses REM, or dreaming, sleep, and leads to worse sleep quality.

DEHYDRATION & WATER RETENTION

Alcohol has a temporary diuretic (water- flushing) effect, followed by a rebound water retention effect. This can lead to both thirst and puffiness.

LIVER FUNCTION

Compared to men, it takes less alcohol to cause liver damage and disease in women, and it progresses more quickly.

menopause and alcohol

Moderate Consumption...Less Than You Might Think

Because of the health risks, most women would benefit from capping things off at moderate consumption… and probably even less. Even at low levels, alcohol can have wide-ranging health effects.

Moderate consumption is considered 5–7 drinks a week (i.e., one a day on average). 

What is a standard drink?

A standard drink contains 10 grams of pure alcohol. The type of alcohol makes no difference, 10 grams of alcohol is 10 grams of alcohol, whether it is in beer, wine or spirits.

 

It does not matter whether it is mixed with soft drink, fruit juice, water or ice.

  • Light beer (2.7% alc/vol) 425 mL
  • Mid strength beer (3.5% alc/vol) 375 mL
  • Full strength beer (4.9% alc/vol) 285 mL
  • Regular cider (4.9% alc/vol) 285 mL 
  • Sparkling wine (13% alc/vol) 100 mL
  • Wine (13% alc/vol) 100 mL
  • Fortified wine – for example, sherry, port (20% alc/vol) 60 mL
  • Spirits – for example, vodka, gin, rum, whiskey (40% alc/vol) 30 mL

What Does This Mean For You?

Given all these facts about women, alcohol, and aging – does that mean women should ditch the rosé entirely?

 

Well, that depends.

 

Genetics, body size, overall liver health, medication use, history of drinking, age, and biological sex all affect how the body metabolises alcohol. And for some women, the benefits of drinking alcohol outweigh the risks. (Yes, there are benefits to alcohol, too!)

 

For example:

Maybe you really like the taste.

Maybe your margarita book club is your fave social outlet.

Maybe you get a lot of pleasure and relaxation from drinking a glass of wine as you cook dinner.

Maybe you have a dream of traveling the world and checking out famous breweries with your partner.

 

In other words: People choose to drink for many reasons. You  may not want to change anything, and that’s OK. I’m here to support women’s autonomy to choose their own path.

That being said, below are some options you might like to try if you are wanting to experiment with your alcohol consumption.

Alcohol Experiments To Try Cutting Down:

If you are open to experimenting with alcohol consumption, you can try many things to reduce the short and/or long-term impacts of drinking. Some of the experiments involve drinking less alcohol, and others don’t.

negative drinking

Experiment with the type of alcohol you consume.

Some women love beer but maybe it makes them super bloated and gassy. Other women may enjoy wine but it gives them a pounding headache the next day. Maybe some women feel fine when they drink clear liquor (e.g., gin, vodka, or rum), but find they get a terrible hangover from bourbon or Scotch).  If that’s you, try experimenting with the type of alcohol you consume to see if you can find one that gives you fewer negative side effects.

Experiment with food/hydration around alcohol consumption.

You just learned that alcohol has a temporary diuretic (i.e., water-flushing) effect, and on average, women have less blood to dilute alcohol, and mid- life women tend to have less water in their blood than younger women.

This means you might be able to decrease some of the short-term negative side effects of alcohol consumption by ensuring you’re well-hydrated while you drink. Try pairing your alcohol with meals, and alternate your alcoholic beverages with water or sparkling water to stay hydrated.

 

You may also consider drinking a beverage with electrolytes to help replenish what you’re losing through increased urination.

Experiment with alcohol timing.

This experiment can be two-fold. You can experiment with:

  • When in the day you consume alcohol (e.g., earlier vs. later).
  • How quickly you consume it (i.e., how long it takes you to consume a given number of drinks).

Because alcohol can make sleep worse, some peeps find it helpful to consume alcohol slightly earlier in the day, further away from their bedtime so it has more time to clear their bloodstream before they fall asleep.

 

Now, I’m not advocating for you starting to drink at 9 a.m. or anything (ha ha!), but if you plan to have two glasses of wine, it might be helpful to drink them from 5:30 p.m. to 7:30 p.m. vs. 7:30 p.m. to 9:30 p.m.

 

Similarly, if you normally drink two glasses of wine in 45 minutes, try stretching that consumption out over a couple of hours to give your body more time to metabolise the alcohol.

As you can see, there are many options to explore. Observe how alcohol affects you both physically and emotionally, and then make informed choices about alcohol intake.

Refreshing Watermelon Mojito Mocktail

Ingredients

  • 3/4 cup Frozen Watermelon (Seedless)
  • 1/4 cup Frozen Strawberries
  • 1 tbsp Lime Juice
  • 3 Fresh Mint Leaves
  • 1 cup Sparkling Water/Soda Water
  • 6 Ice Cubes
Watermelon Mojito Mocktail
  • Begin by combining the lime juice and mint leaves in the base of a sturdy glass. Using a wooden muddler or the back of a wooden spoon, press down on the mint leaves 3 to 4 times.
  • Press enough to bruise the leaves and release their fragrant oils, not to shred them.
  • Add the frozen watermelon and strawberries to a high-speed blender and pulse until they are pureed.
  • Transfer the pureed fruit into the glass over the muddled mint and lime.
  • Add the ice cubes to the glass with sparkling water.
  • Stir gently and enjoy.
Would you like support around cutting down the booze or with transitioning through peri and menopause?
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References:

1  Milic J, Glisic M, Voortman T, Borba LP, Asllanaj E, Rojas LZ, et al. Menopause, ageing, and alcohol use disorders in women. Maturitas. 2018 May;111:100–9.

2  Topiwala A, Wang C, Ebmeier KP, Burgess S, Bell S, Levey DF, et al. Associations between moderate alcohol consumption, brain iron, and cognition in UK Biobank participants: Observational and mendelian randomization analyses. PLoS Med. 2022 Jul;19(7):e1004039.

3  Ward RJ, Coutelle C. Women and alcohol susceptibility: could differences in alcohol metabolism predispose women to alcohol-related diseases? Arch Womens Ment Health. 2003 Nov;6(4):231–8.

4  White AM. Gender Differences in the Epidemiology of Alcohol Use and Related Harms in the United States. Alcohol Res. 2020 Oct 29;40(2):01.

5  Davies BT, Bowen CK. Total body water and peak alcohol concentration: a comparative study of young, middle-age, and older females. Alcohol Clin Exp Res. 1999 Jun;23(6):969–75.

6  Epstein EE, Fischer-Elber K, Al-Otaiba Z. Women, aging, and alcohol use disorders. J Women Aging. 2007;19(1-2):31–48.

7  Newman CB. Alcohol use in midlife women. In.

8  Schwartz B. Older women are consuming more alcohol. Contemporary OB/GYN; Monmouth Junction. 2019 Nov;64(11):39.

9  Mineur YS, Garcia-Rivas V, Thomas MA, Soares AR, McKee SA, Picciotto MR. Sex differences in stress-induced alcohol intake: a review of preclinical studies focused on amygdala and inflammatory pathways. Psychopharmacology . 2022 Jul;239(7):2041–61.

10  Levesque C, Sanger N, Edalati H, Sohi I, Shield KD, Sherk A, et al. A systematic review of relative risks for the relationship between chronic alcohol use and the occurrence of disease. Alcohol Clin Exp Res. 2023 Jul;47(7):1238–55.

11  Cai S, Li Y, Ding Y, Chen K, Jin M. Alcohol drinking and the risk of colorectal cancer death. Eur J Cancer Prev. 2014;23(6):532–9.

12  World Cancer Research Fund (WCRF) and American Institute for Cancer Research. Continuous Update Project Expert Report 2018. Recommendations and public health and policy implications. World Cancer Research Fund International London, United Kingdom; 2018.

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