Women’s Health

Women should drink less than men for several reasons. The stomach enzyme that metabolizes alcohol works less well in women because woman have half as much of the enzyme alcohol dehydrogenase per unit of body mass in their stomach. The result is that more of ingested alcohol goes directly into the bloodstream. Woman have less water in their body per pound than men so the same amount of ingested alcohol leads to a higher concentration in the blood. Woman have more body fat which has a poor blood supply so alcohol is rapidly distributed to the organs of the body. The speed at which women can metabolize alcohol is dependent on the stage of her monthly cycle. When a period is due, she will become inebriated more easily and will have a worse hangover. After menopause, women begin to develop a distribution of alcohol dehydrogenase between the stomach and liver that is similar to men so they can drunk more as a result. They have a small risk of breast cancer, especially with higher alcohol intake. The health benefits of alcohol with moderate drinking disappear at lower doses for women than men.

The North American Menopause Society points out the following general benefits of drinking in moderation based on scientific information to date. Light to moderate female drinkers have a significantly lower risk of coronary heart disease than nondrinkers which becomes apparent when heart disease risk increases at menopause and thereafter. Women who drink moderately have a lower risk of type 2 diabetes. Moderate drinkers, especially wine, have a lower risk of dementia than those who don’t drink at all. Women who drink lightly or moderately have a lower risk of stroke than nondrinkers. At and after menopause, women who drink moderately have stronger bones than nondrinkers. Midlife and older women who drink lightly or moderately have a lower risk of becoming obese than nondrinkers. The downside of drinking at and after menopause is that drinking may trigger hot flashes in some women, and the consumption of one drink a day leads to a small increase in risk for breast cancer with the risk increasing the more alcohol that is drunk.

Alcohol Consumption, Weight Gain, and Risk of Becoming Overweight in Middle-aged and Older Women Archives of Internal Medicin (now JAMA Internal Medicine) March 2012 This study tracked 19,220 American women 30 and older who, at the beginning of the study, fell into the ‘normal weight’ category based on their body mass index. About 60% of women whose drinking habits were studied over nearly 13 years were light or regular drinkers with 40% abstainers. 41% of the women became overweight or obese with the nondrinkers gaining more weight, an average of 9 pounds, compared to about 3 pounds among regular moderate drinkers. The risk of becoming overweight was almost 30% lower for women who consumed one or two alcoholic beverages a day compared with nondrinkers. This study refutes the idea that dieters should lower their intake or cut alcoholic drinks from their diet. It suggests that for many women with weight problems, the extra calories are probably not coming from alcoholic beverages. However, once a women is overweight, her alcohol metabolism is more efficient, and she may gain more weight from alcohol than a lean woman.

Long-Term Alcohol Intake and Risk of Rheumatoid Arthritis in Women: A Population Based Cohort Study BMJ 345 July 10, 2012 A follow-up of 34,000 Swedish women followed for ten years found that moderate drinkers compared with abstainers had a significantly lower risk of developing rheumatoid arthritis. Woman who consumed more than three glasses of alcohol per week had a 37% lower risk of developing rheumatoid arthritis than subjects who were nondrinkers or consumed less than one drink per week. Those who drank one or two glasses per week had up to a 14 percent lower risk compared to nondrinkers. There were no differences among women who preferred wine or beer. This ten year follow-up indicates that longterm consumption is beneficial. The effect is thought to be due to a reduction in the production of chemicals that cause inflammation by alcohol.

Alcohol Consumption and Risk of Stroke in Women Stroke 43 March 2012 This group of subjects came from the Nurses’ Health Study. The study showed that the risk of ischemic (clot-induced) and hemorrhagic stroke is slightly lower among light-to-moderate consumers of alcohol compared to subjects who drank no alcohol. The estimated risk is 17-21% lower for women who averaged up to a little over one drink a day compared to abstainers. For women who drank heavily, the risk of stroke was slightly increased, but not significantly. The results support a “J-shaped” curve for total stroke. The results are consistent with other studies showing overall lower risk for low and moderate drinkers with an increased risk for heavier drinkers, compared to abstainers. The findings suggest that lower levels of alcohol consumption have anti-thrombotic and atherogenic actions leading to decreased platelet aggregation, clot formation and increased fibrinolysis and high-density lipoprotein (HDL). The study’s limitations included self-reported data and there was limited assessment of heavy alcohol consumption.

Recent Alcohol Consumption and Risk of Incident Ovarian Carcinoma: A Pooled Analysis of 5,342 cases and 10,358 controls from the Ovarian Cancer Association Consortium BMC Cancer 13 (1) January 2013 Studies to date on the association between alcohol intake and ovarian carcinoma are inconsistent (large numbers are needed to estimate risk association since there are many different types). This study found no evidence that recent moderate alcohol drinking is associated with increased risk for overall ovarian carcinoma, or that variation in risk is associated strongly with specific histologic types.

Do Lifestyle Choices Explain the Effect of Alcohol on Bone Mineral Density in Women Around Menopause? Am J Clin Nutr 95 (5) May 2012 A study of the association between alcohol intake and bone mineral density in women around menopause in the United Kingdom. The study concluded that moderate alcohol intake appears to be positively associated with increased bone mineral density independently of the type of lifestyle (smoking, exercise, and fruit and vegetable intake) led by women around menopause.

A paper was presented at the Meeting of the American Sociological Association in August 2012. A study of 5,000 Wisconsin residents over a 47-year period looked at alcohol use among different types of unmarried people (never-married, divorced and widowed). Men and women tend to converge in marriage with women’s alcohol use higher due to the influence of their drinking spouses, while men’s declines due to their wives’ lower drinking habits. The net result, as shown in previous studies, is that married people drink less than single people. This study confirmed this relationship in men, but it showed that married women drink more on average than women who were never married, divorced or widowed. Stable marriage curbs men’s drinking yet is associated with a slightly higher level of alcohol use among women. Recently divorced men drank significantly more than men in long-term marriages, while women who were divorced showed a sharp fall in alcohol consumption. The authors of the study suggest that one key to a successful marriage may be for men to follow their light-drinking spouses’ lead on alcohol consumption.