Women and Alcohol: What to Know

In recent years, there has been a shift in perspective on women and alcohol consumption, particularly the normalization of drinking behaviours. As a dietitian, I’ve seen alcohol use in women skyrocket, so I think it’s time to have the difficult conversation about alcohol with you.

The change in womens’ alcohol use is influenced by many factors such as targeted marketing efforts, where wine, in particular, is portrayed as a symbol of relaxation, self care and empowerment for women.

I’m sure you’ve noticed the use of phrases like “wine o’clock” and “rose all day”, reflecting societal acceptance of women openly discussing, and engaging in drinking activities. Platforms like Instagram and TikTok have given rise to popular hashtags such as #WineWednesday, where women share images and stories of their wine experiences. Even Peloton (and don’t come at me for this, because I love my Pelotons) has a #pelo4wine tag.

Alcohol has become something to joke and brag about, apparently.

While this trend signifies a growing acceptance of women’s engagement with alcohol, it’s crucial to acknowledge the ongoing discourse around the potential health risks and consequences associated with excessive drinking. 

We don’t just drink because social media tells us it’s okay. Stressors of modern life also play a role. Women lead increasingly stressful lives, with aging parents, children, work, and many other responsibilities. Alcohol seems to be becoming a coping mechanism for women navigating the demands of daily life. It’s not uncommon at all for women to pour themselves a glass or two of wine to help them relax on weeknights, and then to consume more on weekends.

What are the stats around women and alcohol?  

The research around women and alcohol has given us increasingly grim outcomes.

There has been a rise of alcohol induced deaths over the last couple of years, especially since the pandemic.  In fact, rates of alcohol induced death for women increased across all age groups for those 25 and older. The largest increase of 27% occurred between 2019-2020. 

These increased rates were driven largely by alcoholic liver disease, and mental health/behavioural disorders linked to alcohol consumption. 

Looking back pre pandemic women aged 25 and over, rates increased by 76% from 2000 to 2018. 

According to a RAND Corporation study, it was observed that a women experienced a increase in heavy drinking during the pandemic. The study found that heavy drinking among women increased by 41% compared to pre pandemic. 

The Center for Disease Control and Prevention states that approximately 13% of women report binge drinking and among them, 25% do so at least weekly, and 25% consume at least six drinks during a binge.

What are the safe alcohol consumption guidelines?

Guidelines for alcohol consumption are crucial for promoting public health and mitigating potential risks. 

It’s important to know what a ‘drink’ really looks like.

• a bottle of beer (12 oz., 341 ml, 5% alcohol)
• a bottle of cider (12 oz., 341 ml, 5% alcohol)
• a glass of wine (5 oz., 142 ml, 12% alcohol)
• a shot glass of spirits (1.5 oz., 43 ml, 40% alcohol)

In Canada, the low risk alcohol drinking guidelines recommend drinking no more than 2 drinks per day, 10 per week, 3 on specific occasions, and to avoid drinking alcohol on some days. 

The United States offers similar guidance for women. The general recommendation is for women to limit their alcohol consumption to one drink or less per day.

For women, binge drinking includes consuming 4 or more drinks on one occasion, which is defined as being between 2-3 hours. 

In early 2023, the Wold Health Organization stated that the risks and harms associated with drinking alcohol have been systematically evaluated and documented that they can confidently say when it comes to alcohol consumption, there is no safe amount that does not affect human health.

These guidelines, whether set nationally or globally, underscore the importance of understanding and acknowledging the potential risks associated with alcohol consumption. 

They serve as valuable tools for individuals to make informed decisions about their drinking habits, promoting a culture of responsibility and well-being.

What are the harms of alcohol? 

Alcohol consumption affects individuals differently, and women are more susceptible to long term negative health effects form alcohol compared to men.  

After drinking the same amount of alcohol, women tend to have higher blood alcohol levels then men, and the immediate effects on alcohol usually occur more quickly and last longer in women. 

Women’s bodies differ from men’s in terms of composition. Women generally have a higher percentage of body fat and lower water content. 

This distinction matters because alcohol is water-soluble, and the less water available to dilute it, the higher the concentration of alcohol in the bloodstream. This can result in a quicker and more pronounced intoxicating effect for women than men. 

Alcohol dehydrogenase, the enzyme responsible for breaking down alcohol in the stomach, tends to be less active in women. Consequently, a higher percentage of alcohol enters the bloodstream before it can be metabolized, leading to increased intoxication. 

Both body composition and available enzymes in the body differ between women and men, resulting in a quicker effect from the alcohol activity.

Some East Asian, such as Chinese, Japanese and Korean individuals, often have higher frequency of genetic variant that leads to decreased activity of one of the alcohol dehydrogenase enzymes.

Effects of Alcohol on the body

It’s safe to assume that alcohol – especially with prolonged, excessive use – has an impact on pretty much every organ and system in the body. 

Chronic alcohol use can weaken the immune system, making individuals more susceptible to infections and illnesses.

Since the gastrointestinal system is typically the first point of contact from alcohol consumed it can affect the structure and integrity of the GI tract. 

Alcohol can alter the number of microbes in the gut, which then can disrupt communication between organism and the intestinal immune system affecting the bodies ability to find infections and illnesses. 

It can cause gastritis, which is a painful inflammation of the stomach lining. This may increase the risk for stomach ulcers. Excessive drinking can cause alcoholic pancreatitis, and extremely painful inflammation of the pancreas.

While alcohol may induce drowsiness, it can disrupt the sleep cycle, impacting overall sleep quality. This can occur because alcohol acts as a sedative that interacts with neurotransmitter that are involved in the regulation of sleep. 

It’s a central nervous system depressant, leading to slowed brain function, impaired judgement and coordination. 

The liver has a large role when it comes to alcohol consumption, as the liver is able to metabolizes alcohol breaking it down into byproducts in the body.  Chronic alcohol consumption can lead to cirrhosis, which is scarring of the liver. This leads to liver failure if not addressed.

Alcohol and weight

Alcoholic beverages can be high in calories. Consuming alcohol may contribute to weight gain, especially when accompanied by sugary mixers or high-calorie snacks. Unlike food, alcohol contributes completely useless calories to our diets.

Alcohol consumption can also lead to feelings on permissiveness/disinhibition, which may also increase consumption. And there’s a reason why we crave salty foods after we drink: because alcohol is a diuretic, our bodies are looking to replace that sodium we’ve peed out.

Alcohol and mood

Alcohol impairs judgment and inhibitions, potentially leading to risky behaviours and mood fluctuations. 

While some individuals may turn to alcohol to alleviate negative emotions or stress, alcohol can subsequently impact mood and mental health in various ways contributing to a cyclical pattern. 

There is evidence to show that many people do consume alcohol to help deal with anxiety and depressive thoughts connecting mood, mental health and alcohol together. 

Alcohol affects the parts of the brain that control inhibition, so people may feel more relaxed and less anxious at first. Eventually though, alcohol may lead to chemical change in the brain and to more negative thoughts and feelings. 

Alcohol and breast Cancer Risk

Research has shown that long-term alcohol use can be associated with an elevated risk of breast cancer.

Alcohol has been shown to alter estrogen levels, which may then lead to changes in breast density, affecting a women’s risk of breast cancer. 

It’s not just breast cancer that alcohol may raise risk for: it’s also gastric, esophageal, pancreatic, colorectal, head and neck, and liver cancers.

Screening For alcohol use disorder

Identifying whether you have an alcohol use disorder is an important step towards seeking and making positive changes. Your doctor can help you through this step.

To screen you, your doctor may ask you questions such as (but not limited to):

1. Have you had times when you ended up drinking more, or longer, than you intended?

2. Have you more than once wanted to cut down or stop drinking, or tried to, but couldn’t?

3. Have you spent a lot of time drinking, being sick from drinking, or getting over other aftereffects?

4. Have you ever wanted a drink so badly you couldn’t think of anything else?

It’s so important to answer truthfully, in order to get the help you need.

how to reduce alcohol consumption 

Reducing alcohol consumption is a goal that can positively impact overall health and wellbeing. As a registered dietitian, it’s something I recommend to pretty much all of my clients, because for most people, it’s a low-hanging fruit goal that can be achieved without much issue. That being said, if you have an alcohol use disorder, you can see the recommendations I’ve included below.

I usually tell clients to reduce their alcohol consumption by half to start. Also recommend to consume alcohol wisely and mindfully, understanding why and how much they’re drinking. Often, we don’t even know how much alcohol we’re drinking until we journal it or even make an effort to take notice.

The Centers for Disease Control and Prevention outlines some great tips, if you’re ready to drink less and don’t know where to start.  Harvard Medical School has also outlined some additional tips to reduce drinking. 

Where can you find help?

There are several resources available to support individuals in their journey to reducing alcohol consumption. 

The National Institute on Alcohol Abuse and Alcoholism have launched a alcohol treatment navigator. 

This tool helps people to find the right treatment near them. It will guide patients through a step by step process to finding a highly qualified professional treatment provider. This would be a great resource to look into when starting the journey to reducing alcohol intake. 

Aside from this consider speaking with a licensed therapist to engage in talk therapy that can help people build copying mechanisms and skills to stop and or reduce drinking. 

Life is about balance. If you are able to moderately consume alcohol, please do so. If you don’t drink, please don’t start. And if you believe your alcohol consumption is problematic, please take steps to get help.