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?
That may seem strict, but Terry D. Schneekloth, M.D., a Mayo Clinic psychiatrist with expertise in alcoholism and addiction, explains that the evidence backs up this limit.
“The epidemiology shows that for either men or women, drinking eight or more standard drinks in a week has a linear association with alcohol-related health problems,” Dr. Schneekloth says.
The official recommendation from the Dietary Guidelines for Americans is for women to drink no more than one drink a day. Never drink four or more drinks in the span of a few hours, as this is considered binge drinking. One drink is 12 fluid ounces of beer, 5 fluid ounces of wine, or a mixed drink with 1.5 fluid ounces liquor with 40% alcohol.
The number of drinks you regularly consume actually matters more than how intoxicated you feel, Dr. Schneekloth says.
“People tend to think, ‘If what I’m drinking doesn’t hit me that hard, it’s probably not a problem,'” Dr. Schneekloth says — but this doesn’t account for increasing tolerance. Over time, regular drinkers will need more and more alcohol before they feel its effects. And some people just naturally have a higher baseline tolerance than others.
Women who drink two glasses of wine each evening may never “feel intoxicated,” Dr. Schneekloth says, but that doesn’t mean it’s not affecting them. They may not experience any negative social consequences from their drinking, he says, “but the health consequences may slowly develop since they’re drinking twice the amount that their body can tolerate over the course of the week.” For men, the maximum recommended amount per week ranges from 7 to 14 drinks, depending upon the study.
And if you’re drinking a certain amount of alcohol every day, your body will come to expect it.
“I’ve been called to see an elderly woman after she had undergone surgery. She experienced symptoms of alcohol withdrawal, even though she was previously drinking just two drinks per day. She never had negative social consequences of her drinking, but her body had developed a physical need for the alcohol use,” Dr. Schneekloth says. “When you’re not getting that two drinks a day, your body’s screaming ‘Where is it?’ and you may experience symptoms as severe as seizures and delirium.”
If you’re wondering whether you should reevaluate your relationship to alcohol, ask yourself:
- How much am I drinking?
- Is my tolerance creeping up?
- How regularly am I drinking?
- Am I breaking my own rules about drinking?
- Am I drinking alone?
- Is my drinking putting others at risk?
- Am I drinking to deal with stress?
You can learn about potential warning signs from the National Institute on Alcohol Abuse and Alcoholism here.
Even if you don’t think your drinking is in a bad place, you may want to try a temporary pause — say, a month without alcohol. This can help put your drinking habits in perspective. Just be sure you don’t “reward” yourself with a binge when you’re done.
Replace the ritual
If you’re looking to scale back, replace your drinking ritual with another enjoyable activity or habit. At the times you normally drink, connect with friends or family. Dive into hobbies like woodworking or gardening. Instead of a glass of wine on the porch, go for an evening bike ride. Or try mixing up a mocktail or sampling the ever-expanding array of nonalcoholic liquors, wines and beers.
And if you’re looking for a better way to manage your stress, it’s hard to beat exercise.
“We’re encouraging people to take that walk, get to the gym. Twenty minutes or more of doing some sort of rigorous activity that gets your heart rate up,” Dr. Schneekloth says. “Both aerobic exercise and weightlifting help to release the endorphins and enkephalins and some of the other internal compounds that relax us and lift our mood.”
Ultimately, a healthy relationship with alcohol is one that recognizes that alcohol can be a pleasant, tasty or relaxing drink — but that it comes with caveats.
“There must be recognition that, ‘This is something pleasant, but it slows me down.'” he says. “And it doesn’t become a substitute for healthier relaxation and coping strategies.”
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.
Camille Kezer, M.D., answers questions about alcohol use in women and liver disease.
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