Alcohol and women
The lower risk guidelines for women, and the facts about the specific health harms women put themselves at risk of from regularly drinking too much alcohol.
• The guidelines for men and women are different
• Alcohol can increase your risk of getting breast cancer
• Alcohol can affect your fertility and sexual performance
• Drinking alcohol can affect appearance
• Staying in control
Women’s bodies, in general, process alcohol at a slower rate than men’s. When they drink similar amounts, women tend to feel the effects far more, even compared to a man of the same weight.
In terms of health implications for women, alcohol can affect fertility, put you at greater risk of breast cancer and increase some side-effects of the menopause. So, whatever age you are it’s important to keep an eye on your alcohol consumption and drink within the government`s lower risk guidelines.
The guidelines for men and women are different
The government advises that people should not regularly drink more than the lower risk guidelines of 3-4 units of alcohol for men (equivalent to a pint and a half of 4% beer) and 2-3 units of alcohol for women (equivalent to a 13% ABV 175 ml glass of wine). ‘Regularly’ means drinking every day or most days of the week.
Women are advised to drink less because, in general, their bodies can’t process alcohol as well as men’s. There are a few reasons for this:
• The average woman weighs less than the average man. This means she has less tissue to absorb alcohol.
• Women have a higher ratio of fat to water than men and so they’re less able to dilute alcohol within the body. It’s why women will tend to have a higher concentration of alcohol in their blood than men after drinking the same amount.
• Alcohol stays in a women’s system longer before being metabolised (processed) than it does in a man’s. This is because women generally have lower levels of alcohol dehydrogenase (AHD) the chemical that metabolises alcohol in the liver.
Alcohol can increase the risk of getting breast cancer
The more alcohol you drink, the higher your risk of developing cancer.
Drinking alcohol can increase your risk of several types of cancer, including liver, bowel, breast, mouth, oesophageal cancer (food pipe) and laryngeal cancer (voice box).
Breast cancer is the most common cancer among women. Oxford University’s Million Women Study of 1.3 million women across the world found that the relative risk of breast cancer increases by 7.1% for each 10 grams of alcohol (1 unit of alcohol) you typically drink a day (2).
Alcohol can affect your fertility and sexual performance
Couples who are trying for a baby should take a break from alcohol.
The Department of Health recommends that pregnant women, or women trying for a baby, should avoid alcohol altogether. If they do choose to drink, to minimise risk to the baby, the Department of Health advise not to have more than one to two units of alcohol once or twice a week, and not to get drunk.
The National Institute for Health and Clinical Excellence (NICE) additionally advises that the risks of miscarriage in the first three months of pregnancy mean that it is particularly important for women not to drink alcohol at all during that period. Alcohol may damage the unborn baby - you can read more about this here.
Alcohol can also disrupt a woman’s menstrual cycle and studies have shown that even drinking small amounts can reduce her chance of conceiving.
Alcohol affects male fertility too. In men, alcohol reduces testosterone levels and can harm sperm so that it’s less able to move towards an egg. And then there’s the infamous ‘brewer’s droop’ – where alcohol depresses the central nervous system, making it more difficult for a men to get and keep an erection.
Drinking alcohol can affect appearance
Tired eyes. Spots. Weight gain. There’s no doubt alcohol can have an effect on your appearance.
Alcohol interferes with the normal sleep process so you often wake up feeling – and looking – like you haven’t had much rest. Alcohol dehydrates your body too, including the skin. It’s also thought to deprive the skin of certain vital vitamins and nutrients.
With two large glasses of wine containing the same number of calories as a hamburger, it’s easy to see why regular drinking can make you gain weight. Alcohol reduces the amount of fat your body burns for energy. Because we can’t store alcohol in the body, our systems want to get rid of it as quickly as possible, and this process takes priority over absorbing nutrients and burning fat (1).
Alcohol tends to affect older women more than younger women
As we get older, we lose muscle and gain fat. We also break down alcohol more slowly, which means we’re more sensitive to its effects. So, even if you drink the same amount of alcohol as you get older it is likely to affect you more than younger people. Middle aged to older people tend to drink less alcohol than younger people, but even so, one in 15 older women (and one in six older men) are drinking enough to harm themselves (3).
When women reach the menopause their bodies are affected by changing hormones. Alcohol can trigger some symptoms of the menopause, such as hot flushes and night sweats (4). Menopause can also disrupt your sleep because of night sweats and cause you to gain weight. Alcohol often makes both of these issues worse (5).
As we get older, our bones slowly get thinner too, particularly in women after the menopause – drinking a lot of alcohol can make this worse, increasing your risk of osteoporosis (a condition that affects the bones, causing them to become weak and fragile and more likely to break) (6).
• About one in six women may develop a health problem caused by alcohol (7).
• Nearly a quarter (24%) of women surveyed on behalf of the NHS in 2012 had drunk more than twice the lower risk guidelines in the week before they were interviewed (8).
• In 2013 34% of UK women were “high risk” drinkers (drinking more than 35 units a week) and 135 were ‘increasing risk’ drinkers (more than 14 but less than 35 units a week) (9).
Staying in control
Drinking within the lower risk guidelines will help you keep your drinking under control.
Here are three ways you can cut back:
1. Give alcohol-free days a go. If you drink regularly, your body starts to build up a tolerance to alcohol. This is one of the main reasons why many medical experts recommend taking regular days off from drinking to ensure you don't become addicted to alcohol. Test out having a break for yourself and see what positive results you notice.
2. Stress less. Some people drink alcohol to relax, but in reality alcohol can make you feel even more stressed out. Try not to make alcohol key to your after work wind down, and consider some alternative stress-busters like hitting the gym or having a hot bath.
3. Know what you’re drinking. Check out the ABV of alcohol before you buy it. ABV stands for Alcohol by Volume, which is the percentage of the drink that is pure alcohol. It’s not uncommon for a bottle of wine, for example, to be verging on 14% ABV, which could easily push you over the daily unit guidelines if you drink more than one glass. You can cut down on units by switching to low alcohol drinks which have an ABV of 1.2% or less – or replace an alcoholic drink with water or a soft drink.
Your GP can help you figure out if you should make any changes in your drinking, and offer help and advice along the way.
If you’re concerned about someone’s drinking, or your own, Drinkline runs a free, confidential helpline. Call 0300 123 1110
The Family Planning Association can help you make informed choices about sex and contraception. Visit their website at www.fpa.org.uk
If you have questions about cancer, call the Macmillan Support Line free on 0808 808 0000 (Monday to Friday, 9am-8pm).
(1) Annual Reviews website, Alcohol: Its Metabolism and Interaction With Nutrients. Available at:http://www.annualreviews.org/doi/pdf/10.1146/annurev.nutr.20.1.395
(2) The Million Women Study website, Study progress. Available at:http://www.millionwomenstudy.org/study_progress/
(3) Royal College of Psychiatrists website, Alcohol and older people. Available at:http://www.rcpsych.ac.uk/mentalhealthinfoforall/problems/alcoholanddrugs/alcoholandolderpeople.aspx
(4) (5) Royal College of Nursing website, Menopause: lifestyle and therapeutic approaches. RCN guidance for nurses, midwives and health visitors (PDF). Available at:http://www.rcn.org.uk/__data/assets/pdf_file/0007/349720/003839.pdf
(6) NHS Choices website, Osteoporosis: an introduction. The Information Standard member organisation. Page last reviewed: 08/05/2012. Available at:http://www.nhs.uk/Conditions/Osteoporosis/Pages/Introduction.aspx
(7) Royal College of Psychiatrists website, Alcohol and Depression. Available at:http://www.rcpsych.ac.uk/mentalhealthinfo/problems/alcoholanddrugs/alcoholdepression.aspx
(8) (9) Health & Social Care Information Centre, Statistics on Alcohol – England, 2014. Available at:http://www.hscic.gov.uk/catalogue/PUB14184
Page updated: May 2015
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