Alcohol and women

Alcohol affects women differently to men in some ways. This is because of the differences in anatomy and physiology between female and male bodies.^1,2

For example, the female body has a different proportion of body fat and body water to the male body, which means the same amount of alcohol typically has a larger effect for women.³ Body size is a factor too – being smaller means alcohol is more concentrated in your body, and women are typically smaller than men.⁴

Alcohol can lead to long-term harm to your baby if consumed in pregnancy.⁵ And alcohol is a proven cause of breast cancer – the most common cancer for women.⁶

Find out more here, and how you can keep your risk of alcohol-related health problems low.

Your gender (whether you identify as a woman, man, or a different gender) can influence your risk from alcohol too.⁷ That’s because people’s perception of themselves, and the way society sees them, can influence their drinking behaviour.

Does alcohol affect women differently?

The UK Chief Medical Officers’ low risk drinking guidelines recommend it’s safest for women, if they choose to drink, to have no more than 14 units a week, spread over three or more days with several drink-free days, and no bingeing.⁸

The guidelines are the same for both women and men, but there are sex differences in the way alcohol affects men and women.⁹

If a woman and a man drink the same amount, the woman’s blood alcohol level will almost always be higher than the man’s. There are several reasons for this:

• Women tend to be smaller than men, meaning ‘drink for drink’ the same amount of alcohol is going into a smaller body and so can have a greater effect¹⁰

• Water makes up around 50-55% of an average woman’s weight.¹¹ After drinking, alcohol is absorbed by the gastrointestinal tract, travels to the liver and is distributed throughout the water in the body. Since women have a lower proportion of water than men,¹² the alcohol that is absorbed is more concentrated

• The female body makes less of an alcohol-processing enzyme called ‘alcohol dehydrogenase’ in the liver compared with males. This allows a greater proportion of alcohol to reach other organs, exposing them to alcohol’s toxic effects^13,14,15

These sex differences mean that ‘drink for drink’ women are more vulnerable to health conditions caused by alcohol than men.¹⁶

For example, women are at risk of developing alcohol-related liver disease at roughly half the level of consumption compared with men. For women that develop alcohol-related liver disease, it’s more likely to progress more quickly – including the development of liver cancer.^17,18

There is also evidence that shows women’s hearts are likely to suffer serious damage at lower levels of alcohol consumption than men.^19,20

Alcohol and breast cancer

Breast cancer is the most commonly diagnosed cancer in the world among women.²¹ Research has found that the more you drink over the years, the higher your risk of developing breast cancer.²² And alcohol doesn’t only contribute to breast cancer – it’s also linked to six other types of cancer in women and men.²³

Drinking alcohol doesn’t automatically mean you will get cancer, and not drinking cannot guarantee you won't. But there is evidence that shows your risk of developing any of the seven known alcohol-related cancers increases the more you drink on a regular basis,²⁴ and these risks start to increase even at low levels of drinking. So, the less you drink, the lower your risk.

Alcohol, pregnancy, and fertility

Drinking alcohol at any stage during pregnancy can cause harm to your baby – and the more you drink, the greater the risk.²⁵

Because drinking during pregnancy can lead to serious long-term health problems for your baby, the UK Chief Medical Officers’ advise that it’s safest not to drink any alcohol if you are trying to conceive or are pregnant.²⁶

If you didn’t know you were pregnant and you drank alcohol during early pregnancy, talk to your GP or midwife about any concerns you have. If you had just one or two drinks, it does not necessarily mean your unborn baby has come to any harm. Most importantly, stop drinking as soon as you do realise you’re pregnant.

Drinking alcohol during pregnancy increases the risk of miscarriage, premature birth, and your baby having a low birthweight. It can also affect your baby after they’re born.^27,28

Continuing to drink alcohol during pregnancy can cause Fetal Alcohol Spectrum Disorder (FASD) – a serious, life-long condition that affects a child’s brain development, behaviour, and growth.²⁹

Sadly, in the UK, between 1.8% and 3.6% of babies born to mothers who drink during their pregnancy are affected by FASD.³⁰

If you’re trying for a baby, evidence suggests that light drinking reduces fertility in women, and fertility is reduced even further for women drinking moderately or heavily.^31,32

If you’re trying to get pregnant the NHS recommends both men and women to stop drinking alcohol, don’t smoke, and maintain a healthy weight.³³

Alcohol impairs inhibition, making unprotected sex far more common when alcohol is involved which can lead to sexually transmitted diseases and unplanned pregnancy.^34,35

Alcohol and the menopause

Alcohol can trigger some symptoms of the menopause, such as hot flushes and night sweats.³⁶ Alcohol can also disturb your sleep³⁷ and contribute to weight gain because of its high calorie content.³⁸ If there are symptoms you experience because of the menopause, such as hot flushes and night sweats, avoiding alcohol can help ease them.³⁹

Changes in your hormones during the menopause can also impact your mental wellbeing.⁴⁰ Alcohol can impact your mental health too – with heavy, regular drinking associated with anxiety and depression.⁴¹ The good news is that reducing or stopping drinking can improve your mood and mental health⁴² – find out more on our mental health pages.

Another change linked to the menopause is weakening of your bones. Drinking alcohol regularly further increases the risk of osteoporosis, causing bones to become fragile and more likely to break.⁴³

Everyone's relationship with alcohol is different, but certain drinking patterns can have risks that aren't always obvious.

Find out more about different types of risky drinking

Support

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 would like to talk to someone about your drinking or someone else's, you can have a free and confidential chat with someone at Drinkline who are trained to help. Call 0300 123 1110

• The Family Planning Association can help you make informed choices about sex and contraception

• If you have questions about cancer, call the Macmillan Support Line free on 0808 808 0000 (open from 8am to 8pm every day)