March 25, 2021 – Women tend to have worse outcomes from increased drinking — worse outcomes in health issues, psychological consequences, and progression to an alcohol use disorder.  Increased drinking is especially evident in women 30 years of age and older in the U.S. Research also indicates that women over 60 are binge-drinking more often. A nationwide study showed that between 2006 and 2014, emergency room visits due to excessive alcohol rose by 61.6%, with a staggering 272% increase in related costs. Another study showed that between 1993 and 2010, alcohol-related hospital diagnoses increased by 90% for women 45–64 years of age (versus 30% for men of the same age). In a look at alcohol-related liver issues, one study shows that between 2000 and 2015, rates of alcohol-related liver issues for women increased by 85%.

What do we know about how alcohol impacts women specifically?

One study on women and alcohol shows that women react more to alcohol because of lower amounts of water and muscle mass in their body and higher amounts of estrogen. Dr. Joseph Volpicelli, an addiction medicine specialist, confirms this. He also points to the fact that women have higher estrogen levels as an important part of the puzzle in alcohol addiction.  Volpicelli explains that because women have large fluctuations in estrogen, it makes the effects of alcohol more pronounced. Estrogen enhances a sense of well-being, and since alcohol also increases blood estrogen concentration, the effects of alcohol may be more pleasurable for women, says Volpicelli. One study shows a definite increase in alcohol craving for women when estrogen levels are dropping. In his practice, he notices that women have more alcohol cravings postpartum once estrogen levels drop.

Volpicelli also notes that the withdrawal process is more pronounced for women due to changing estrogen levels. A drop in estrogen levels has a highly irritating effect on the nervous system in women, which explains many premenstrual symptoms. This can compound the effects of alcohol withdrawal, especially if estrogen levels are naturally dropping at the same time.  In my case, I experienced worsening health issues due to alcohol use in my late thirties and early forties when my estrogen levels were fluctuating more wildly. My hangovers produced harsher neurological symptoms, I had worsening chronic pain, and my menstrual symptoms became unmanageable. At the time, I had no idea that the combination of changing estrogen levels and heavy alcohol use was causing me harm.



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