• Crystal Rose-Wainstock

Cheers! What you need to know about alcohol and menopause

Unwinding at the pub after a long day of work. Celebrating the marriage of a family member with a toast of champagne. Chatting over a glass of wine with some old friends. These are all situations in which alcohol consumption is integrated into our lives.


The risks and benefits of drinking alcohol are fairly widely recognized. Acute risks like driving under the influence are broadcasted on the nightly news. And risks related to more chronic, long-term exposure to alcohol include more serious things like liver damage.

Three women stand around a table drinking wine, smiling.
Alcohol is an important part of many cultural practices around the world. But how does it impact menopause?

There is also some research that supports moderate alcohol use can support bone and heart health, although these findings are more recently being reexamined.


But what is the relationship between alcohol consumption and menopause? How does alcohol impact menopause symptoms? Can alcohol make menopause symptoms worse?


Let’s explore some of the ways alcohol can impact your menopause experience. And then we’ll take a peek at some strategies you can use to change your relationship with alcohol if you so wish.


Alcohol consumption guidelines

First, let’s take a look at alcohol consumption guidelines. How much wine should you really be drinking per week?


The guidelines for alcohol consumption vary from place to place and over time, so determining exactly how much is too much can be difficult. However, more and more health departments and agencies are recognizing the long-term and acute risks of drinking alcohol, and they often suggest abstaining from alcohol altogether.


However, if you do choose to drink alcohol, many health agencies recommend using moderation. But what does that mean?


According to the Centers for Disease Control (CDC), adults are recommended to limit alcohol consumption to one drink per day for women and two drinks per day for men. They define one drink as:

  • 12 oz. 5% beer

  • 8 oz. 8% malt liquor

  • 5 oz. 12% wine

  • 1.5 oz. 40% distilled spirits

As with anything you ingest, the way it interacts with your body systems can vary depending on a number of factors. For instance, having an occasional glass of beer is a different type of exposure than if you have a glass of beer every day at dinner. Or if you binge drink every weekend.


And how alcohol impacts your body might be different than how it impacts someone else. When considering the risks of drinking alcohol generally, the more you consume, the more likely you are to experience negative side effects. And if you drink less often or in lower quantities, you are probably less likely to see the negative effects, whether acute or chronic.

A glass with clear liquid, ice, and a lime slice sits on a table.
The way alcohol impacts menopause symptoms may vary from person to person.

Alcohol and menopause

So when it comes to alcohol and menopause, there are many different points of intersection. Alcohol consumption can impact different menopause symptoms and body functions.


Unfortunately for those who enjoy a drink from time to time, most of the potential effects are rather negative. That being said, each person experiences menopause differently. And each person may experience the side effects of alcohol use differently.


Let’s take a closer look at some of the ways alcohol can influence specific aspects of your menopause experience.


Hormonal imbalances

You may not associate drinking alcohol with hormones, but alcohol consumption has been shown to sometimes lead to an increase in oestrogen levels in the body. The jury is still out on this, but some research suggests that alcohol is oestrogenic. This means that oestrogen levels can increase after consuming alcohol, or drinking alcohol can have similar effects as an increase in oestrogen.


In younger people, this can mean disruptions of menstrual cycles. And in those going through perimenopause or menopause, it can mean an even larger hormonal imbalance than usual.


Hormones are the key to the menopause experience, most notably the balance between progesterone and oestrogen, and drinking alcohol may cause an imbalance. This imbalance can lead to an increased risk of oestrogen-related cancers (some breast cancer), disturbances in mood, and an increase in vasomotor symptoms.


As with much research related to reproductive health and menopause, there are still a lot of questions about how exactly all of this is connected and which relationships are causal. But generally, to avoid hormone imbalances, it can be useful to avoid drinking too much alcohol.


Vasomotor symptoms

Hot flushes and night sweats are two of the most recognized symptoms of menopause. These types of vasomotor symptoms are caused by changes in hormone levels, specifically oestrogen. Fluctuations in hormones mean that your brain doesn’t work quite the way it used to. Namely, the hypothalamus, the part of the brain responsible for temperature regulation, may give your body signals to make you sweat to cool off, causing hot flushes and night sweats.


Research exploring the connection between drinking alcohol and vasomotor symptoms suggests that regular alcohol consumption is pretty strongly correlated with an increased risk of hot flushes and night sweats. In short, if you drink alcohol regularly, you may experience more vasomotor symptoms during menopause. And your symptoms may be more noticeable.


Gut health

Gut health is really important during menopause. And this is another area that may be impacted directly by alcohol consumption.


With a diverse gut microbiome, the digestive system is able to function properly. Recent studies have looked at the relationship between gut health and other systems in the body, specifically brain function.

A bowl of grains and fruit sit on a counter
Gut health is connected to brain health through the Gut-Brain-Axis. Alcohol can disrupt this system.

Gut-brain axis

The gut-brain axis (GBA) is a system in the body in which the brain and the gut communicate. Gut health has been shown to impact mental health and overall brain function.


And communication between these systems is bidirectional. A healthy gut supports a healthy brain. And a healthy brain supports a healthy gut.


So, how does alcohol impact the gut-brain axis? Drinking alcohol can disrupt your gut microbiome. Instead of promoting diversity in the gut microbiome, alcohol can wipe out some of the helpful microbes in your digestive tract.


This disruption can lead to a number of symptoms and conditions, such as:

  • Obesity

  • Metabolic syndrome

  • Endometriosis

  • Polycystic ovary syndrome

  • Cardiovascular disease

  • Decreased cognitive function

If a healthy gut promotes brain health, a compromised gut due to alcohol consumption may also lead to disruptions in brain function.


Brain health

It should be clear by now that the impacts of drinking alcohol aren’t limited to one system of the body. And we’ve already touched on how hormonal imbalances can lead to symptoms in various areas of the body. One more area that is impacted by drinking alcohol is the brain.


In addition to the possible effects associated with hormone imbalances, brain health more generally is impacted by alcohol in a couple of other ways.


The hippocampus and alcohol

First, when looking at chronic side effects, studies have shown that even moderate drinkers were more likely to have damage to the hippocampus than those who didn’t drink. In fact, the moderate drinkers in the study were three times more likely to show atrophy of the hippocampus.


This means that functions related to memory processing and learning can be impacted when alcohol is consumed. This isn’t even considering more acute brain functionality issues that occur when you consume alcohol. Think: delayed reaction time and impaired judgment.


Cognitive function

The study also found that those who drank more alcohol showed decreases in the integrity of the brain tissue and some cognitive functions, like the ability to recall appropriate words and categories as measured in lexical fluency clinical tests. With people experiencing alcohol dependency, there was also an increased risk of dementia and other cognitive disorders over time.


Those in menopause may experience changes in brain function due to fluctuations in hormones even without alcohol in the picture. One of the main jobs of oestrogen as it relates to the brain is to help create energy. Long story short, oestrogen helps your brain metabolise glucose into energy. Which helps you think and process and do all the things you need your brain to do.


Menopause and the brain

This means that when oestrogen levels fluctuate and decrease during menopause, your brain doesn’t have the same amount of energy. This shows up as the following neurological symptoms during menopause:

  • Insomnia

  • Hot flushes

  • Night sweats

  • Anxiety

  • Depression

  • Brain fog

The addition of alcohol during this time can exacerbate these symptoms and cause long-term damage to your brain with prolonged exposure.


Bone health

Those in the menopause phase of life have an increased risk of osteoporosis. And it turns out that an increased risk of osteoporosis is also associated with alcohol consumption.


While there may be some tenuous evidence that moderate drinking can sometimes protect bone health, the research clearly indicates that regular, heavier alcohol consumption (exactly how heavy is unclear), especially during young adulthood, is linked to decreased bone quality. The research also suggests that the effects of alcohol use on bone health cannot be reversed by stopping drinking. Once the damage is done, it’s done.


The good news, however, is that it’s never too late to make lifestyle changes to avoid further damage to your bone health. With some changes in physical activity and diet, you may be able to prevent additional deterioration of your bones.


Mental health

Direct impacts of alcohol on mental health

Alcohol is a depressant. This means that when you drink alcohol, the communication from your brain to the rest of your body through the neurons and transmitters is slowed. This can cause changes in coordination and concentration. In small amounts, it can also lead to feelings of inhibition and even relaxation.


In larger quantities and over time, the use of alcohol, though, can cause damage to the transmitters and the way the brain communicates with the body. This can lead to increased tolerance and even dependence. Basically, your body needs more of the depressant substance, alcohol in this case, to achieve the same results.


And acute anxiety can be the result of alcohol disrupting the balance of serotonin and other neurotransmitters in the brain. Greater amounts of alcohol are associated with an increased risk of depressive symptoms while drinking and anxiety symptoms are associated with withdrawal.


The good news is that while drinking alcohol at any stage of life can lead to increased risks of anxiety and depression, and those in menopause already run a greater risk for these symptoms, there isn’t clear evidence that drinking alcohol during menopause exacerbates these symptoms.

A woman is smiling and looking back behind her.
Your mental health can be impacted by both alcohol and the menopause experience.

Indirect impacts of alcohol on mental health

That being said, alcohol can indirectly impact mental health in a number of ways. Potential challenges created by alcohol dependence or even more moderate consumption can wreak havoc on mental health and general well-being.


Both menopause and alcohol use can lead to the following challenges that may impact your mental health:

  • Sleep disturbances

  • Difficulties adjusting to changes in life

  • Miscommunication with loved ones

  • Strained personal relationships

Alcohol use can lead to increased anxiety and depression directly by changing levels of serotonin and other neurotransmitters in the brain. It can also make life changes and challenges more difficult.


Onset of menopause

Finally, the onset of menopause, meaning when menopause begins, has been linked to alcohol consumption in a number of studies. The research shows that menopause begins on average 2.2 years later for those who drink 5-7 days per week than those who did not drink alcohol. The data also suggests that even those who drink more moderately may begin menopause a bit later than those who do not drink.


Some research suggests that this later onset is caused by increased levels of oestrogen due to alcohol consumption since alcohol appears to be oestrogenic, while others claim that additional factors may be at play (other lifestyle factors, genetics, etc).


More research is needed in this area to really understand the possible link between alcohol and oestrogen, but if alcohol use does in fact increase exposure to oestrogen, there may be some positive impacts. For instance, increased exposure to oestrogen is associated with brain and bone health as mentioned previously.


For the moment, the research is a bit unclear about the possible benefits in this area, so each individual should weigh the possible pros and cons of alcohol use in relation to their health and general well-being.


Drinking moderately

Alright, so ingesting alcohol might have an impact on a variety of aspects of your menopause experience and overall well-being. What can you do with this information?


If you’re concerned about how much or how frequently you are drinking alcohol, it’s important to seek support from qualified professionals. It may be useful to speak to your doctor to get more information about local resources for cutting back or stopping drinking alcohol.


If you’re not really concerned about how much or how often you’re drinking alcohol, but you think maybe it could be useful to exercise a bit more moderation, the following tips might be for you.


First, it’s important to realise that establishing a healthy relationship with alcohol looks different for everyone. Whether you are concerned about your health during the menopause phase of life, or you’re looking to save some money otherwise spent on drinks over the weekend, whatever the reason for changing your relationship with alcohol, your decision is valid.


Now for some tips for integrating moderation into your relationship with alcohol.


Observe and reflect

By observing and noting when you consume alcohol, you can get a clear picture of your starting point. Observing your feelings and the context in which you find yourself when drinking alcohol can also be insightful. For example, maybe you notice that you always want a glass of wine after visiting your sister. Or when you’re under pressure at work.


Just noticing and reflecting on your feelings when you typically drink can help you observe any patterns and make informed decisions about any changes you want to implement.

Tracking feature from Olivia menopause app.
You can track habits, symptoms, and medication in the Olivia menopause app.

Track how much and how many

In addition to tracking your feelings, tracking your alcohol use is a great way to really get a sense of your relationship with drinking. And it can be a useful tool for reducing how much or how often you drink.


In the Olivia app, for example, you can track your alcohol use and even take notes about how you’re feeling, when you find yourself thinking about drinking, and what strategies work best for you to reduce how much you’re drinking.


There are also tons of other great online trackers and apps that might be useful for this purpose. If you’re a bit more old-school, you might pick up a new journal or diary to keep track of your alcohol use, too. Whatever works for you, go for it!


Make a plan

Another important step in moderating your alcohol consumption includes making a plan and setting goals for yourself. What do you hope to achieve through moderating your drinking?


Set specific goals that are achievable and realistic. For instance, you might want to limit drinking during the week or to a certain number of times per month.


Once you have a couple of specific goals in mind, write them down. Keep them close. And make a plan for how you can achieve them. It can be tricky turning down a night out with friends if it doesn’t align with your new goals. How are you going to stay alcohol-free during this outing? What can you tell your friends?


By making a specific plan for these instances, you’ll be prepared to address them as they come up. Remember that your choice to change your relationship with alcohol is valid, and you don’t owe anyone an explanation.


And, you can still enjoy a night out with friends even if you’re not drinking. The pressure to drink can be difficult to navigate, though, if you don’t have a plan.


Practise

Ok, so you have some goals, and a plan. You’re tracking your feelings and how much you’re drinking, and you’re building a new relationship with alcohol. Even after all of this, it can sometimes still be challenging to stick to your plan.


One way you can make it a bit easier is to practise. Practise saying what you plan to say to your friends and family if they offer you a drink. Practise responding to coworkers if they invite you to happy hour. By being prepared, you can take some of the pressure off of yourself in the moment.


And again, you can still be social and enjoy events with other people while reducing your alcohol use. You don’t need to stay home alone just because you’re not having wine this month.


Find support

Luckily for anyone interested in changing their relationship with alcohol, there are tons of great resources and communities available. You might think of traditional programs like Alcoholics Anonymous (AA) when you think of finding support, but there are many other options to suit all kinds of people wherever they may be on their journey.


Exploring resources and finding communities that fit with who you are can be important for a positive experience. You might try searching for communities of sober-curious people online or for people looking to partake in specific hobbies without alcohol in your local area (boozeless book clubs, alcohol-free camping, sober food tastings).


The following resources might be useful as you explore your relationship with alcohol:

Olivia isn’t affiliated with these resources, but you may find them valuable. As always, if you’re concerned about specific symptoms you may be experiencing or if you have specific medical questions you want answers to, you should consult your doctor. There’s a lot of great information out there, but your doctor can help answer specific questions about your personal experience.

Three women stand proudly overlooking a colorful bay.
Knowledge is power! You have what it takes to keep yourself healthy and strong during menopause.

Going forward

Whew! So, we’ve explored a few different ways alcohol can impact your health and overall well-being during menopause. It can influence many different systems in the body and aspects of your life. And, unfortunately, most of the impacts are rather negative.


We’ve also looked at some specific tips and tricks you can use to change your relationship with alcohol. The thing to keep in mind about all of this is that you’re not alone! Even if you may feel alone at times.


A silver lining in all of this is that it’s never too late to make adjustments to your lifestyle. No matter what your relationship with alcohol has been in the past, you don’t have to maintain those same patterns. You have the power to support your health and well-being during menopause and beyond.


Disclaimer: This website does not provide medical advice. The information, including but not limited to text, graphics, images, and other material contained on this site are for informational purposes only. No material on this website is intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen. And never disregard professional medical advice or delay in seeking it because of something you have read on this website.


References:

  1. “Alcohol.” https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm Accessed 13 September 2022.

  2. “Alcohol consumption and brain health.” https://doi.org/10.1136/bmj.j2645 Accessed 13 September 2022.

  3. “Alcohol, anxiety, and depressive disorders.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6876499/ Accessed 13 September 2022.

  4. “Alcohol and Other Factors Affecting Osteoporosis Risk in Women.” https://pubs.niaaa.nih.gov/publications/arh26-4/292-298.htm Accessed 13 September 2022.

  5. “Alcohol, Hormones, and Postmenopausal Women.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761897/ Accessed 13 September 2022.

  6. “Alcohol use and menopause.” https://doi.org/10.1097/GME.0000000000000631 Accessed 13 September 2022.

  7. “Can alcohol promote aromatization of androgens to estrogens? A review.” https://doi.org/10.1016/S0741-8329(00)00124-5 Accessed 13 September 2022.

  8. “Determinants of hot flashes and night sweats.” https://doi.org/10.1080/03014460500421338 Accessed 13 September 2022.

  9. “Estrogen-gut microbiome axis: Physiological and clinical implications.” https://doi.org/10.1016/j.maturitas.2017.06.025 Accessed 13 September 2022.

  10. “The effects of moderate alcohol consumption on female hormone levels and reproductive function.” https://doi.org/10.1093/alcalc/35.5.417 Accessed 13 September 2022.

  11. “Menopause, ageing, and alcohol use disorders in women.” https://doi.org/10.1016/j.maturitas.2018.03.006 Accessed 13 September 2022.


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