Women and alcohol – reduce your health risks

11th January, 2023 • 12 min read

Did you know that alcohol affects women’s health and wellbeing more than men’s? Discover the links between alcohol and breast cancer, fertility, weight gain, periods and more – plus how to cut your risk if you’re drinking too much without realizing.

What you need to know about women and alcohol

Sharing a bottle of wine over dinner, sinking a few beers while watching the game, or enjoying cocktails with friends after work – they can all feel like normal ways to unwind.

“But drinking can easily become a regular routine,” says Dr Ann Nainan, family doctor and Healthily expert. “And it turns out that we might have lost touch with what safe levels of alcohol are – more people are binge drinking, or drinking amounts that can affect their health without realizing it.”

It can also be a shock to realize how much more easily women’s health and wellbeing can be affected by alcohol than men’s. So find out the hows and whys here, and sense-check your risk.

Why are more women drinking more alcohol?

Research has found that US women in their 30s and 40s are drinking more than in previous decades. Which means you’re not alone if you find yourself:

  • changing plans because you’ve got a hangover
  • finishing the bottle because there’s only a bit left
  • relying on alcohol to help you get to sleep
  • looking forward to ‘wine o’clock’ every evening
  • seeing friends who drink less than you less often

Culture shifts encouraging women to drink more

Although men traditionally drink more often and more heavily than women, scientists say the gap is closing. According to the Centers for Disease Control and Prevention (CDC), almost 58% of adult men say they drank in the past 30 days, while women aren’t too far behind, at 49%.

Some of the reasons for this increase may include:

  • the COVID-19 pandemic – this led to an increase in women drinking, and drinking a lot more. Studies found women increased their ‘heavy drinking’ days by 41% compared with before the pandemic, and that stress caused by COVID-19 was linked to greater drinking in women, but not in men
  • media culture – in TV shows and films, images of busy mums or hard-working women pouring themselves a large glass of wine at the end of the day can be seen as a cultural phenomenon; it’s become shorthand for an instant way to relax or reward ourselves. Who can forget the Sex and the City girls getting together over their Cosmopolitans?
  • the quick-fix for stress – figures show that women are working longer hours than ever before, and are still responsible for the majority of childcare and household chores, too. A drink can feel like a quick way to tune out feelings of stress and anxiety (although it can lead to more in the long run)
  • female-focused drinks – more alcoholic drinks are now aimed specifically at women (known as ‘pinking’ the market), with ready-made cocktails, ‘skinny’ seltzers or fruit-based versions of regular drinks
  • larger – or unknown – measures – just as food portions have grown bigger over the years, drinks measures have crept up in some places, too. In the US, a standard pour is 1.5oz – but high-end bars and restaurants tend to serve 2oz. It also depends on the drink you order, so check with bar staff if you’re not sure. In the UK, some bars have moved from using 25ml of spirits as ‘a shot’, to 35ml or even 50ml. Wine glasses have also increased in size over the years. In the UK, a standard glass of wine is now 175ml, meaning you might have to ask for a smaller (125ml) glass

Female hormones might increase your desire to drink

Fluctuating female hormones may have a surprising effect on your drinking – as the drop in progesterone the week before your period may make you more anxious and sensitive to stressful situations.

“As relieving stress and anxiety are key reasons why people have an alcoholic drink, research shows women may be more likely to drink during that week of their menstrual cycle,” says Dr Ann.

What about the rise of the ‘sober curious’?

A growing number of studies show that younger adults (aged about 16-24) are more likely to drink less or avoid alcohol altogether. But although this ‘sober curious’ generation is on the rise, that doesn’t mean harmful drinking isn’t still happening.

In fact, binge drinking – having 4 or more drinks on 1 occasion for women (or 5 for men) – is most common in adults aged 18-34. In the US, over 90% of adults who drink excessively are binge drinkers.

And you may not even realize you’re binge drinking. “You only need 4 or 5 drinks in 1 session for it to be classed as a binge,” says Dr Ann. Read more about whether you’re drinking too much without realizing.

Why alcohol affects women more than men

Simply put, it’s down to differences in biology:

  • women tend to be physically smaller – so even if we drink the same amount as a man, there’ll be proportionately more alcohol in our body
  • women’s bodies don’t dilute alcohol as much, so its effects stay stronger – alcohol is held in the water in our bodies, not in body fat. Women have proportionately more body fat, and therefore less water, which means the alcohol in our blood becomes more concentrated
  • more alcohol passes through women’s stomachs and into their bloodstream – some alcohol is broken down by the stomach before it passes into the bloodstream. It’s suggested that men are better able to do this than women, so the amount of alcohol passing into our bloodstream is actually higher

Drinking is more damaging for women

There are some common health risks with drinking alcohol that can affect women more seriously:

  • hangovers – women can get worse hangovers than men
  • weight gain – if you’re wondering, does alcohol make you gain weight? The answer is yes. Alcohol is full of calories – around 7 calories per gram – and women need fewer calories than men before their bodies may store the extra as fat
  • appearance – experts say getting drunk leads to dehydration that, in turn, can make your skin look dull, wrinkled and gray. Women are more likely to get dehydrated during their periods
  • liver damage – women who drink regularly are more likely than men who drink the same amount to get alcohol-related hepatitis and cirrhosis, which causes scarring on the liver
  • brain damageexcessive drinking causes brain damage more quickly in women than men. This means damage such as alcohol-related cognitive decline and shrinkage. Women may also be more likely to experience blackouts when drunk
  • heart disease – drinking too much, too often is a leading cause of heart disease. Women have a higher risk of damaging the heart muscle and getting heart disease due to drinking, even if they drink less over the years than men

Woman sitting on couch with headache (credit - fizkes)

The specific health risks of drinking for women

Women are also at risk of some specific problems from drinking alcohol.

Alcohol and breast cancer

Although the exact causes of breast cancer aren’t known, we do know that drinking alcohol – even at low levels – increases your risk of getting breast cancer.

Why might alcohol increase breast cancer risk?

Scientists say drinking alcohol increases the amount of estrogen in our bodies – a risk factor for breast cancer – and creates a chemical called acetaldehyde.

Our bodies break down alcohol into acetaldehyde, which can trigger cancerous cells to grow, and also stops our bodies being able to fix any damaged cells.

Know the risks

A major study published in The Lancet revealed that alcohol was directly responsible for 98,300 cases of breast cancer worldwide in 2020 alone.

Other research has found that:

  • women who have 1 drink a day have a 5% to 9% higher risk of developing breast cancer than those who never drink
  • your risk increases with every extra alcoholic drink per day – the more you drink, the greater your risk

Does alcohol affect fertility?

Trying to get pregnant? Or asking: why does my period stop when I drink alcohol? Wine time could be a problem:

  • it can stop ovulation – the US National Institute on Alcohol Abuse and Alcoholism (NIAAA) says that heavy drinking (defined by the CDC as 8 or more drinks a week for women) can stop you ovulating, or cause your periods to stop entirely
  • it can change your cycle – the NIAAA says women who have 3 drinks a day can also have abnormal menstrual cycles
  • even moderate drinking may affect your fertility in the 2 weeks before your period – a small US study found that drinking just 3 to 6 alcoholic drinks a week during this phase affected women’s ability to get pregnant. And more than 6 alcoholic drinks a week at any time of the cycle was associated with a reduced chance of getting pregnant

See your doctor if you’re worried that your periods have become irregular or stopped altogether. They can check if it could be to do with your drinking, or if there’s another cause.

Alcohol and pregnancy

  • avoid drinking alcohol if you’re pregnant – drinking during pregnancy can cause long-term health problems for your baby, such as fetal alcohol spectrum disorders (including fetal alcohol syndrome), and increase your risk of miscarriage or premature birth. The more you drink, the greater the risk
  • if you were drinking small amounts before you found out you were pregnant, the risk to your unborn baby is likely to be low – a few drinks early on doesn’t necessarily mean you’ve harmed your child. But it’s best to stop drinking from now on

Talk to your doctor if you’re worried about drinking and a pregnancy, or if you feel you may be alcohol dependent (read more about alcohol misuse).

Alcohol and menopause

There are several ways that alcohol can affect your body as you go through menopause (when your periods stop):

  • you may get drunk much faster, on less alcohol – because you lose muscle and water, and gain body fat, during this time
  • drinking too much can weaken your bones – which are already at risk thanks to the hormonal changes that happen during menopause
  • alcohol can make menopause symptoms feel worse – “hot flashes, insomnia and mood swings may all feel more intense after a few drinks,” says Dr Ann

Read more about drinking during menopause.

Evening primrose oil menopause hot flashes

Are you drinking too much without realizing?

“There are 3 types of drinking that can cause health and wellbeing problems, and they all come under the umbrella of ‘excessive alcohol use,” says Dr Ann. “But many of us don’t even realize we’re drinking to excess. This is partly because alcohol affects women differently to men, and so health risks happen at lower levels.”

Here’s what you need to know about excessive alcohol use:

  • binge drinking is 4 or more standard drinks on 1 occasion for a woman (or 5 or more for a man) – “in some cultures, our mothers and grandmothers didn’t have so much of a culture of binge drinking at the weekends, or watching a boxset on the sofa with a bottle of wine,” says Dr Ann. According to the CDC, men are still more likely to say they binge drink: 21% say they binge drink, compared with 13% of women
  • heavy drinking levels are much lower for women than men – just 8 or more standard drinks a week is heavy drinking if you’re a woman, while it’s 15 or more drinks a week for a man
  • in the US, any drinking while pregnant is considered excessive – in the UK, no alcohol during pregnancy is considered the safest option for you and your baby

Should you cut down on your drinking?

This depends on how much you’re drinking right now, and whether you want to make a difference to your lifestyle.

Here’s what the experts say:

  • in the US, the advice is for adult women to drink no more than 1 regular drink a day. This is about 5oz (148ml) of 12% alcohol wine, 12oz (usually a can or bottle) of 5% alcohol beer, or 1.5oz (a shot) of 80-proof gin, rum, vodka, or whiskey
  • in the UK, the Chief Medical Officer says both women and men should drink no more than 14 units of alcohol a week. That’s about 10 small (125ml) glasses of lower-strength wine, or 6 pints of average-strength beer

What happens when you quit drinking?

The good news is that if you do decide to stop drinking alcohol, you’ll start to notice improvements to your health and wellbeing, including:

  • early on – you’ll usually see an improvement in your sleep and energy levels, better concentration, and fewer symptoms of anxiety
  • in the longer term – you’ll reduce your risk of heart disease, stroke and high blood pressure, among other conditions

However, if you feel you’re dependent on alcohol, or you get withdrawal symptoms, don’t try to suddenly stop drinking by yourself. This can be dangerous. Speak to a doctor – they can help you cut down safely. Read more about alcohol support.

Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.