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Alcohol in Menopause

Much has been written about the alcohol and health…some say a little resveratrol in red wine is a good thing, while other research clearly shows that too much alcohol has a major impact on the health of our organs and body systems.

We need our organs working well, not just the liver which processes alcohol, but the gut, the brain, the adrenal glands, the spleen – in fact the whole immune system. All of these organs and systems are impacted by alcohol. Alcohol is processed by an enzyme called alcohol dehydrogenase (ADH) in the stomach and liver. Women have less ADH in the stomach than men which means women absorb more alcohol into the blood stream – increasing intoxication.

Recent studies indicate that North Americans consume 50% more alcohol than the global average and it’s likely that between 7% and 10% of North Americans suffer from current alcohol use disorders (AUDs). A component of AUD’s is Craving. Craving incorporates the drive for “reward” and “I deserve” thinking, the need to reduce some felt stress, and a compulsion to reach for the chosen bottle to get that reward. How many overworked, overtired, over-stressed women get home from work at the end of the day, depleted of food, stretched so thin that they reach for a glass of wine or a beer, just to feel better for just a little while as they work out what to feed everyone.

Alcohol & Hormones

What about hormones? Does alcohol impact hormone levels? Hormones are chemicals traveling through your body that control the function of ALL tissues and organs. Research has shown that alcohol consumption can increase estrogen levels and also testosterone levels. If testosterone levels rise out of range consistently, this increase in testosterone can be an indicator of Metabolic Syndrome, the precursor to Diabetes. High testosterone can also impact fertility rates in younger women. High testosterone (and DHEA) is also associated with Non Alcoholic Fatty Acid Liver Disease. The liver has lots of estrogen receptors and estrogen is known to have a protective effect on the liver, reducing the buildup of fatty acids in the liver and reducing the effects of oxidative stress. However, the liver will prioritize metabolizing alcohol over estrogen and the increase in estrogen levels with alcohol consumption could be because estrogen takes a back seat while the alcohol clears the body. Elevated levels of estradiol are associated with increased alcohol drinking by women, likely because estradiol increases dopamine levels, which plays an important role in binge drinking. Low estrogen after menopause reduces liver function and can lead to cell and tissue aging, as well as impaired response to injury.

Adrenal Function & Hot Flashes - How Alcohol Plays A Role

The adrenal glands make hormones (including cortisol and DHEA) which help to regulate metabolism, blood pressure, and the immune system. Sometimes, regular alcohol use can ramp up adrenaline and later cortisol – which can increase anxiety, appetite, and cravings. Overtime, alcohol will suppress adrenal gland function, and with regular use may cause adrenal fatigue. Adrenal fatigue isn’t just about being too tired to get off the sofa, it decreases the ability to fight off disease, dampens sexual response, increases food cravings and weight gain, and can increase blood pressure. Alcohol is a vasodilator and will widen blood vessels…think pink cheeks after a glass or two of wine! Women already experiencing hot flashes from vasodilation can expect to have even more hot flashes if they drink alcohol. However, here’s another quirk – as the alcohol level goes up, the effect is reversed. Blood vessels constrict which can cause headaches and migraines.

Alcohol & Sleep

And how about sleep? Some women will start to drink a little more during and after menopause in the hope that it will help with sleep but now their hormones are so variable that alcohol actually disrupts sleep. Just a few glasses of alcohol can be relaxing…alcohol does increase GABA after all. However, alcohol also increases glutamate – the excitatory neurotransmitter. And here’s the kicker, GABA wears off much faster than glutamate, so the brain stays more alert, you don’t get as sleepy and then certainly don’t reach the deep sleep phase needed for restful healing. Alcohol also lowers the hormone melatonin so it can be harder to actually settle and get to sleep. Plus, as a diuretic, alcohol can often mean nighttime waking to pee.

The Link Between Alcohol, Weight, & Blood Sugar

Midlife weight gain, hormones, and alcohol – yes, there’s a relationship. The decrease in estrogen, progesterone, DHEA, and testosterone at menopause and beyond will trigger metabolic changes in the body. Women often burn 200 or more calories a day less than they used to. It doesn’t take a math whiz to know that 2-3 extra glasses of wine/beer or a couple of cocktails equals more than 200 calories. In addition, alcohol will reduce your blood sugar level which in turn will increase the hormones that signal “I’m hungry”. Alcohol has a “disinhibiting” effect so that the reasoning brain that says, “you have actually had plenty to eat today, you don’t not need more, especially so close to bedtime,” is completely drowned out by the other part of your brain that’s chanting “eat now, eat now, eat now”. These powerful hunger hormone messages are hard for the brain to ignore so off to the pantry and the fridge we go. This is really why ice cream is so popular at 10.30 pm – a low blood sugar situation will be very quickly solved with a tub of fatty, sugary deliciousness.

Alcohol & Breast Cancer

Globally, more than 2 million new cases of breast cancer are reported annually. The United States alone has more than 496,000 new cases every year…that’s almost 25% of new cases. Alcohol is metabolized to acetaldehyde, a known carcinogen made in the liver and the breast. Alcohol damages DNA which can lead to tumor development. If you are interested, for a really extensive article on this topic, go to https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295577/

Alcohol and the Gut

The human gut microbiome describes a complex community of bacteria, viruses, and fungi which varies both with environmental factors (such as diet and drugs) and age. The gut lining has a layer of cells forming a mucous barrier wall to prevent large molecules passing through into the blood stream. Disruption of the microbiome (dysbiosis) has been linked with a wide range of conditions including diabetes, obesity, cardiovascular disease, inflammatory bowel disease and liver cirrhosis. Alcohol has been shown to reduce the good bacteria and increase the bad bacteria. Alcohol can also disrupt that mucous barrier wall, leading to what’s called a “leaky gut”, and that increases inflammation.

While alcohol, especially too much alcohol, can affect women of all ages, the changes in hormone levels found during and after menopause do increase the risk for damage and therefore disease. If you find that it’s not as easy to have a drink, or to get over the effects of having a drink – there are some good hormonal reasons why.