Effects of alcohol on females

Why are men more susceptible to alcoholism? It may be in their dopamine

A new study published in Biological Psychiatry reveals that dopamine may be an important factor.

Researchers from Columbia and Yale studied male and female college-age social drinkers in a laboratory test of alcohol consumption. After consuming an alcoholic or non-alcoholic drink, each participant underwent a specialized positron emission tomography (PET) scan, an imaging technique that can measure the amount of alcohol-induced dopamine release.

Dopamine has multiple functions in the brain, but is important in this context because of its pleasurable effects when it is released by rewarding experiences, such as sex or drugs.

Despite similar consumptions of alcohol, the men had greater dopamine release than women. This increase was found in the ventral striatum, an area in the brain strongly associated with pleasure, reinforcement and addiction formation.

“In men, increased dopamine release also had a stronger association with subjective positive effects of alcohol intoxication,” explained Dr. Nina Urban, corresponding author for this study. “This may contribute to the initial reinforcing properties of alcohol and the risk for habit formation.”

Dr. Anissa Abi-Dargham, senior author on this project, notes that “another important observation from this study is the decline in alcohol-induced dopamine release with repeated heavy drinking episodes. This may be one of the hallmarks of developing tolerance or transitioning into habit.”

These findings indicate that the ability of alcohol to stimulate dopamine release may play an important and complex role in its rewarding effects and abuse liability in humans. This identification of an in vivo neurochemical mechanism that could help explain the sex difference in alcoholism is an exciting step forward in alcoholism research.

An international team of researchers may have found one of the reasons why alcohol harms women more than men: women, it appears, are deficient in an enzyme that helps metabolize alcohol. The findings appear in the April issue of Alcoholism: Clinical and Experimental Research. “It has been known for a long time that, in general, both women and female animals are more susceptible to the negative or toxic effects of alcohol,” team member Steven Schenker of the University of Texas at San Antonio says. “This is true for the liver, heart muscle and skeletal muscle, and it may be true for the pancreas and the brain. In other words, there is something about the female gender that makes them more susceptible to toxic amounts of alcohol.”

In the past scientists attributed this susceptibility to women’s smaller body size and their relatively higher percentage of fatty tissue. For this study, however, the researchers focused on what is known as first-pass metabolism. Before alcohol reaches the blood stream, it goes through the stomach, where so-called gastric alcohol dehydrogenase (ADH) isozymes break some of it down. “In an earlier study we found that women have less of this ADH activity than men do,” notes lead author Charles Lieber of the Mount Sinai School of Medicine. “Accordingly, women have a lesser first-pass metabolism and, therefore, for a given dose of alcohol, their blood level is higher than it is for men.”

Following up on that research, the team recently turned their attention to the makeup of ADH. They found that one of the enzyme’s three components, glutathione-dependent fomaldehyde dehydrogenase (x-ADH), is deficient in women, thus explaining their lower ADH activity levels. To Schenker, the take-home message is clear: “Women simply need to be more cautious than males in terms of the amount of drinking they do.”

The Effects of Alcohol on Women

The effects of alcohol are stronger in women than in men, and women who drink too much alcohol are more likely to suffer from significant alcohol problems than men, studies show. In addition, women who have alcohol problems have higher death rates due to suicide, accidents, and other health related issues — more than twice the rate of men. Given these facts, you may be wondering: Why do women drink, and what can you do to enjoy alcohol without risks to your health?

Understanding Why Women Drink

Women drink for many of the same reasons that men drink: to relax, to gain confidence in social situations, to get to sleep, and to relieve stress.

Other reasons why women may drink alcohol include the following:

  • Women are more likely to drink if they have problems with a loved one.
  • Alcohol problems are more common in women who are unmarried, divorced, or separated.
  • Women whose husbands have alcohol problems are more likely to drink themselves.
  • Women who have been sexually abused are more likely to drink to excess.
  • Women may start out drinking more. Seventeen percent of ninth grade girls admit that they had more than five drinks at one time in the past month. This is a higher rate of drinking than for boys of the same age.

Alcohol Affects Women Differently Than Men

The blood alcohol level in a woman who just drank the same amount of alcohol as a man will be higher because women are usually smaller, have less water in their bodies, and metabolize alcohol more slowly than men.

This means that the brain and liver of a woman who drinks are exposed to more alcohol pound for pound than a man’s brain and liver. Women who have alcohol problems may drink less than men but still experience the same level of impairment. They can also develop liver damage and other alcohol-related health problems more quickly than men, even though they may be drinking less.

Benefits of Alcohol in Women

If you are a woman over the age of 55, one drink per day may lower your risk for heart disease. Moderate drinking for a woman is defined as one alcoholic drink per day. This translates to one 5-ounce glass of wine, a 12-ounce bottle of beer, or 1.5 ounces of hard liquor.

On the other hand, women who drink beyond moderation may increase their risk of heart disease. If you are younger than 55, there may be no health benefits to alcohol consumption.

Risks of Alcohol in Women

Too much alcohol consumption clearly has risks for both men and women. Other risks to women who drink alcohol include:

  • Cancer. Women who drink alcohol may increase their risk of breast cancer and head and neck cancers.
  • Brain damage. Alcohol kills brain cells and women are more susceptible to this alcohol effect than men.
  • Pregnancy. Alcohol can affect a woman’s ability to get pregnant. In addition, alcohol use during pregnancy can have serious harmful consequences on the unborn child. No amount of alcohol consumption is safe during pregnancy.
  • Victimization. Women who have alcohol problems have a higher risk of becoming victims of sexual assault or other acts of violence.
  • Depression and personal injury. In addition, alcohol consumption can contribute to depression, sleeping problems, heart failure, falls, and poor nutrition in women, especially older women.
  • Cancer. Women who drink alcohol may increase their risk of breast cancer and head and neck cancers. One recent study published in the Journal of the American Medical Association found that consuming as few as three to six alcoholic drinks a week may be linked to a 15 percent increased risk of breast cancer.

Warning Signs of Alcohol Problems

If the effects of alcohol are causing problems for you or for others, you may have an alcohol problem. The risk of developing an alcohol problem is greater if you have a family history of alcoholism. Some warning signs of alcohol problems are:

  • Missing work or school because of drinking
  • Driving while impaired by alcohol
  • Having a strong urge to drink
  • Needing more alcohol than you previously did to get a pleasurable response
  • Finding that people who care about you are concerned about your drinking
  • Having more than seven drinks per week
  • Finding yourself drinking alone or early in the day

If you think you might have an alcohol problem, it’s important to get help. Experts believe that the hardest part of getting better is admitting you have a problem. Contact Alcoholics Anonymous or talk to your doctor if you are concerned that you may have an alcohol problem.

Learn more in the Everyday Health Women’s Health Center.

Alcohol
and women

Drinkaware is an independent charity working to reduce alcohol misuse and harm in the UK. We’re here to help people make better choices about drinking.

For women, alcohol can put you at greater risk of breast cancer and negatively affect fertility. It can also increase some side-effects of the menopause. So, whatever age you are, it’s important to keep an eye on your alcohol consumption and drink within the guidelines to keep risks from alcohol at a low level.

The health harms covered below are those specific to women but there are many others that affect people of all genders. You can find out more about these in our Health Effects of Alcohol section.

The low risk guidelines for women

The UK Chief Medical Officers’ (CMO) advice is that both women and men should not regularly drink more than 14 units a week to keep health risks from alcohol low. If you do choose to drink that amount, it’s best to spread your drinking evenly over three or more days. If you wish to cut down the amount you are drinking, a good way to do this is to have several drink-free days per week.

Take our Self Assessment to find out if you’re drinking too much

How does alcohol affect women differently to men?

There are some similarities in how alcohol affects men and women, but there are differences too.

If a woman and a man drink the same amount, the woman’s blood alcohol level will almost always be higher than the man’s. There are several reasons for this:

  • Women tend to be smaller than men. That means, the same amount of alcohol is going into a smaller body.
  • Even if a woman is the same weight as a man, she will have a higher blood alcohol level if she drinks the same amount as that man. Alcohol is held in the body in body water, not in body fat. Women generally have a higher proportion of body fat than men1, so have less body water. That means the alcohol is more concentrated.
  • It’s possible that some alcohol is broken down in the stomach before it reaches the bloodstream. This may happen less in women if they drink a lot of alcohol2.

Alcohol can increase the risk of getting breast cancer

It’s clear from a number of large scale studies that there is a link between alcohol consumption and cancer. A 2014 report by the World Health Organisation concludes that around one in five (21.6%) of all alcohol-related deaths are due to cancer3. Breast cancer is the most common form of cancer among women4 so it’s important to be aware of how drinking alcohol can increase the risk of developing the disease.

The more you drink the higher your risk of developing cancer

Oxford University’s Million Women Study of 1.3 million women estimated that each additional alcoholic drink regularly consumed per day was associated with 11 additional breast cancers per 1000 women, in developed countries, up to age 756.

Drinking alcohol also increases your risk of several other types of cancer, including liver, bowel, mouth, oesophageal cancer (gullet) and laryngeal cancer (voice box).

Learn more alcohol and cancer

Alcohol can affect your fertility

The UK Chief Medical Officers’ guidelines do not have specific advice on the effects of alcohol on fertility. But they do have guidelines for those trying to conceive: It’s recommended that women trying to have a baby, or pregnant women, should not drink alcohol at all to keep health risks to the baby as low as possible.

Alcohol can also disrupt a woman’s menstrual cycle. Studies have shown that even drinking small amounts can reduce the chances of conceiving8,9.

Male fertility can also be affected by alcohol consumption. View our Alcohol and men webpage for more information.

Alcohol and pregnancy

Drinking alcohol at any stage during pregnancy can cause harm to the baby7 and the more you drink, the greater the risk. This is why the UK Chief Medical Officers recommend that the safest approach is to not drink alcohol at all during pregnancy.

If you are now pregnant and drank only small amounts of alcohol before realising you were pregnant, and stopped when you found out, the risk of harm to the baby is low. However, if you are worried, you should talk to your doctor or midwife.

Find out more about alcohol and fertility and pregnancy

Drinking alcohol can affect appearance

Tired eyes. Spots. Weight gain. There’s no doubt alcohol can have an effect on your appearance.

Alcohol interferes with the normal sleep process so you often wake up feeling – and looking – like you haven’t had much rest. Alcohol dehydrates your body too, including the skin. It’s also thought to deprive the skin of certain vital vitamins and nutrients.

With two large glasses of wine containing the same number of calories as a burger, it’s easy to see why regular drinking can make you gain weight. Alcohol also reduces the amount of fat your body burns for energy. Because we can’t store alcohol in the body, our systems want to get rid of it as quickly as possible, and this process takes priority over absorbing nutrients and burning fat10.

Alcohol and ageing

As we get older, we lose muscle and gain fat. We also break down alcohol more slowly. This means we’re more sensitive to its effects. So, even if you drink the same amount of alcohol as you get older it’s likely to affect you more than younger people.

When women reach the menopause their bodies are affected by changing hormones. Alcohol can trigger some symptoms of the menopause, such as hot flushes and night sweats11. Menopause can also disrupt your sleep because of night sweats and cause you to gain weight. Alcohol often makes both of these issues worse.

As we get older, our bones slowly get thinner too, particularly in women after the menopause. Drinking a lot of alcohol can make this worse, increasing your risk of osteoporosis (a condition that affects the bones, causing them to become weak and fragile and more likely to break)12.

Staying in control of your drinking

You can keep your risk low by staying within the CMOs’ recommended low risk guidelines.

Here are three ways you can cut back:

  1. Have several drink-free days a week: If you want to cut down, a great way is to have several drink-free days a week. Test out having a break for yourself and see what positive results you notice.
  2. Find other ways to relax: Some people drink alcohol to relax, but in reality alcohol can make you feel even more stressed out. Try not to make alcohol key to your after work wind down. Consider some alternative stress-busters, like hitting the gym or having a hot bath.
  3. Know what you’re drinking: Check out the ABV of alcohol before you buy it. ABV stands for Alcohol by Volume, which is the percentage of the drink that is pure alcohol. Six glasses of wine at 13% ABV strength contain 15 units, putting you over the weekly low risk guidelines. You can cut down on units by switching to drinks that are lower in alcohol, or try having a spritzer with a small (125ml) measure of wine topped up with soda, instead of a large glass of wine. The Drinkaware app will help you to track the units in your drinks so you can be sure you’re staying within the guidelines.

Check the units in your favourite drinks

Further information

Your GP can help you figure out if you should make any changes in your drinking, and offer help and advice along the way.

If you’re concerned about someone’s drinking, or your own, Drinkline runs a free, confidential helpline. Call 0300 123 1110

The Family Planning Association can help you make informed choices about sex and contraception.

If you have questions about cancer, call the Macmillan Support Line free on 0808 808 0000 (Monday to Friday, 9am-8pm).

Last review: 26 May 2017

Next review due: 26 May 2020

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“An estimated 5.3 million women in the United States drink in a way that threatens their health, safety, and general wellbeing,” according to a report from the Office of Research on Women’s Health and the National Institute of Alcohol Abuse and Alcoholism (NIAAA), both part of the National Institutes of Health (NIH). The report further states, “… drinking more than one drink per day for women can increase the risk for motor vehicle crashes, other injuries, high blood pressure, stroke, violence, suicide, and certain types of cancer.” Another serious issue is binge drinking, or having four or more drinks on one occasion.

Any amount of alcohol can have both short-term and long-term effects on your body. Women are at a greater risk than men for developing alcohol-related issues due to body structure and chemistry. It takes a woman’s body longer to break down alcohol, exposing them to the effects for a longer time period.

What Happens to Your Body

  • Dehydration by decreasing water reabsorption or from vomiting
  • Fatigue, confusion, and/or lightheadedness
  • Changes in brain cells, which can change mood, behavior, and coordination
  • Weakened immune system, increasing the likelihood for illness and disease
  • Damage to the heart, which may lead to arrhythmia, stroke, and/or high blood pressure
  • Liver damage with the potential for cirrhosis and other alcohol-related diseases
  • Pancreas inflammation that prevents proper digestion

Other Health Risks

  • Dangerous medication interaction or loss of medication effectiveness (both prescription and over-the-counter)
  • Riskier behavior, including driving while intoxicated and unplanned/unsafe sex
  • Increased risk of being a victim of sexual assault or other violence
  • Infertility or increased chance of miscarriage
  • When pregnant, serious consequences that can affect the baby for life, including fetal alcohol syndrome, low birth weight, learning disabilities, and behavioral problems
  • Increased risk of cancers, specifically breast, mouth/throat, and liver

If you are concerned about your drinking habits and are not sure where to find help, contact your Capital Women’s Care provider. He or she can recommend available resources.

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