Menopause & Wine: Is My Nightly Glass a Friend or Foe?

Is that nightly glass of wine sabotaging your health during your menopause transition? Many women find themselves caught in this dilemma. On one hand, that evening wind-down ritual can feel essential. On the other, you might be wondering about the impact of alcohol on your hot flashes, sleep, and mood.

As a board-certified OB GYN and menopause expert, I'm here to guide you through the intricate relationship between alcohol and your peri- or menopausal journey. We'll explore the very real risks, including the latest research on cancer risk, and most importantly, how to navigate this delicate balance with grace and awareness.

Recent data reveal a troubling rise in excessive alcohol use among women and older adults, highlighting a significant public health concern. Women are particularly vulnerable to alcohol-related health consequences, which can worsen with age. Factors such as hormonal changes during the menopausal transition and mood disturbances like depression may further influence alcohol consumption in women. 

This study explored these connections, focusing on transitions in excessive drinking during the menopausal transition and examining the roles of sex hormones, including estradiol and testosterone, as well as depression, in shaping drinking behaviors. The findings shed light on the complex interplay between menopause, mental health, and alcohol use, emphasizing the need for targeted interventions and further research.

The rise in excessive alcohol use among women and older adults appears to stem from a complex combination of biological, psychological, and social factors. Hormonal fluctuations during the menopausal transition, such as changes in estradiol and testosterone, can impact mood regulation and stress responses, making alcohol an appealing coping mechanism for some. 

Mental health challenges like depression and anxiety, which are more common during perimenopause and menopause, may further drive alcohol consumption as a form of self-medication. Additionally, societal norms have increasingly normalized drinking among women, with targeted marketing and the widespread acceptance of alcohol as a stress-relief tool. 

Women in midlife often face unique stressors as part of the "sandwich generation," juggling the demands of caring for both children and aging parents, navigating greater work pressures, and experiencing increased loneliness. These stressors, combined with physiological changes and reduced alcohol tolerance, create a perfect storm that can lead to excessive alcohol use, highlighting the urgent need for greater awareness and supportive interventions.

Unveiling the Truth: Alcohol and Perimenopause

If you’re wondering if alcohol can affect the age at which you enter menopause, the answer is, we don’t know. We need more research and some studies are starting to look into this. ⁽¹⁾ But we do know that good habits can have a huge benefit during peri- and postmenopause. Limiting alcohol intake is a core principle of an anti-inflammatory lifestyle, which can significantly improve your overall health and well-being during this transition.

It is also crucial to acknowledge the potential downsides. And there are a lot, especially during peri- and postmenopause:

Weight gain 

Have you ever heard that alcohol is empty calories? What that means is alcohol is high in calories and lacks essential nutrients. It also slows metabolism, and increases appetite, all of which can contribute to weight gain. There are helpful online tools that can show you just how many calories are in that glass of wine.

Hot Flash Intensification

Alcohol can trigger or worsen hot flashes and night sweats, making an already uncomfortable experience even more challenging. ⁽⁵⁾  I hate to break it to you, but that glass of red wine might be triggering your hot flashes.

Sleep Disruption 

Alcohol may initially make you feel drowsy, but it can interfere with deep sleep cycles, leading to restless nights and daytime fatigue. ⁽⁶⁾

Mood Swings 

While a small amount might have a mild mood-lifting effect, excessive alcohol consumption can significantly worsen mood swings and increase irritability. 

Stress and Anxiety 

Limiting alcohol intake can help with stress reduction. This may seem counterintuitive, as many turn to alcohol as a way to 'relax.' However, drinking can actually exacerbate feelings of anxiety and low mood during menopause. Have you heard of the term ‘hangxiety’? ⁽⁷⁾

Serious Health Risks of Alcohol:

Increased Cancer Risk

Recently, the Surgeon General has issued a strong warning about the link between alcohol consumption and cancer risk. ⁽⁸⁾ Any amount of alcohol increases the risk of certain cancers, including breast, colorectal, and liver cancer. The risk increases with the amount of alcohol consumed.

Breast Cancer

Studies have shown a significant increase in breast cancer risk among postmenopausal women taking menopause hormone therapy (MHT) and consuming alcohol. ⁽⁹⁾  

Drinking alcohol increases estrogen levels, which, when combined with MHT, may significantly increase breast cancer risk.

Even without MHT, moderate alcohol consumption (6 drinks per week) can increase your risk of breast cancer as you age. ⁽¹⁰⁾

Increased Osteoporosis Risk

Alcohol can weaken bones by interfering with calcium absorption, disrupting hormone production, and increasing the risk of falls.  

Excessive alcohol consumption has been linked to decreased bone density and an increased risk of fractures, particularly in the hip and spine.

Heart Disease

Alcohol consumption is a significant risk factor for heart disease, and the link is especially strong for women. ⁽¹¹⁾ The more you drink, the higher the risk. One study found that women who consumed 8 or more alcoholic drinks per week were significantly more likely to experience heart problems compared to those who drank less.

Liver Disease

Alcohol is a hepatotoxin, meaning it can damage the liver. Excessive alcohol consumption over time can lead to a range of liver diseases, known as alcohol-related liver disease (ALD). ALD is rising in women. ⁽¹²⁾ Women's bodies process alcohol differently than men's, which can lead to liver damage more quickly.

Binge drinking is a major concern: Binge drinking is common among women, often fueled by societal pressures, stress from unrealistic expectations, and underlying issues like eating disorders or past trauma.

The normalization of drinking in popular culture: Phrases like "Mommy Juice" and "Wine Down Wednesdays" can make it seem like drinking is a normal and even necessary part of life for women. This can lead to unhealthy drinking habits.
 

Navigating the Maze: Tips for Mindful Drinking

Now that we've explored the potential benefits and thoroughly examined the major risks of alcohol consumption during perimenopause, it's time to empower you with strategies for making informed choices about your alcohol intake. If you decide the amount of alcohol you're currently drinking isn't right for your body at this time, there are things you can do to cut back. Here are seven tips for moderating your alcohol intake during perimenopause.

1. Be Aware:
• Become aware of your drinking habits. Pay attention to how often you reach for a drink and how much you consume.
• Practice mindful consumption. Notice how each drink makes you feel – physically and emotionally. Are you truly enjoying it, or are you simply drinking out of habit?
2. Mindful Moderation:
• Adhere to the recommended daily limits: no more than one drink per day for women.
• Track your weekly alcohol intake to stay within healthy guidelines.
• Work on your awareness. Next time you go to pour that glass of wine, get out a measuring cup. How much is really in your “one glass”?
3. Prioritize Hydration:
• Alcohol is a diuretic. That means it helps your body get rid of extra fluid by making you pee more often. So stay well-hydrated throughout the day to minimize dehydration.
• Drink plenty of water before, during, and after alcohol consumption. Consider enjoying your favorite flavor electrolyte powder mixed with water or seltzer to ensure you’re staying well hydrated. My absolute favorite brand is LMNT. Their grapefruit salt flavor is chef’s kiss!
4. Choose Wisely:
• Opt for low-alcohol or alcohol-free alternatives whenever possible. Flavored seltzers or seltzer with a twist of citrus or herbs such as basil, rosemary or thyme make delicious, refreshing and attractive mocktails.
• Explore other delicious mocktail alternatives and savor the flavors without the alcohol. I’ve seen a few alcohol alternative drinks that include adaptogens plus magnesium, just be sure you’re watching out for those sneaky added sugars.
5. Listen to Your Body:
• Pay close attention to how alcohol affects you.
• If you notice an increase in hot flashes, difficulty sleeping, or worsening mood, consider reducing or eliminating alcohol consumption. ⁽¹³⁾
• Experiment with a “Dry Month.” Many people participate in challenges like "Dry January," "Go Dry for July," or "Sober October" to reduce their alcohol intake. Data shows people who take a month off alcohol tend to reduce their drinking afterwards. ⁽¹⁴⁾
6. Prioritize Your Well-being:
• Remember that perimenopause and your menopause journey is a unique phase.
• Prioritize your overall well-being through healthy eating, regular exercise, and stress-reducing techniques like yoga or meditation.
7. Reclaim Your Evenings:
• Find enjoyable alternatives to drinking. Explore new hobbies, connect with loved ones, or simply relax and unwind without alcohol.
• Remember that moderation is key. You don't have to give up alcohol entirely, but by making conscious choices and prioritizing your well-being, you can enjoy a healthy and fulfilling life during and after menopause.

Reaching Your Destination: A Healthier You

I hope the information I’ve provided helps you to navigate your journey through the world of alcohol and the menopause transition. By understanding the potential impacts and implementing these mindful strategies, you can make informed choices about your alcohol consumption and prioritize your overall health and well-being during this transformative phase of life. You've likely discovered that there's more to consider than simply enjoying a glass of wine.

If you’ve decided you’d like to break up with alcohol and would like support, consider joining my friend Dr. Rocio Salas-Whalen over on her Instagram channel The Dry Revolution.

Now, I'd love to hear from you! What are your experiences with alcohol during perimenopause, menopause and beyond? Do you have any tips or strategies that have helped you? Share a tip in our free The ‘Pause Life Community or on social media and be sure to tag me!

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