It may not seem fair, but drinking just isn’t the same for women. Though men are more likely to have a drinking problem, there are unique physical and emotional factors that can lead women to have an unhealthy relationship with alcohol.
Terry D. Schneekloth, M.D., a Mayo Clinic psychiatrist with expertise in alcoholism and addiction, helps break down some of the differences.
Physical differences in drinking
Drinking tends to affect women’s bodies differently than men’s bodies. This is still being researched, but possible reasons for the difference include:
- Women tend to weigh less.
- Women have lower body water content. When you drink, the alcohol is absorbed and dispersed into your body water.
- Women metabolize alcohol differently.
- It’s thought that women’s gastric emptying — transit time out of the stomach — takes longer than in a man. The alcohol will sit there for longer and have more time to be absorbed.
- Women’s livers can’t handle alcohol in the same way men’s livers can.
All of these factors point to women absorbing more alcohol, and therefore having a higher blood alcohol content than men with a comparable dose of alcohol.
“When you’ve got that higher blood alcohol level, it’s going to impact all of the organs more significantly,” Dr. Schneekloth says. “And this is likely why we’re seeing women developing alcohol-related problems if they’re drinking roughly the same dose as a man, because they’re absorbing more and it’s hitting their organs harder. We see it with cardiomyopathy, or enlargement of the heart, and we see it with liver disease.”
According to the National Institute of Alcohol Abuse and Alcoholism, mounting evidence suggests that women are at higher risk for some of alcohol’s negative effects, such as liver disease, cardiovascular disease and neurotoxicity. There’s also a link between drinking and an increased risk of breast cancer.
Emotional differences in drinking
Unfortunately, women are prone to several conditions that may tempt them to overindulge in alcohol. For starters, women are more likely to be depressed and anxious than men — and are also more commonly victims of sexual violence — and drinking can be one way that women cope with these experiences.
In fact, among people with alcohol problems, studies have found that women are more likely than men to also have depression or anxiety. Research has also shown that in women, depression tended to come first and was followed by alcohol use disorder. It was the opposite in men: Depression tended to show up after alcohol use disorder.
Dr. Schneekloth points to a study done on men that found that about 42% were depressed when they started alcohol treatment. After four weeks, their depression rate dropped down to 6% — without the use of any antidepressants. For most of these men, alcohol appeared to be the primary cause of their depression.
“Depression is more common in women,” he says. “And there’s a substantial group of women with anxiety and depression that start drinking to manage it.”
Hope for change
If you’re unhappy with your alcohol use, it’s never too late to consider cutting back or quitting. A large study of women who quit drinking demonstrated an improvement in their mental well-being. Talk to a trusted friend, relative or your health care team if you need help.
How much is too much alcohol? Go by the numbers, not by feel
If you’re a woman wondering whether you’re drinking too much, here’s a simple check: Are you drinking over seven drinks in a week?
Booze and the female liver
Camille Kezer, M.D., answers questions about alcohol use in women and liver disease.
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