Alcohol and Menopause - What You Need To Know | Stella
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Alcohol and menopause: Can you drink during menopause?

byDr. Nick Morse

The fact is, alcohol and menopause are not the best of friends. While you absolutely can drink during menopause, there are many reasons it might be worth keeping an eye on how much and how often you are drinking. Alcohol can have an impact on menopause symptoms, from hot flashes to mood swings. Find out how your drinking habits could cause issues and why cutting back on your alcohol may be worthwhile.

Low-risk drinking and safe limits

Humans have enjoyed drinking alcohol for a long time, but we are only now beginning to understand how it can harm your health.

The 2020-2025 Dietary Guide for Americans recommends that women who drink should have no more than one drink each day.

Research into alcohol consumption and overall health shows mixed results. That said, it is clear that heavy drinking – for women, more than three drinks per day or more than seven drinks per week – is bad for your health and associated with an increased risk of death. Drinking too much alcohol is linked to several types of cancer, liver disease, and heart failure.

How much alcohol is in one drink? 

When scientists talk about a single ‘drink’, the measurement is based on how much of the liquid you need to drink to consume 14 grams or 0.5 fluid ounces of pure alcohol. This means one drink is equal to:

  • 12 fluid ounces of beer
  • 5 fluid ounces of wine
  • 1.5 fluid ounces of 80-proof liquor

Keep in mind that the alcohol content of beer and wine can vary widely and many single cocktails may contain much more than 14 grams of pure alcohol.

Can alcohol help you feel better during menopause?

One study found that drinking small amounts of alcohol can be associated with improved well-being through menopause.

It is important to think about your personal balance of risks and benefits and to ensure that you really are drinking moderately. Aim to have no more than one drink per day or seven drinks per week.

Menopause, hot flashes, and alcohol

If menopause and hot flashes are disrupting your life, it might be worth thinking about the way you drink alcohol.

Some studies have shown that hot flashes are more bothersome in women who consume more alcohol regularly, while others have found that moderate alcohol use is associated with lower intensity of hot flashes. Clearly more research needs to be done for us to be sure about the relationship between alcohol and hot flashes. Most likely, the relationship is not the same for everyone.  

Red wine was linked to more bothersome hot flashes in some studies. If you struggle with hot flashes, try switching to another type of alcohol, like beer or white wine, and monitoring your symptoms.

If you are still struggling with hot flashes, lifestyle changes and HT may help. If your symptoms are problematic, speak to your healthcare provider about whether this could be suitable for you. 

Menopause, mood, and alcohol

Low mood is common at menopause, as are a number of other psychological symptoms including irritability, anger, anxiety, and mood swings.

Alcohol is also linked to mental health issues including anxiety and depression due to the way alcohol acts on your brain.

If you are having a hard time with low mood or other mood changes, consider cutting down on alcohol and talk to your healthcare provider. Treatments include:

  • HT
  • Talking therapies
  • Antidepressants

Menopause, sleep, and alcohol

Sleep can be a real challenge during menopause and well into your postmenopausal life. Physical symptoms that can interfere with sleep include night sweats, anxiety, and aches and pains. These can all contribute to interrupted, unsatisfying sleep.

Although alcohol can sometimes make it easier to get to sleep, it also decreases your sleep quality overall. This is because alcohol reduces the amount of time you spend in the REM phase of sleep – the sleep phase that is most associated with restful, restorative sleep. It also means you need to pee more frequently during the night, leading to more sleep interruptions. 

It is probably worth thinking twice about that second glass of wine if you are struggling with sleep issues during menopause.

HT, alcohol, and breast cancer risk

HT is a proven and effective treatment for many symptoms of menopause. However, like all medications, it comes with certain risks and side effects.

If you take combined HT – estrogen and progesterone – one of these risks is an increase in your chance of developing breast cancer. For every 1,000 women aged between 50-59 who take combined HT there will be one additional case of breast cancer each year compared to the baseline risk.

Alcohol also increases your risk of breast cancer. One study found that drinking more than one drink per day carries the same increased breast cancer risk as taking HT for five years.

Combining HT and alcohol can be riskier still. In the same study the risk of breast cancer doubled among those who have more than one alcoholic drink per day and use HT for five years or more.

Although breast cancer risk is a complex topic, this may be a good time to think about cutting down on your alcohol intake. Other things you can do to reduce your breast cancer risk are:

  • Maintaining a healthy body mass index (BMI)
  • Quitting smoking
  • Exercising at least two and a half hours per week

Read more about HT, breast cancer, and your family history.

Menopause, bone density, and alcohol

At menopause, your bone density and resistance to bone fractures decreases. This is due in part to the decrease in estrogen levels which happens at this time. Mild loss of bond density is called osteopenia, while more severe thinning is known as osteoporosis.

Your bones grow, change, and repair themselves constantly throughout your life. This happens due to the balance of activity by bone-dissolving cells called osteoclasts, bone-building cells called osteoblasts, and the hormones that control them.

Premenopausal levels of estrogen help to maintain bone density by influencing this process. Estrogen reduces the amount of bone that is reabsorbed by osteoclasts. It follows that once the protective effect of estrogen is removed, we become more prone to thinning of the bones.

Moderate to high levels of alcohol consumption – more than one drink per day – have also been linked with osteoporosis. However, there is some evidence that low to moderate alcohol consumption is sometimes associated with less decline in bone density.

So what does this mean for you? The best conclusion to draw from all of this is to think about your own personal risk.

If you are particularly at risk from osteoporosis – for example, if you have a strong family history of the condition – you should be more cautious about your alcohol intake.

Other things you can do to boost your bone mass include regular strength training and considering HT, which is proven to help.

Menopause, weight, and alcohol

You may notice weight gain during menopause, especially around your middle. Extra pounds become more difficult to lose during menopause, so it is worth noting that alcohol can be a source of extra – and nutritionally empty – calories.

For example, a pint of beer contains around 240 calories – as much as a chocolate bar or even a sandwich!

Cutting down on alcohol consumption can be a quick win if you are trying to manage your weight. Giving up just one glass of wine per week could save 7,000 calories over a year, equivalent to nearly two pounds of fat.

While this sounds like an easy way to lose weight, beware! Some non-alcoholic beverages are often very sugary and high in calories. Also, many contain caffeine which can worsen menopause symptoms. Ensure that you are switching to low-calorie, caffeine-free alternatives to make the most of your healthy choice.

Problem drinking

It is all too easy for problem drinking to creep up on you. You may even notice that you have an unhealthy relationship with alcohol despite drinking within the recommended limits.

Here are signs it might be time to rethink your drinking:

  • Feeling like you should cut down
  • Other people criticize your drinking
  • Feeling guilty about drinking
  • Needing to drink first thing in the morning to steady your nerves or get rid of a hangover

If you need help or advice about your alcohol use, speak to your healthcare provider.

Do not stop drinking suddenly if you think you could be dependent on alcohol. This is because withdrawal can be dangerous and cause serious medical problems including seizures. Instead, speak to your healthcare provider for support in cutting down gradually.

For further help, see:

Final word

Be mindful about your alcohol consumption if you are going through menopause. Be aware of your symptoms and think about cutting down, particularly if you have more than one drink a day or more than seven a week. Swapping to caffeine-free, soft drinks could help ease hot flashes, mood swings, or broken sleep.

Alcohol can also have implications for your long-term health, including the risk of certain cancers, liver disease, and osteoporosis. Speak to your healthcare provider if you need help cutting down.

Find out more about menopause on our blog or in our symptoms library