Does Menopause Change the Way You Metabolize Alcohol?

December 23, 2024

Many women over 40 are familiar with the symptoms of perimenopause. During this transitional phase before menopause, hormone fluctuations can trigger a variety of unpleasant effects, such as hot flashes, night sweats, mood changes and sleep disruptions.

When the uncomfortable symptoms of perimenopause strike, you may be inclined to reach for a glass of wine or a cocktail to help you relax. But experts say alcohol can actually make those symptoms worse. University Hospitals OB/GYN provider Jean Marino, CNP, explains more about how the body processes alcohol differently as you enter perimenopause and menopause, and how abstaining or cutting back on alcohol can have a positive impact on your health.

Alcohol Metabolism Changes as You Age

As you get older, you may observe that alcohol affects you differently than it did in your 20s. Many people notice that they feel tipsy after just a drink or two, or they have a stronger hangover the next day. This change can be more pronounced in women who already have a lower alcohol tolerance than men due to factors like body fat ratio, liver size and liver enzyme levels.

As you age, the liver becomes less efficient at metabolizing alcohol and may eliminate it more slowly from our body. The liver is also responsible for breaking down hormones such as estrogen, which naturally begins to fluctuate during perimenopause. Alcohol can impede this process, leading to an increase in hormone-related symptoms of perimenopause.

Hot Flashes and Night Sweats

Moderate to heavy drinking can increase the intensity and frequency of hot flashes and night sweats. Alcohol use in general can cause the body temperature to rise. This can trigger hot flashes as the blood vessels beneath the skin dilate to release heat. While not all women will experience this effect from alcohol, many women notice an increase in hot flashes with alcohol consumption.

Sleep Disruptions

Poor sleep is a common complaint among women during perimenopause and menopause. Alcohol can make it even harder to get a good night’s rest. Though alcohol can make you feel sleepy, the quality of sleep may be sub-optimal. With more night-time wakings or the inability to fall asleep, it can leave you over-tired the next day and more prone to irritability or impaired thinking.

Mood and Mental Health

The hormone shifts of perimenopause can bring about emotional symptoms as well, including mood swings, anxiety and depression. While many may reach for a drink to relax or ease anxiety, alcohol can actually make these symptoms worse. As a depressant, alcohol may cause changes in the brain chemistry that can increase anxiety and take a further emotional toll.

Age-Related Health Conditions

During perimenopause, changes in hormone levels can put women at an increased risk for certain health conditions, such as heart disease, osteoporosis and weight gain. Alcohol use may elevate these risks because it can raise blood pressure and cholesterol and make it more difficult to maintain a healthy weight. Alcohol can also impede calcium absorption, which can lead to weakened bones, and may also increase the risk for diseases such as breast cancer and colorectal cancer.

Reducing Your Alcohol Consumption

Cutting back on alcohol consumption is healthy for a lot of reasons but can be especially helpful if you are experiencing unwanted side effects from an evening of imbibing. Marino says that ideally, abstaining from alcohol completely is the best option. However, moderation is key if you still wish to enjoy an occasional glass of wine.

Some helpful tips for curbing your alcohol use include:

Cut back on the amount you drink. Many health experts recommend no more than one drink per day for women. But be mindful of the amount you’re consuming. One drink usually equates to 5 ounces of wine, 12 ounces of beer or 1.5 ounces of spirits such as vodka or whiskey. Also pay attention to the alcohol by volume (ABV) of the drinks you are consuming. Easy ways to lower the alcohol levels include making a wine spritzer by mixing wine with soda water, choosing a low ABV beer, or simply using less spirits when mixing a cocktail.
Cut back on how often you drink. It may also be helpful to cut back on how often you drink. For instance, instead of a glass of wine every night with dinner, you can limit yourself to only drinking on weekends.
Eat and stay hydrated. Consuming alcohol on a full stomach will slow the effect of alcohol on the body. Likewise, make sure you drink plenty of water to ward off unpleasant effects.
Enjoy a non-alcoholic substitute. There are plenty of non-alcoholic beverages that can be great substitutes on nights you don’t want to drink. Try a low-sugar or low-calorie drink option instead or select one of the many non-alcoholic beer or zero-proof liquor options on the market.