Alcohol-Related Risks in Women's Health

Women deal with gender-distinct experiences from childbirth to gender wealth inequality. To add to that, drinking alcohol presents specific risks to women’s health that differ from those that impact men. 

While trends like “wine mommy” or “mommy juice” drive increased consumption for women, the alcohol-related harms warn us of the detrimental effects of the change in female drinking patterns. Alcohol impacts all components of women’s health. Let’s take a deep dive into how to minimize the risks.

Women and Alcohol Consumption: An Upward Trend

Alcohol consumption has skyrocketed in recent years. That’s due in part to COVID. According to the NIAAA, more males than females drink per year — 68% vs. 64%. However, the gap is narrowing. Although consumption has increased for both men and women, it has increased disproportionately for women. A number of factors appear to be behind that increase:

• Social influences
• Cultural factors
• Psychological factors
• Biological factors

Increased alcohol consumption negatively affects men and women, but why are women at higher risk?

Why Do Women Experience Increased Risks From Drinking Alcohol?

When we drink alcohol, it enters our bloodstream and GI tract and begins to break down. The amount of alcohol in our body — our blood alcohol content (BAC) — affects how intoxicated we feel. However, men and women have significant differences that affects how alcohol impacts them. Women may be more affected by alcohol for a variety of reasons.

• Lower fluid volume. Since women tend to be smaller, they also have less water in their body. This means that when the same amount of alcohol is consumed by a man and a woman, it may be more diluted in a man’s body and less in a woman’s — leading to her higher BAC. Think of mixing a shot of liquor in a small glass of water vs. a gallon jug. Even though the same amount of alcohol is added, the smaller vessel has a greater concentration of alcohol due to its lower fluid volume.
• Less muscle. Women also tend to have less muscle than men. While this may not seem important, muscle also impacts fluid volume. Muscle contains more water than fat — meaning that alcohol is more diluted for those of us with more muscle.
• Alcohol-related crimes. When we drink, alcohol impacts areas of our brain that lower our inhibitions and impair our judgment. 

Given that alcohol affects women more than men, do women face greater consequences from drinking?

Side Effects of Alcohol Consumption in Women

We know that alcohol can affect any one us in the short and the long term. However, women — whose blood alcohol content is generally higher than men’s — experience a greater risk of intoxication. That means they have a greater risk of alcohol poisoning and alcohol-related accidents. And for those women whose alcohol consumption is both excessive and prolonged, the long-term effects are especially impactful. Let’s examine further how drinking affects different aspects of women’s health.

Health Problems Caused by Alcohol

Long-term health conditions are the leading cause of alcohol-related deaths. When we drink, our body breaks alcohol down into a toxic compound called acetaldehyde before it gets eliminated. While our liver works to eliminate the toxins, acetaldehyde hangs around and causes damage to our cells and organs. 

Since women may metabolize alcohol more slowly, they may also be at higher risk of these alcohol-related health conditions.

• Liver damage. Since alcohol is primarily metabolized by our liver, regular exposure to the toxins in alcohol leads to liver damage and disease. 
• Cardiovascular disease. Alcohol consumption can lead to several cardiovascular issues including high blood pressure and heart tissue damage. It’s also linked to a specific type of heart failure called alcoholic cardiomyopathy.
• Certain types of cancers. The exact causes of cancer continue to be studied. However, excessive drinking is directly linked to an increased risk of developing certain types of cancers, including liver, colorectal, breast, and esophageal cancers.
• Diabetes. Alcohol leads to an increased risk of developing type 2 diabetes due to its negative impacts on our blood sugar and insulin resistance. 
• Obesity/weight gain. Heavy drinking and weight gain in females and males are frequently associated with alcohol consumption. Alcohol consists of empty calories that can lead to excess caloric intake. It also can impact our habits negatively — leading to poor food choices and less exercise. 
• Hormone imbalance. Alcohol disrupts our hormones, which can lead to a variety of health issues. Since hormones regulate many different body processes, imbalances can disrupt metabolism, appetite, sleep cycles, mood, and reproductive cycles.

Because alcohol is a central nervous system depressant, it affects our brain — impacting our mental health as well.

Mental Health Consequences

When we drink, alcohol promotes the release of our “feel-good” hormones — notably, dopamine and serotonin. This hormone release can explain the temporary feeling of pleasure typically associated with drinking. However, after those effects wear off, we may experience negative mental health effects.

Research shows that women are at higher risk of mental health conditions due to a number of psychosocial factors. With alcohol added to the equation, the risk of developing poor mental health or mental health conditions is increased. Common mental health conditions associated with alcohol include the following:

• Anxiety
• Depression
• Mood disorders

Not only can alcohol affect our physical and mental health, but it also can harm our social well-being. 

Social Effects of Alcohol

As far as we’ve come with addressing the social inequalities that women have face for centuries, the truth is they still exist. Add on the negative social effects of excessive drinking, and it’s no surprise that women often experience heightened social consequences. 

As social beings, peer perception plays a major role in our decisions and actions. Research shows that societal perception of drinking in men vs. women is different. The public tends to view women who drink more negatively than men who drink. This can impact women’s access to treatment and cause greater harm to their social status. Some social effects of alcohol include:

• Legal issues. Excessive drinking increases the chance of public intoxication and driving under the influence. Since alcohol can have a greater impact on women, the risk of legal issues increases.
• Work/academic performance. Alcohol doesn’t only affect us when we’re drinking but also afterward. Post-drinking, we can feel tired, and our cognition is diminished. The result? Negative impact on employment and academic performance. 
• Financial problems. In addition to impacting employment, drinking can also drain our bank account. Prioritizing drinking over other responsibilities can cause greater financial issues.

An unhealthy relationship with alcohol can lead to alcohol use disorder when untreated. Let’s see how this affects women.

Effects of Alcoholism in Women

Alcohol use disorder (AUD), or “alcoholism,” is characterized by the inability to quit or cut back drinking despite its negative consequences. Criteria from the DSM-V are used to determine if an individual has AUD and the severity of their condition. 

According to the 2022 National Survey on Drug Use and Health, 12.2 million females age 12 and older experienced AUD in the past year. That’s a staggering 8.5% of this age group. Although AUD harms both men and women, it’s women who are less likely to be treated. Left untreated, women who drink to excess will continue to suffer mental, physical, and social consequences.

Health conditions caused by excessive drinking can lead to alcohol-related mortalities. According to a report by the CDC, alcohol-related mortalities increased 34.7% in females and 26.8% in males from 2016-2021. While alcohol-related deaths increased in both males and females, the disproportionate harm of drinking for women may explain the difference. What risks do women face specifically?

Specific Risks of Drinking for Women

Since drinking can affect women more significantly than it does men, women are at higher risk of developing AUD and experiencing alcohol-related health effects. This can lead to greater rates of mortality due to excessive drinking. 

Women also face these specific health conditions.

• Breast cancer. While breast cancer isn’t solely a female condition, it is in the majority of cases. Since women have more breast tissue, 99% of breast cancers occur in women. Acetaldehyde, the toxic compound in alcohol, is also a known carcinogen. That fact explains why drinking is associated with an increased risk of cancer. 
• Fetal alcohol spectrum disorders (FASDs). FASDs cover a range of conditions that affect a baby when a pregnant mother consumes alcohol. The range of physical, behavioral, and cognitive conditions impairments occur from alcohol exposure before birth. FASDs not only affect the child but also the mother. Mothers who give birth to a baby with FASD have a higher rate of mortality.

Specific risks make drinking more harmful for women, but are there any specific practices in place to address these differences?

Addressing Gender-Specific Risks of Alcohol Consumption

To reduce gender-specific risks of alcohol consumption, we need to address the issue individually and systemically. We can work on developing a healthier personal relationship with alcohol, but public structural changes can help address the situation on a broader scale. Some ways we can address gender-specific risks to drinking include the following:

• Public health interventions. Specific interventions that target alcohol-related risks in women can help spread education about the topic.
• Screening and brief interventions. Since women are less likely to seek treatment for AUD, screening in general healthcare settings can help ensure that prevention opportunities aren’t missed. Brief interventions are critical in preventing problematic drinking from progressing to a more serious issue.
• Gender-specific approaches. Women and men are affected by alcohol differently, a fact that supports the case for gender-specific approaches to prevention and treatment.
• Community-based programs and support services. Aftercare and peer support are also a major aspect of recovery. Female-specific programs for women with AUD can help them connect with others who can offer support and motivation.
• Awareness and reducing stigma. Acknowledging gender-specific risks of alcohol consumption helps to reduce stigma. This may increase the number of women who seek treatment for AUD.

We can address the situation after the fact. However, prevention and early intervention is the most effective way to reduce alcohol-related harms.

Preventing Alcohol-Related Risks for Women

Because alcohol affects women in more ways than it does men, women are encouraged to take additional considerations into account whenever they drink. Here are some of the ways women can prevent disproportionate alcohol-related harms.

• Recognize additional risks. Acknowledging gender-specific differences in the way alcohol affects men and women helps us drink more mindfully. Now that we’re aware that the same amount of alcohol will lead to greater risks for women, we can set more useful limits and achievable goals to quit or cut back.
• Quit/cut back on alcohol. Since women are at greater risk for alcohol-related health effects, quitting or cutting back on alcohol will eliminate or minimize the consequences. 
• Prioritize overall wellness. There are many different facets to health. Along with limiting toxic substances, we can prioritize other aspects of our health through participating in daily movement, managing stress, and eating a balanced diet.
• Manage underlying conditions. Alcohol consumption can be impacted by underlying mental health conditions. Addressing these conditions helps us manage our alcohol consumption by getting to the root problem.  
• Explore treatment options. Because each of us is unique, one treatment approach might be more effective for one person, while an alternative might help another. Finding an option that works for us can help set us up for success.

Alcohol is detrimental to men’s and women’s health. However, drinking can cause greater harm to women’s health, which is why quitting or cutting back on alcohol is particularly important for women.

The Big Picture

Drinking is detrimental to men’s and women’s health. However, since it affects women more, the consequences can be greater for women. Women are at higher risk of developing AUD, long-term health conditions, mental health issues, and societal consequences. Acknowledging these gender-specific differences helps us set goals that are more specific to individual needs. Women can quit or cut back on alcohol to promote their health overall.