Is Alcohol Bad for PCOS?

“That time of the month” can be a pain, especially for those of us with PCOS, or Polycystic Ovary Syndrome. We may have tried the usual remedies: heating pads, warm baths, tea, or even the newest cramp-relieving device on the market. While these may temporarily soothe debilitating pain, managing PCOS requires an all-around approach. 

Managing our diet is a huge component of PCOS treatment. That includes everything we eat and drink — even alcohol. Some women with PCOS may be able to have a drink now and then, but for those with PCOS, that may not be a suitable option. Let’s further examine the effects of alcohol on our hormones and PCOS to help us make mindful drinking decisions.

What is PCOS?

Polycystic Ovary Syndrome (PCOS) is a condition characterized by hormonal imbalance that affects the female reproductive system, mainly the ovaries. While the causes are still being studied, it’s theorized that genetics and insulin resistance can play a part. 

PCOS stems from unusually high levels of male hormones (androgens), which inhibit ovulation. Since ovulation does not occur, small cysts may form on the ovaries. The cysts produce more androgens, which cause the symptoms of PCOS:

• Missing/irregular periods
• Cysts on the ovaries
• Excess body hair (hirsutism)
• Weight gain
• Acne/oily skin
• Infertility
• Skin tags

Although PCOS most commonly affects women of childbearing age, recent studies show that men can also develop a PCOS-like condition.

Alcohol’s Effects on the Endocrine System

To determine whether alcohol affects PCOS, we first have to understand how it affects the hormones in our body. Our endocrine system uses hormones to control our metabolism, reproduction, energy levels, response to injury, and mood. It spans our entire body and affects almost every cell and organ. 

Alcohol is a toxic substance that disrupts the endocrine system and, by extension, our hormone balance. There are three primary ways alcohol affects our endocrine system:

• Insulin, glucagon, and growth hormone (GH).
These three hormones manage glucose, our body’s main source of energy. Acutely, alcohol interferes with insulin and glucagon, which help to regulate our blood sugar. It also increases GH which can cause insulin resistance. Over time, alcohol can increase glucose levels and reduce our responsiveness to insulin, dysregulating our blood sugar and increasing the risk of developing diabetes.
• Dopamine, serotonin, and cortisol.
Alcohol also significantly disrupts the hormones that affect our mood and emotions. When we drink, alcohol stimulates the release of dopamine and serotonin, which may temporarily boost our mood. Over time, our body adjusts to the artificial increase and produces less of these hormones, increasing the risk of developing depression and anxiety. Alcohol also increases cortisol, which is known as our stress hormone. The imbalance of all three can create an emotional roller coaster.
• Estrogen, testosterone, and progesterone.
The effects of alcohol on sex and reproductive hormones differ based on our sex. For men, alcohol can decrease testosterone levels, impacting all facets of our overall health. For women, alcohol can increase estrogen and testosterone, affecting secondary sex characteristics. This helps explain symptoms such as increased body hair and deepening of the voice. Alcohol also decreases the production of progesterone, the hormone that supports menstruation. This can lead to cycle disruptions and potential infertility. 

Through these three main effects on our endocrine system, we can see the extensive impact that alcohol has on our hormones. So how does it affect people with PCOS?

The Connection Between Alcohol and PCOS

Since PCOS is caused by a hormonal imbalance, treating PCOS is a constant effort to correct that imbalance. The diet we follow and the medications we take all work to balance our hormones. Alcohol disrupts the balance further, exacerbating our symptoms. Imagine firefighters working hard to put out a fire, and someone comes around the corner and throws gasoline on it. That’s what drinking does to PCOS.

Can I Consume Alcohol with PCOS? 

When deciding to drink with PCOS, it is important to consider additional types of alcohol, medications, and prior health complications.

Types of Alcohol

Different additives and processing of varying types of alcohol can affect PCOS differently. Let’s compare the three main types to help determine the best option for more balanced hormones.

• Wine. Through the fermentation process, some of the carbohydrates from grapes are turned into alcohol. Wine is slightly lower in carbs in comparison to other alcoholic beverages, but it’s important to be cautious of sugars that are commonly added to enhance the taste. For those of us with PCOS, we might want to reconsider weekly wine nights. Wine is a better option compared to other alcoholic beverages, but it can still negatively influence PCOS.
• Spirits.
Due to the distillation process, spirits contain a higher alcohol content. Spirits are also often mixed with sugary drinks that can spike our insulin levels. The high alcohol content can also cause greater disruptions to our hormones — negatively impacting PCOS. 
• Beer.
Since it is full of carbohydrates, beer is the least recommended alcoholic drink for those of us with PCOS. Carbohydrates are broken down into sugar, effectively raising our blood sugar.

Mixing With Medication

Alcohol interacts with various medications. Those with PCOS are often prescribed Metformin to help regulate insulin levels. Since both alcohol and Metformin can lower blood sugar, the combination could lead to hypoglycemia. Another possible but less common side effect of mixing the two is lactic acidosis, which is caused by a buildup of lactic acid. Symptoms include weakness, muscle pain, and trouble breathing. If untreated, lactic acidosis can even lead to organ dysfunction and death.

Prior Health Complications

Those of us with PCOS also have a higher risk for developing co-occurring health complications such as diabetes, hypertension, non-alcoholic fatty liver disease, heart disease, and sleep apnea. Alcohol can both increase the risk of developing disease and aggravate conditions that originally may not have been caused by drinking.

How Alcohol Interacts With PCOS Treatment

Not only does alcohol act on the same hormones that affect PCOS, but it can also impact the treatment of PCOS in several different ways:

• Change in diet and activity.
While there is currently no cure, a PCOS-friendly diet and regular exercise help lower blood glucose and regulate insulin. Drinking lowers our inhibitions, increasing the probability of making poor food choices. Alcohol is also correlated with weight gain and linked to other diseases, such as fatty liver, that can negatively impact PCOS.
• Medications. A variety of medications can treat symptoms of PCOS or co-occurring conditions. Alcohol can cause potentially dangerous interactions with these medications and additional side effects.
• Birth control. Hormonal birth control is commonly used to treat symptoms of PCOS. While alcohol does not have effects on the efficacy of contraception, it can aggravate the side effects of birth control. Common symptoms include mood swings, headaches, and nausea — all of which alcohol can amplify.

Consequences of Drinking Alcohol With PCOS

So far, we’ve determined that alcohol disrupts hormones and can interfere with the treatment of PCOS. Now, let’s evaluate in greater depth the direct consequences of drinking with PCOS. 

• Increased menstrual irregularity. The effects of alcohol on our sex and reproductive hormones can cause disruptions to the menstrual cycle. This leads to not only short-term effects, such as heavy bleeding or painful periods, but also long-term impacts on fertility. 
• Impacted nutrient absorption.
Alcohol negatively impacts our ability to absorb essential nutrients because our body prioritizes getting rid of toxins. Those with PCOS tend to be nutrient deficient, which adds to the psychological and physiological symptoms we feel. 
• High blood sugar.
Regulated blood sugar is essential to managing symptoms of PCOS. Since alcohol contains simple carbohydrates that break down quickly into sugars, it can spike insulin levels. Excessive drinking is also linked to the risk of developing insulin resistance, which is another contributing factor to the onset of PCOS.
• Risk of developing mental health disorders.
Those of us with PCOS are already at increased risk of developing mental health conditions. Alcohol consumption is also linked with diminished mental health, compounding the risk of developing psychiatric disorders such as anxiety, depression, and bipolar disorder.
• Weight gain. Insulin resistance, a common factor of PCOS, can often lead to weight gain. Alcohol is also linked to weight gain due to the calories in the drinks and the behavioral effects it causes. Alcohol compounds PCOS weight gain, which could lead to other health issues. 
• Chronic inflammation. A common symptom of PCOS is low-grade inflammation, which leads to other complications such as diabetes and obesity. With the inflammatory properties of alcohol, drinking with PCOS can lead to severe chronic inflammation that damages our cells, tissues, and organs over time. 

Through the long list of harmful effects, we can see that alcohol exacerbates the symptoms of PCOS.

Tips for Navigating PCOS and Alcohol Consumption

When working on our relationship with alcohol with PCOS in the equation, there are several helpful practices we can implement to improve it.

1. Choose wisely. Wine or low-alcohol-content beverages are a better option for reducing the risk of spiking blood sugar and further disrupting hormones. To manage our diet, Ibe mindful of additives and mixers that can also impact PCOS. When in doubt, choose alcohol-free options with limited added sugars.
2. Practice moderation. While drinking with PCOS is not advised in any amount, cutting back on alcohol can reduce the negative effects that drinking causes. It lowers the extent of hormonal disruptions and may prevent long-term effects caused by excessive drinking. Setting limits and tracking our alcohol intake are helpful tools for cutting back on drinking.
3. Beware of interactions. Alcohol is a drug, and it has interactions with other drugs, even prescribed medications. Discuss any concerns with a physician to avoid dangerous effects and interactions that can make required medications ineffective. 
4. Maintain proper diet and hydration. Proper diet and hydration are essential for our overall health, but even more so for those of us with PCOS. They can mitigate symptoms of PCOS and replenish vitamins and minerals that are crucial in managing the condition. A balanced diet of whole grains, non-starchy vegetables, healthy fats, and lean proteins is recommended. 
5. Prioritize a balanced lifestyle. Lifestyle changes are shown to be an integral tool in helping manage PCOS symptoms. This not only includes diet and exercise, but also psychological, sleep, behavior intervention, and a range of traditional, complementary, and integrative medicine (TCIM) approaches. 

If You Choose to Drink Alcohol with PCOS

While drinking is not recommended, these mindful choices can help minimize potential damages while working to reduce alcohol consumption 

• Limit empty calories.
All alcohol has little nutritional value, but certain beverages are higher in calories. Try to avoid mixed drinks and beers, which are on the high end calorically.
• Drink with meals. Having a balanced meal with an alcoholic drink will fill us up faster and help us cut back on the number of drinks we have. A proper meal can also help replenish essential vitamins and minerals that may be depleted by the metabolization of alcohol.
• Avoid certain mixers. High-sugar, high-fat mixers will impact PCOS the most. Stick with unsweetened fruit juices or tonic water to help dilute an alcoholic beverage.
• Pace consumption. Taking breaks between drinks can effectively decrease overall alcohol consumption. Grab a PCOS-friendly non-alcoholic beverage in between drinks to stay hydrated and cut back on alcohol.  
• Supplement with vitamins.
Alcohol depletes essential nutrients, which can aggravate symptoms of PCOS. In addition to a balanced diet, vitamins and supplements can help replenish nutrient deficiencies.

Key Takeaways

PCOS affects a high percentage of women, but unfortunately, there is no cure yet. Managing PCOS is a balancing act that requires lifestyle changes. When trying to handle PCOS, alcohol can cause even greater disruptions. It wreaks havoc on our hormones, compounding the symptoms of PCOS. Cutting back or quitting alcohol is unquestionably the most effective way to minimize alcohol-related consequences of PCOS. Women are known to be jugglers and can handle the curve balls that life throws them. Making mindful drinking decisions while navigating PCOS means one less worry!