Alcoholism In Women, What We Know

Alcoholism, or alcohol use disorder (AUD), is a serious condition that can have life-long, potentially fatal consequences. Since the pandemic, alcohol use has been on the rise among women, potentially due to higher reported levels of anxiety and depression.

According to the CDC, nearly half of adult women have drunk alcohol in the last 30 days, with around 13% of adult women reporting binge drinking. Among those who binge drink, a quarter average weekly binge drinking, and almost 18% of women between the ages of 18-44 binge drink. In 2020, 9% of all women and 17% of women from 18-35 years old suffered from alcohol use disorder.

Alcohol use disorder wrecks just as much havoc on the lives of men as women, but women face even more physical challenges related to AUD than men due to a range of physiological factors.

Why Alcohol Affects Women Differently Than Men

Even though men are statistically more likely to consume alcohol and in greater quantities, biological differences in body chemistry and structure mean that it takes most women longer to metabolize alcohol, and that most women end up absorbing more alcohol than men.

Since women have less water in their bodies pound for pound than men, have slower metabolisms, and are typically physically smaller, the immediate effects of alcohol take hold faster and last longer. These metabolic differences compound the long-term negative health effects of alcohol for female bodies.

Hormonal Factors That Impact Female Drinking

While research is still in the preliminary stages, female reproductive hormones may play a role in how women consume and react to alcohol. Senior scientist and head of the Division of Neuroscience at the Oregon National Primate Research Center Kathleen Grant, Ph.D., has been studying the way female menstrual cycles and resulting hormone fluctuations impact when and how much we drink.

Products of progesterone metabolism known as metabolites interact with our brain circuitry in a similar way as alcohol, and metabolites decrease anxiety and stress. Her research suggests that women may drink more during the premenstrual phase of their cycle, since progesterone declines and causes increased anxiety.

Products of progesterone metabolism known as metabolites interact with our brain circuitry in a similar way as alcohol, and metabolites decrease anxiety and stress. However, further research is necessary on other factors like age-induced hormonal changes affect alcohol consumption.

Women Face More Alcohol-Related Health Risks

Compared to men, women have had more significant increases in alcohol-related medical emergencies and deaths in the last two decades. Some other alcohol-related health risks women face include:

• Heart disease: Many people may not directly correlate alcohol use with heart disease, but long-term alcohol misuse is in fact a leading reason behind heart disease. Even though women who don’t misuse alcohol are much less susceptible to heart disease than men, compared to men, they are more susceptible to alcohol-related heart disease. This holds true even though most women consume smaller quantities of alcohol throughout their lifetime than men. 
• Liver damage: Women who misuse alcohol on a regular basis are more likely to develop a potentially fatal alcohol-related liver condition known as alcohol-associated hepatitis than males who consume the same amount. If this pattern of drinking continues, it can ultimately result in permanent liver scarring (cirrhosis).
• Breast cancer: Drinking alcohol has been linked to developing breast cancer, which is significantly more prevalent in women. Research shows that women who consume around 1 drink per day have a 5% to 9% higher chance of developing breast cancer than those who abstain from alcohol. The risk of developing breast cancer goes up with every additional drink they have on a daily basis. 
• Brain damage: Studies have found evidence that alcohol misuse may produce brain damage at a faster pace in women compared to men. Moreover, more and more studies are illustrating that alcohol can disrupt normal brain development during the adolescent years, and among teenage boys and girls there may be further differences with the impact of alcohol on the brain. In one study, for example, teen girls who reported binge drinking showed less brain activity and poorer performance on a memory test compared to peers who abstained or drank lightly. However, this wasn’t found in teen boys. Moreover, teen girls who were heavy drinkers had a larger decrease in the size of essential brain areas involved in decision-making and memory compared to teen boys who did the same. On top of this, women are likely more susceptible than men to blackouts due to alcohol. Blackouts refer to memory gaps due to intoxication, which occur when someone consumes enough alcohol to block the transfer of memories from short-term to long-term storage temporarily (in a process known as memory consolidation) in the hippocampus.

Alcohol and Pregnancy

For women who are pregnant or potentially may become pregnant, there isn’t any proven safe amount of alcohol consumption. Children exposed to alcohol in the womb have significant higher risks of cognitive, physical, and behavioral problems, which may be fetal alcohol spectrum disorders. The risk for preterm labor also increases when you drink during pregnancy.