Alcohol and Menopause: Do They Mix?

Drinking a nice glass of wine or a cocktail feels natural for many people.

But can alcohol make menopause symptoms worse or better?

The available information about the relationship between alcohol and menopause can be confusing. On the one hand, you often hear that it can make menopause symptoms worse. On the other hand, it’s reported that it can help with hot flashes and heart health. 

So before you draw any conclusions about drinking and menopause, let’s review the evidence. 

Alcohol and Menopause Symptoms

Menopause Weight Gain

It is not a surprise that drinking can add calories to your day, leading to weight gain. But it is not only the calories but the way alcohol is processed in the body.

Calories

Many menopausal women struggle with weight gain during menopause. Drinking can make it more difficult to achieve and maintain a healthy weight. 

Simple math can give clarity to this topic:

One 5-oz glass of wine equals 125 calories If you drink one glass of wine a day, four times a week for a year, you drink approximately 26,000 calories in a year. 3,500 = 1 additional pound 26,000 = 7.4 pounds You would need to walk approximately 130 hours at a moderate intensity to burn those calories.

Alcohol Can Make You Hungry

First of all, alcohol lowers your inhibitions and can trigger overeating. Have you ever eaten a nice juicy burger after a happy hour? It’s common to crave unhealthy snacks or greasy food to offset the effects of the drinks.

The smell of food is so appetizing after drinking, and it’s hard to control. There’s a physiological reason for that. A small study suggests that it causes an increase in activity in the reward region of the brain, which is also what regulates eating behavior.

It’s possible that alcohol inhibits the hormones leptin and ghrelin, which are responsible for regulating hunger. As a result, you end up eating more than usual and gaining weight. However, the studies are quite old and relatively small. So we cannot say for sure that this happens, but if you’ve ever had one too many, you know there’s something to it.

Can Alcohol Slow Metabolism?

When you drink, your body prioritizes breaking down and metabolizing alcohol over other nutrients like carbohydrates, proteins, and fats. This means that if you drink it while also consuming food, your body will store the calories from the food as fat because it’s not using them for energy.

Additionally, alcohol can also disrupt sleep patterns, shown to affect metabolism. Poor sleep quality frequently leads to increased hunger and cravings, which can lead to overeating and weight gain.

Excess alcohol intake can also result in what is known as alcoholic fatty liver. This is a serious condition that, amongst other things,  affects how your body uses and stores carbohydrates and fats.

Hot Flashes

When it comes to having a few drinks, it’s not all bad news, though. Some studies suggest that alcohol users might have less severe hot flashes.  

For example, a study among 732 women showed that those who regularly imbibed were less likely to have severe hot flashes. However, there has not been enough research to support this conclusion.

Other studies suggest that resveratrol (found in red wine) can help treat hot flashes. It has been suggested that this substance reduces the number of episodes and the severity of hot flashes.  Keep in mind that you can also find resveratrol in grapes and supplements.

In spite of the evidence showing that drinking might be beneficial to hot flashes, it can actually trigger hot flashes in women who have lower amounts of the enzyme that helps break down alcohol.

In addition, alcohol can trigger hot flashes when you take certain medications.

Night Sweats

For some women, a night-time glass of wine or two can cause night sweats because of the effect on the nervous system. Additionally, alcoholic drinks can also affect how the body regulates temperature.

If the drinking is excessive, night sweats could even be the result of withdrawal. 

Sleep

So, for those who fall asleep after drinking, the alcohol prevents them from reaching deep sleep, decreasing sleep quality and quantity.

Furthermore, as discussed earlier,  your favorite tipple can make hot flashes and night sweats worse, making a good night’s sleep impossible.

Another way that alcohol disrupts sleep is by increasing the risk of sleep apnea, a common sleep disorder.

Anxiety

Anxiety is common in menopause, and many women drink to cope with these unwanted feelings.  Alcohol disrupts the chemicals in the brain that help you to relax. So you may find that instead of relieving anxiety, the glass of wine that you take to unwind can do the opposite and fuel your anxiety. 

Risks of Drinking Too Much

Drinking in excess can affect women in several ways. In the short term, drinking too much can put you at risk of injuries, accidents, violence, alcohol poisoning, and unsafe sexual behavior.

In the long term, it can result in serious chronic conditions such as cirrhosis, alcoholic fatty liver, heart disease, stroke, cancer, weakened immune systems, memory deficit, anxiety, depression, and relationship problems.

Why are Hangovers Worse as We Age?

As women age, there are have less of the enzyme that helps process alcohol, so it is broken down more slowly.  This makes us more intolerant to alcoholic effects during the menopausal years.

Also, women in their forties and fifties are more likely to take supplements and medications that might interfere with the body’s ability to metabolize alcohol.

Benefits

There are a few potential benefits of drinking alcohol.

It has been reported that having some in moderation can help decrease the risk of cardiovascular disease. However, this finding has recently been challenged by large studies.

Recommendations for Alcohol Intake

The current recommendation is one drink a day for women.

How much is one drink?

• Wine: 5 ounces
• Beer: 12 ounces (1 bottle)
• Spirits: 1.5 ounces

Tips to Drinking Less

Practice Mindful Drinking

The first step is to be mindful about drinking. For many, drinking is a habit, and to break it, you first need to be aware of how much you have and when you have it.

For example, if you notice that you routinely drink at specific times or events, start questioning if you really want to drink at those times or if it is just a repeated habit. 

You might realize that you pour a glass of wine after work without even thinking about it or considering whether or not you really want it. Once you are aware of the habit, you can decide if you really want it or if you could drink tea or water or to go for a walk instead. 

If you decide to have the drink, then enjoy it and drink slowly. 

Choose Mocktails over Cocktails

The variety of mocktails available at bars is expanding as well as the variety of non-alcoholic drinks that are available to buy and enjoy at home. 

There are plenty of alternatives beyond common choices like sparkling water and juices. You can choose to follow one of these great recipes or get creative and make your own combination. 

Create New Routines

It’s difficult to skip a glass of wine if you’re in a bar with your girlfriends. So it can help to start new routines with them instead, like going to the movies or walking as a group. You can get healthier together!

If you drink at home, then creating new routines at home will help break the habit of mentally connecting a time of day or activity with alcohol. 

When to Avoid Drinking

There are times when alcohol should be avoided completely. Avoid consuming it if:

• You have been diagnosed with alcoholism
• You have liver disease
• You have pancreatic disease
• You have heart failure
• You are taking medication that interferes with alcohol (read the labels)
• Your doctor advises you to stop drinking

My Expert Opinion

Alcohol and menopause is one of the conversations I have most with my patients in perimenopause and menopause. Alcohol is a well-known trigger for hot flashes and night sweats, and it disrupts the deep sleep that’s already harder to come by at this stage. A glass of wine that felt fine in your 30s can hit differently now, both in how your body processes it and in how you feel the next day. I also hear from patients that it tends to amplify the mood swings and irritability that already come with the hormonal shifts of menopause.

It’s also a topic that comes up with weight loss, menopausal or not. While it is possible to drink and not gain weight, it depends on how much and how often you drink. We discuss how alcohol affects them as individuals and how to incorporate alcohol into their diets.

I encourage them to find alternatives they enjoy on weekdays and drink in moderation when out with friends and family.

I emphasize the importance of setting boundaries and discuss strategies to reduce risk, such as alternating between alcoholic drinks and nonalcoholic drinks or drinking a glass of water in between each alcoholic drink. I also remind them to always keep track of how much they’re drinking and that it’s okay to say no to drinks.

We also talk about making better drink choices such as a light beer or a hard seltzer if that fits their preferences. Personally, I love to have a drink at the end of the day. But I learned that a very cold kombucha served in a beer glass does the trick for me.

Between what it does to sleep, hot flashes, and mood, I’ve come to find that, for me, it’s rarely worth it. My advice to you is the same: figure out what it’s actually costing you right now, and if you choose to drink, keep it in moderation.

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