
Your liver is your friend, but probably one you haven’t paid much attention to. As the largest solid organ in the body, the liver sits in the upper right of your abdomen nestled near the bottom of your rib cage. And it gives so much. Your liver metabolizes everything you take in — what you eat, what you drink and many of your medications.
What’s more, you have way more liver than you will ever need to maintain its function throughout a normal lifespan — unless, of course, something comes in and interferes with that process.
This could be a viral infection or autoimmune condition. It could be medications, including seemingly benign over-the-counter products like acetaminophen (Tylenol, others). But for most people in the U.S. with serious liver disease, the damage came from diet. This might be sugary, processed, fatty foods — but often, it’s alcohol.
Each time your liver is injured, it tries to repair itself. In the process, scar tissue forms. Advanced scarring is known as cirrhosis, and as it progresses, it becomes difficult for your liver to function. Advanced cirrhosis is life-threatening.
In the past, most people with alcohol-associated liver disease — which includes alcohol-related cirrhosis — were men. Women, unfortunately, are catching up. Researchers are trying to figure out the reasons for this and have come up with a few possibilities:
- Women are drinking more.
- Women’s livers can’t handle as much alcohol as men’s livers.
Below, Camille Kezer, M.D., answers questions about alcohol use in women and liver disease.
How much is too much alcohol?
It is recommended that women drink at most one drink per day. Men are recommended to have no more than two drinks per day.
So, what counts as a drink?
One drink is 14 to 15 grams of alcohol, which equals one bottle (8 to 12 fluid ounces depending on alcohol content) of beer, 5 fluid ounces of wine and 1 shot (1.5 fluid ounces) of hard liquor. It is very common for people to have a single drink that contains multiple servings of alcohol depending on factors like the type of alcohol, size of the glass and amount of alcohol poured.
Why are men permitted to have more drinks per day?
Women develop liver disease with less alcohol exposure and suffer worse disease compared to their male counterparts. There are differences in alcohol metabolism and hormones between women and men that account for this discrepancy in the effects of alcohol between the sexes.
Does my weight matter?
Yes. Being overweight or obese is a known risk factor for the development and progression of alcohol-associated liver disease. People who have undergone gastric bypass surgery also are at increased risk for the development of alcohol-associated liver disease.
How do I know if I have a problem?
While multiple studies have demonstrated that men are more likely to consume alcohol and are more likely to binge drink as compared to women, recent studies have shown that this gender gap is narrowing. You should talk to your health care team if you are concerned that you are drinking too much alcohol. There are many tools including medications for cravings, counseling and support groups that can help. Your health care team can guide you through this process, so reach out!
Who should avoid all alcohol?
If you have a history of alcohol use disorder, have certain medical conditions or are on certain medications, are or might be pregnant, you should avoid all alcohol. Ask your doctor if you have questions about whether or not it is safe for you to drink alcohol in moderation.
To learn more or to get support for any alcohol problems, check out:
- Substance Abuse and Mental Health Services Administration
- Rethinking Drinking from the National Institutes of Health
- Alcoholics Anonymous
Related Articles:

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