According to research alcohol use appears to be potentially both beneficial and hazardous. On one hand, light to moderate alcohol use (defined as no more than one drink per day for women) is thought to have a number of heart–healthy benefits for some women. On the other hand, overuse of alcohol among women has been associated with serious conditions such as alcoholic heart failure, alcoholic cardiomyopathy, high blood pressure, obesity, arrhythmia, breast cancer and liver–related diseases. In addition, female alcoholics have a death rate that is up to twice as high as male alcoholics, and are more likely than men to die from alcohol-related accidents and suicide.
Women are urged to use moderation when drinking alcohol and to seek help if they feel that their alcohol use has gotten out of control. Women who do not drink should not start simply to obtain the health benefits of alcohol. There are other preventive strategies that are equally or even more effective in reducing the risk of heart disease.
About alcohol and women
Alcohol has a greater effect on women than men. Women become intoxicated or “drunk” after drinking smaller amounts of alcohol than men. This is due to women’s smaller size and body weight, as well as the following:
Body water content. Women have less water in their bodies than men do, partly because they normally have more body fat. Water content plays an important role in the absorption of alcohol into the cells. Because women have a smaller amount of water in their bodies, they develop a higher concentration of alcohol in their bodies’ cells. As a result, alcohol has a greater and long-lasting effect on women.
Metabolism. Alcohol is broken down or metabolized faster and more efficiently in men than in women because they have different levels of enzymes. The breakdown of alcohol is especially slow and inefficient in female alcoholics. This means that alcohol remains in the system for a longer time, giving women longer exposure to its damaging effects.
Hormones. Female hormones affect the metabolic rate. Therefore, depending on the point at which a woman is in her menstrual cycle, a particular amount of alcohol can produce different levels of alcohol in the blood.
Liver. Women appear to be more susceptible to alcohol-related liver diseases such as cirrhosis and hepatitis than men, even after drinking smaller amounts than men.
Cancer. According to the American Cancer Society, multiple cancers may be linked to alcohol consumption. The different types of cancer thought to be linked are: liver, breast, pharyngeal, laryngeal and esophageal. Cancers of the mouth have a six percent higher rate of occurrence verses the liver and breast cancer.
Potential benefits of alcohol for women
Recent studies have suggested that the moderate use of alcohol could have a number of heart-friendly benefits for some women. For example, a number of studies have shown that one drink per day of wine could cut a woman’s risk of dying from heart disease in half, particularly in women over 50 with high blood pressure (hypertension) and a family history of heart disease.
Catheter studies of the coronary arteries as well as autopsy findings have shown regular, moderate alcohol consumption is associated with less fatty blockage in the arteries in comparison with a lack of and/or excess alcohol consumption. Other studies have found that regular moderate drinking also has some effect on raising HDL (“good”) cholesterol levels in the blood. It is important to note that moderate alcohol use for women generally means no more than one drink per day. One drink means 12 ounces of beer, 5 ounces of wine or 1.5 ounces of liquor. It appears that the benefits are not specific for one type of alcohol over another, although some studies have touted the effects of red wine in particular.
At this time, physicians do not recommend that non-drinkers take up drinking solely for its potential heart benefits. There are other preventive strategies that are equally or even more effective in reducing the risk of heart disease.
Potential risks of alcohol for women
Although moderate alcohol use may be helpful for some women’s heart health, excessive alcohol use is very harmful. In women, regular heavy drinking can lead to any of the following:
High blood pressure (hypertension). Regular drinking of more than moderate amounts has been found to greatly increase a woman’s chance of high blood pressure. High blood pressure puts additional strain on the heart and blood vessels, increasing the risk of having either a heart attack or a stroke.
Alcoholic cardiomyopathy. A weakening and damage to the heart muscle that can lead to heart failure.
High triglyceride levels and other fats in the blood. These high levels are serious risk factors for hardening of the arteries (atherosclerosis) and heart disease.
Arrhythmias. Excessive alcohol consumption has been linked to abnormal heart rhythms (arrhythmias).
Breast cancer. The National Institutes of Health believe there is a link to breast cancer and alcohol consumption, more so when a family history of breast cancer exists. Recent studies have shown that even moderate alcohol use may increase a woman's risk of developing breast cancer by up to nine percent.
Bone disease. Osteoporosis has shown to be increased with excessive alcohol consumption. Decreased bone density increases the risk of falls and fractures.
Alzheimer’s disease. Women who consume excessive alcohol have a greater risk than men for developing Alzheimers disease.
Gynecological concerns. The American College of Obstetricians and Gynecologists are concerned that fertility and miscarriages are related to alcohol consumption. Women who drink alcohol while pregnant may also be at risk for babies born with fetal alcohol syndrome.
Alcohol/medication interaction. It is advised that women who like to drink alcohol check with their doctor about possible interactions that could occur with alcohol and prescribed medication.
In addition to the recommendation against heavy alcohol use, there are a number of women who are advised to avoid alcohol altogether:
Because alcohol has a negative effect on fertility and an unborn child, the American Heart Association states that all women who are pregnant, may be pregnant and/or are trying to get pregnant should avoid alcohol altogether.
Alcohol should be avoided while breast-feeding because alcohol can be carried by the milk directly to the nursing infant.
Women who are trying to lose weight are encouraged to avoid alcohol, which does not provide nutritional benefits such as vitamins, and contains a high amount of calories.
Women with a family history of alcoholism are encouraged to avoid alcohol use because they are particularly vulnerable to developing alcoholism themselves. Those with a personal history of alcoholism are also urged to avoid alcohol.
Statistics for alcoholism in women
Some general statistics on women and drinking, according to the Women's Health USA 2006 report, are presented below:
Fifteen percent of females 12 or older are binge drinkers (five or more drinks in succession at least once in the past month)
Thirty-one percent American women 18 to 25 experienced binge drinking.
Twenty-three percent of non-pregnant and three percent of pregnant women ages 15 to 44 experienced binge drinking
Factors that may predispose some women to excessive drinking include:
A family background of heavy drinking
A history of sexual abuse
Low self-esteem
Traumatic life events
Eating disorders
Depression
A lack of multiple roles (e.g., wife, mother, employee)
In many cases, the drinking habits of women are linked to those of their spouses, siblings and close friends. Women’s drinking habits are based in large part on cultural influences, social life, race, economic status, age, mental status and genetic inheritance. Many alcoholics have discovered that giving up alcohol also means making major changes in friendships, working relationships and other aspects of life. People wishing to seek help for the alcoholism of either themselves or a friend are encouraged to take the first step by speaking to a healthcare professional.
Questions for your doctor
Preparing questions in advance can help patients have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions about alcohol use:
