Is It OK To Drink Alcohol During Menopause?

It’s a Sunday brunch and a group of life-long friends gather, their laughter echoing as easily as the clinking of their mimosa glasses — a beloved ritual of association and relaxation, with a hint of sophistication. Yet amid the sparkling merriment, one woman sips on a glass of ice tea. The motivation behind her non-alcohol choice is rooted in her new phase of life: menopause. Her decision stems from a nuanced understanding of the complex interplay between her body and alcohol. 

Below, we’ll examine the hormonal changes women go through in menopause and the effect that alcohol can have on women during this stage. Let’s dive in!

What Is Menopause? 

Simply put, menopause is the time that marks the permanent end of a woman’s menstrual cycles. Reaching menopause means a woman is no longer fertile and can no longer conceive children. 

While the average age of menopause is 51, it can happen any time from the 30s to the mid-50s or later. Women who smoke or are underweight tend to have an earlier menopause, while women who are overweight often have a later menopause. 

Menopause is gradual and happens in three stages:

• Perimenopause (“menopause transition”): This can begin 8-10 years before menopause, when our ovaries gradually produce less estrogen. It usually starts when we’re in our 40s and lasts until menopause, the point when our ovaries stop releasing eggs. In the last one to two years of perimenopause, the drop in estrogen accelerates. At this stage, many women experience menopause symptoms even though they’re still having menstrual cycles and can still get pregnant. 
• Menopause: This is the point when we no longer have menstrual periods. At this stage, our ovaries have stopped releasing eggs and stopped producing most of their estrogen. Menopause is usually confirmed when we’ve gone without a menstrual period for 12 consecutive months. 
• Postmenopause: This is the name given to the time after we haven’t had a period for an entire year (or the rest of our life after menopause). During this stage, menopausal symptoms can improve. However, some women continue to experience symptoms for a decade or longer after the menopause transition. As a result of lower estrogen levels, women in the postmenopausal phase are at an increased risk for several health conditions, including osteoporosis and heart disease. 

What Are the Symptoms of Menopause?

The symptoms of menopause are caused by low levels of reproductive hormones, such as estrogen. Many of them are challenging, even unpleasant: 

• Hot flashes, also known as vasomotor symptoms (a sudden feeling of warmth that spreads over our body)
• Night sweats and/or cold flashes
• Vaginal dryness that causes discomfort during sex
• Insomnia or difficulty sleeping
• Emotional changes, such as irritability, mood swings, or mild depression
• Dry skin, dry eyes, or dry mouth
• Decreased sex drive

How Does Alcohol Affect Menopause Symptoms? 

Drinking alcohol can exacerbate many of the symptoms associated with menopause. In fact, experts recommend limiting alcohol consumption because the physiological reactions to alcohol can either magnify menopause symptoms or destabilize the body’s adaptive capabilities. Let’s take a closer look:

1. Alcohol’s Impact on Hot Flashes During Menopause

The effect of alcohol on hot flashes is complex. Many menopausal women say drinking alcohol — especially red wine — triggers hot flashes. Several studies have supported this finding. However, research suggests that whether alcohol affects hot flashes largely depends on which stage of menopause we’re in.

For instance, one study showed that perimenopausal women who drank had a lower risk for hot flashes compared with women who never drink alcohol. The researchers measured the participants’ sex hormone levels and found them unaffected by alcohol use. 

However, other studies have shown the complete opposite: an increased risk for hot flashes and night sweats for women who drink, especially among postmenopausal women. One survey found that women who drank alcohol daily were much more likely to report hot flashes and night sweats. Drinking alcohol close to bedtime can make night sweats more uncomfortable for some menopausal women. 

The bottom line? Alcohol’s effect on hot flashes may depend on where we are in our menopause transition. Regardless, whether alcohol triggers hot flashes varies widely based on the individual.

2. Alcohol’s Impact on Sleep During Menopause

Research has found that drinking alcohol during menopause increases the risk of disturbed sleep. Even without menopause, alcohol negatively affects our sleep. Many people think alcohol is a beneficial sleep aid because it helps us fall asleep faster. However, it actually reduces our overall quality of sleep. It suppresses and reduces the amount of time we spend in rapid eye movement (REM) sleep — one of the most important stages of sleep for physical and mental restoration. 

If we’re already struggling with sleep due to menopause, alcohol can create further disruptions and contribute to insomnia. 

3. Alcohol’s Impact on Mood During Menopause

During menopause, many women struggle with irritability, mood swings, and depression. This is largely due to decreased amounts of progesterone and estrogen. Estrogen in particular promotes the production of serotonin, a brain chemical that helps regulate our mood. With lower levels of estrogen, serotonin levels also drop, leading to changes in mood. 

Adding alcohol to the mix only makes things worse. Alcohol may provide a temporary mood boost (due to a rush of the “feel good” chemical dopamine), but since alcohol is a depressant, it often makes us feel worse. Since we’re already struggling with mood shifts due to hormonal changes, having a drink will likely exacerbate symptoms. 

In fact, after drinking, many people experience feelings of restlessness, anxiety, and irritability. This is largely due to a disruption in gamma-aminobutyric acid (GABA) and glutamate, two crucial mood-regulating neurotransmitters. 

Lack of sleep during menopause can also contribute to a bad mood. Anxiety and depression symptoms may also contribute to sleep disturbances that are common during menopause. 

4. Alcohol’s Impact on Health During Menopause

During the menopausal years, women are at a greater risk for certain health conditions, such as heart disease, stroke, cancer and osteoporosis. The risk becomes greater the more alcohol we consume. There’s a particularly strong link between alcohol consumption and breast cancer: according to one study, 1 drink per day increases our risk for breast cancer by 12%. In a different five-year study, post-menopausal women who increased their alcohol intake were found to be at a greater risk of breast cancer. 

The increased caloric input from alcohol can contribute to weight gain, which can increase the risk of certain conditions, such as heart disease, diabetes, and arthritis. 

5. Alcohol’s Impact on Our Body During Menopause

As we age, we become more sensitive to the effects of alcohol. This is largely because we metabolize alcohol more slowly due to a decline in the activity of dehydrogenase, an enzyme that breaks down alcohol. This can lead to increased levels of alcohol in the bloodstream for longer periods of time. 

Similarly, as we age, our bodies lose water volume. As a result, we are less able to dilute any alcohol in our system, making us that much more vulnerable to its effects.

Furthermore, our lean body mass also declines with age. With less muscle to absorb alcohol, older adults feel the effects of alcohol more quickly, even while consuming lower amounts of alcohol than when they were younger. 

Since women tend to process alcohol more slowly than men, older women tend to be at higher risk for these effects compared to older men.

How Much Alcohol Can We Drink During Menopause?

Doctors generally recommend limiting alcohol consumption to one drink per day during menopause. Keep in mind that every woman is different, so it’s important to pay attention to how alcohol affects you specifically. Some women may notice just one drink triggers hot flashes or interferes with their sleep, while others might not experience the same effect. 

However, given alcohol’s adverse short- and long-term effects on our physical, mental, and emotional health, it’s worth significantly reducing our consumption or even eliminating alcohol entirely. 

Managing Menopause Symptoms

There’s no doubt about it: menopause is hard. Here are some tips to managing menopause symptoms and staying healthy during this stage in life: 

• Eat foods rich in calcium and vitamin D: Hormonal changes during menopause can weaken bones, increasing our risk of osteoporosis. Calcium and vitamin D are good for bone health, so it’s important to incorporate more of these nutrients into our diet. Calcium-rich foods include dairy products like yogurt, milk, and cheese. Green, leafy vegetables such as kale, collard greens, and spinach have a lot of calcium as well. 
  
  As for vitamin D, we might want to talk to our doctor about a vitamin D supplement, as food sources with adequate amounts of vitamin D (fish, eggs, cod liver oil are the primary ones) are limited. Sunlight is our primary source of vitamin D, since our skin produces it when exposed to the sun. As we get older, however, our skin gets less efficient at making it. ‍
• Eat foods high in phytoestrogens: Phytoestrogens are naturally occurring plant compounds that mimic the physical effects of estrogen. Our estrogen levels drop during menopause, and phytoestrogens may help balance hormones. In fact, experts believe that the high intake of phytoestrogens in Asian countries is one of the reasons menopausal women in these places rarely experience hot flashes.
  
  Foods rich in phytoestrogens include soybeans and soy products, tofu, tempeh, flaxseeds, sesame seeds, and beans.‍
• Exercise regularly: Physical activity is especially important during menopause, and it can help prevent weight gain. Pilates-based exercise programs in particular may be beneficial; they’ve been shown to provide a range of benefits, such as increased energy and metabolism, healthier joints and bones, decreased stress, and better sleep.
  
  Regular exercise is also associated with overall health and protection against diseases and conditions that tend to occur during menopause, such as heart disease, cancer, stroke, and osteoporosis. ‍

• Drink enough water: Dryness and dehydration are often problematic during menopause, likely caused by decreased estrogen levels. Make sure to stay hydrated by drinking 8-12 glasses of water a day. Drinking water can also reduce any bloating that occurs with hormonal changes in menopause. 

The Bottom Line

Drinking alcohol can worsen many symptoms of menopause, including hot flashes, night sweats, and mood swings. It can also increase our risk of developing serious health conditions, such as heart disease and osteoporosis. If we choose to drink alcohol during menopause, we should limit ourselves to one drink per day. 

If you’re struggling to manage your alcohol consumption, consider trying Reframe. We’re a neuroscience-backed app that has helped millions of people cut back on their alcohol consumption and develop healthier lifestyles. It’s never too late to make a change!