Women and Alcohol - Liver Foundation
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Women and Alcohol

Why do women respond differently to alcohol and what are the consequences?

– Meghan Betts



We all know that drinking too much alcohol can be damaging to our health, but evidence shows that women not only respond differently to alcohol compared to men but they are also more vulnerable to alcohol-related diseases.

According to a global study from the National Drug and Alcohol Research Centre, NSW Australia, women have now caught up with men in terms of the amount of alcohol they drink. The study, published in the journal BNJ Open, looked at the drinking habits of four million people over the last 100+ years and reveals that not only are women drinking much more but as a result are doing increasing amounts of damage to their health.

The researchers conclude that increased public health efforts need to be focused on young women.

“Alcohol use and alcohol-use disorders have historically been viewed as a male phenomenon. The present study calls this assumption into question and suggests that young women, in particular, should be the target of concerted efforts to reduce the impact of substance use and related harms,” they say.

Although women are drinking the same amount as men, we respond differently and are more vulnerable to the effects of alcohol than men.

Women’s bodies process alcohol slower than men’s do – in fact, just one drink for a woman can have twice the effect as it would do for a man.

Generally, women weigh less than men, and their bodies are made up of more body fat and less water. Whereas water dilutes alcohol, fat actually retains it, meaning that alcohol remains at a higher concentration and for longer in a women’s body than it does in a man’s.

Women also have lower levels of the enzymes which metabolise (break down) alcohol – alcohol dehydrogenase and aldehyde dehydrogenase. This means that women absorb more alcohol into their blood stream than men do.

Women are also more likely to be restricting their food intake than men. When food is present in the stomach, a valve closes and prevents the food (and alcohol) from entering the small intestine. Alcohol is less easily absorbed in the stomach. Drinking alcohol on an empty stomach, however, allows it to immediately pass through into the intestines where it is readily absorbed due to the large surface area.

There is also some debate as to whether differing hormone levels during the menstrual cycle, or the use of the oral contraceptive pill, may affect a women’s response to alcohol consumption. However, at present the evidence is inconclusive.

As well as responding differently to alcohol consumption, women are also more vulnerable to alcohol-related diseases than men. In particular, women are more likely to contract alcoholic liver disease including hepatitis (inflammation of liver) and are more likely to die from liver cirrhosis (a chronic disease which progressively destroys the livers ability to help with digestion and detoxification).

Women are also more at risk of suffering from alcohol-induced brain damage including loss of mental function and reduced brain size.

Studies also suggest that excessive alcohol consumption increases the risk of breast cancer. The overall lifetime risk of breast cancer in female nondrinkers is 9/100 (9%). For women who drink two standard alcoholic drinks a day, this increases to just over 10/100 (10%). For women who six alcoholic drinks a day this increases to approximately 13/100 (13%).

As well as breast cancer female drinkers have an increased risk of osteoporosis, falls and hip fractures, premature menopause, infertility and miscarriages, high blood pressure and heart disease compared to non-drinking women.

Evidence also shows that women are more likely than men to abuse alcohol for self-medicating conditions such as depression, anxiety, stress and emotional difficulties. Women can also become more easily addicted to alcohol than men, particularly later in life, and although they are more likely to seek help sooner, more barriers exist in preventing them get the treatment they require.

There are many factors that can affect your individual risk of damaging your health from drinking alcohol, as detailed in a special report published by Harvard Health Publications. As a woman, it is important to be aware of the increased risks associated with alcohol consumption by our gender and ideally adapt our behaviour to reduce the incidences and consequences of alcohol abuse.