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Alcohol and Menopause Facts: What You Need to Know

As you age, studies indicate the impact of alcohol on your health and well-being is not black and white. Add in menopause for women, and it’s even more complicated. Research suggests alcohol during and after menopause can lower your risk of certain conditions and increase the risk of others. We’ve reviewed many of the studies and provide information regarding the impact, good and bad, so you can make an educated decision on how much is too much to drink during menopause or if you should drink at all during this stage in life.

Menopause and alcohol

When you begin menopause, it is usually a time of many changes in your life. Daily stressors like work, children leaving home, and health concerns due to aging are just some of the reasons you may grab a glass of wine or have a cocktail.

Then, you have menopause symptoms like hot flashes and sleeplessness which make life even more complicated. Symptoms can be severe enough that they may interfere with your work and personal life.

So, you may notice your consumption of alcohol increases. For the first time in your life, you may find yourself abusing alcohol or drinking heavily. While drinking may relax you, that feeling will be short-lived.

Instead of managing your menopause symptoms, they may increase with alcohol use. That may include hot flashes, sleeplessness, and your ability to lose weight.

There are also long-term effects on your body, too, that silently develop and don’t reveal themselves until years later.

It’s not just how much alcohol you drink during menopause that matters, but how much you drank before too. There’s some evidence that drinking, even in your 30’s, can impact when menopause arrives and the effect it has on your health.

Here’s what the research shows about alcohol and menopause:

  • Breast cancer research is most convincing with an increased risk, even for light drinkers.
  • Drinking can increase menopause symptoms like sleeplessness, hot flashes, and weight gain.
  • Your risk of osteoporosis may be affected by how much you drink in your 20’s and 30’s.
  • Alcohol may offer some benefits to post-menopausal women, e.g., a lowered risk of coronary heart disease (CHD) for light drinkers compared with non-drinkers.

Everyone’s menopause journey is unique, so your risk-factors and menopause symptoms will vary. Pay attention to your body and what it tells you. Think beyond short-term symptoms like hot flashes, and consider the long-term impact as well.

alcohol and breast cancer risk in menopausal women

Breast cancer and drinking

While there are conflicting studies for many of the risks associated with alcohol use during menopause, there’s a definitive link between breast cancer and drinking.

The World Cancer Research Fund believes, “The evidence that alcoholic drinks are a cause of premenopausal and postmenopausal breast cancer is convincing.”

Researchers have done more than 100 studies into this link.

So, what is that risk? The NIH-AARP Diet and Health Study found even one glass of alcohol a day increases a woman’s risk for breast cancer.

The study found a 32 percent increased risk in women who had one or two drinks a day, and a 50 percent increased risk for women who had three or more alcoholic beverages a day.

It’s believed alcohol can increase estrogen and other hormones as well as change cells and affect their growth.

So, drinking even small amounts can increase your risk of breast cancer.

Osteoporosis and alcohol

Osteoporosis is another big health concern for postmenopausal women (greater risk if you are white or Asian), although it’s more of a potentially painful disability than a leading cause of death like cancer. It can lead to death, though, in the case of complications from a situation like a hip fracture, which is often complicated by pneumonia.

In postmenopausal women, light-to-moderate drinking has shown beneficial effects on bone mineral density. In the Nurses’ Health Study, women who drank about 7 drinks a week had more bone density than non-drinkers and those who drank less.

The downside is that alcohol may impair your judgment and physical ability to maintain your balance, no matter your age, increasing the risk of an injury or fall which may be complicated by a fracture.

Other studies, of a more general population, point out that a woman’s risk of osteoporosis may develop based on drinking habits earlier in life, since women reach their peak bone mass around age 35. If you drank heavily during your younger years, there may be irreversible damage to your bone health. 

If you’re a moderate drinker (no more than one drink a day for women), the research is less clear. Some human research indicates moderate drinking increases bone density, but animal studies contradict that.

Of course, other lifestyle factors impact one’s risk for osteoporosis, so an overall healthy lifestyle at an early age is critical to your risks as you age.

Benefits of alcohol use

Interestingly, alcohol lowers a woman’s risk for coronary heart disease (CHD). It’s the leading cause of death in men and women, and a woman’s risk increases after menopause.

In the Nurses’ Health Study, rates of death from CHD were lower for women who had one drink a week, and even for those who had two drinks a day or more. One drink is considered a 5-ounce glass of wine, a 12-ounce beer, or 1.5 ounces of distilled spirits.

The Atherosclerosis Risk in Communities study of middle-aged men and women found a switch from no alcohol to moderate wine drinking (1 drink or less per day for women) in midlife, led to a 38% lower chance of developing cardiovascular disease compared to non-drinkers. The study called that a substantial reduction in four years.

While not specifically focused on menopausal women, the study examined women age 45-64, so at some point during that age range the women likely entered menopause. The study evaluated 7,697 men and women and found no differences between age, race, gender, BMI, or cardiovascular risks.

However, the researchers note that follow-up was limited and the other risks of alcohol should be taken into consideration before you start drinking.

The American Heart Association still cautions people not to start drinking because of the other possible consequences like car accidents, increased risk of hypertension, and certain types of cancer and liver disease. Talk with your doctor and make a decision based on your personal situation.

If you do drink alcohol, the American Heart Association recommends you keep it moderate. That’s 12 ounces of beer, 4 ounces of wine, or 1.5 ounces of 80-proof spirits for women.

Menopause sleeplessness

It’s unlikely you’ll know if you’re increasing or decreasing your risk of cancer, osteoporosis, or coronary heart disease when you drink. You will know, though, if alcohol use affects common side effects of menopause like hot flashes and sleeplessness.

Drinking can cause sleeping problems, no matter your age.

According to the National Sleep Foundation, alcohol can impact your ability to get deep sleep. So, you may fall asleep right away but likely will wake up in the middle of the night or rise in the morning feeling groggy or unfocused. So, imagine the complications if you’re already having trouble sleeping due to menopause symptoms and then adding alcohol to the mix.

Hot flashes and alcohol

Hot flashes are one of the most common side effects of menopause, with up to 80 percent of women experiencing them. Again, there are mixed results on hot flashes and alcohol consumption.

For some women, hot flashes increase. Alcohol can have a warming effect on the body, no matter your age or stage in the life cycle. So, if you’re prone to hot flashes during menopause, you may feel them come on when you drink. Women looking for hot flash treatment are often told to reduce alcohol use or cut it out altogether.

However, alcohol doesn’t always trigger hot flashes or make symptoms worse. Remember, every menopause story is different.

The Midlife Women’s Health Study found moderate drinking is associated with a reduced risk of hot flashes. The study found hot flashes were shorter in duration and took fewer years to peak in severity women for women who had at least 12 drinks in the past year.

Some of this may be due to the unique nature of menopause. While women share common symptoms, they often vary in frequency and intensity.

Weight gain

Weight gain is also a concern when you’re drinking. The extra calories in wine, beer, or hard liquor add up when you’re older, especially if you’re already struggling with your weight due to menopause.

Also, heavy drinking can trigger early menopause in addition to poor nutrition, smoking, and chronic stress. Heavy alcohol use (more than one glass of wine or beer a day) may trigger menopause up to five years earlier.

Healthy menopausal lifestyle

Alcohol use is just one factor that impacts your menopause symptoms and long-term health. Nutrition and physical activity are also important.

While there are risks to drinking, researchers believe that in postmenopausal women, the beneficial effects of moderate alcohol use (better bone mineral density and lower risk of CHD) may outweigh the increased risk of breast cancer.

Of course, everyone’s risks vary, and these same researchers believe more studies are needed to examine the relationship between alcohol and the human body. Furthermore, the benefits should not be an excuse to drink, and post-menopausal women are cautioned to interpret the results carefully “…given the diversity of non-drinking control groups, inaccuracies of self-report, and lack of studies in which subjects are randomly assigned to drinking conditions.”

Pay attention to how your body responds to alcohol. If you’re on medications for other health concerns, check with your doctor because you may have more reactions. Beer, wine, and hard liquor can interact with certain medications. You’ll often find a warning on the packaging if this is the case. It’s not just prescription medications, but also some over-the-counter treatments. Look at this list of medicines that interact with alcohol.

Think about the potential long-term, health impacts too. Depending on your alcohol intake, symptoms may not be apparent immediately but may reveal themselves years down the road.

Menopause is a marathon. Symptoms can last decades, so the earlier you train for this natural part of a woman’s life cycle, the better off you’ll be. Focus on alcohol moderation sooner rather than later.

Think about why you drink. Is stress the main reason? If so, figure out your stress triggers and look for alternative ways to manage it and to relax your body. There are alternative ways to relax and de-stress if your menopause journey throws you curve balls.

If you enjoy a cocktail or a glass of wine, it doesn’t mean you have to eliminate it. Like every other stage of life, moderation, and a focus on an overall healthy lifestyle will optimize the best outcome during menopause and your post-menopausal years.

(Personal Insight MD, LLC, PeopleTweaker, and Insight MD does not provide medical advice, diagnosis, or treatment. If you are feeling extreme anger with thoughts and actions harmful to yourself or others such as physical/verbal abuse or acts of violence, find yourself self-medicating with alcohol, illicit drugs, etc., expressing your anger in such a way that threaten relationships or your job, etc. seek professional help immediately and call 911 if necessary if you find yourself in an out-of-control situation or have the urge to hurt yourself or others.)

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People Tweaker and Insight MD were founded by Z. Colette Edwards, MD, MBA, a physician and life/executive/wellness coach who blends traditional medical and integrative perspectives to help her clients achieve success.

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