Man, what was I thinking?
My girlfriend turned 50 last weekend and hosted the most fabulous party ever! Catered, DJ, speciality cocktails – the whole nine yards! We celebrated like we were 25 again: dancing until 2am, cocktails in hand. Then the stragglers crowded around the dining table and scarfed back greasy pizza. It was the most fun I’ve had in years!
But man, did I pay for it!
The next morning I could barely lift my head off the pillow. I felt woozy and groggy. I couldn’t remember going to bed. And when I finally tried to get up, my hips and feet were so sore, I actually needed my husband to give me a hand.
What is even happening to me?
I am the woman who all my adult life proudly proclaimed that my super power was, ‘I don’t get hungover!’
Clearly this isn’t the case anymore.
And when I think about it, the truth is that this past year I have started to notice my body reacting differently to alcohol. I seem to get drunker faster than I did in my 30s and 40s. A really fun night out now often leaves a lot of black holes in my memory that can take days to piece back together. And the worst thing I’ve noticed, is that after a weekend celebrating with friends, my mood is usually really low and I feel really sad and anxious.
Always curious to figure out what the hell is going on with my perimenopausal body, I decided to do a little digging. Here are few things I learned that you should probably know too:
How alcohol affects our body
Our body sees alcohol as a toxin. And its first impulse is to eliminate toxins as quickly as possible. So after a few drinks, our liver goes into overdrive, focusing all of its efforts on getting the alcohol out of our bodies. All of this puts undue stress on our liver and causes inflammation and oxidative stress. Neither of these are good for our bodies.
Alcohol and women
There’s actually some science behind why women can’t keep up to the guys at the bar:
- Women tend to have less body water compared to men of the same weight. Less water = less alcohol dilution. So when women consume a drink, their blood alcohol levels rise more quickly, and their body tissues are exposed to higher amounts of alcohol per drink.
- Women normally absorb more alcohol and metabolize it at a slower rate than men. This is why we often have higher blood alcohol levels and experience quicker and longer-lasting effects from alcohol compared to men.
Mix our mid-life hormones into this cocktail and we’ve got ourselves one fine mess. More on that really soon.
Alcohol intolerance and perimenopause
Although there’s not a lot of scientific research on this (don’t get me started on the misogyny in health care), many agree that menopause coincides with a reduced tolerance for alcohol.
Some attribute this to a woman’s inability to hold onto as much water as we used to. With less water available to dilute alcohol, its negative side effects can become more severe. Also as we age, it’s harder for our bodies to metabolize alcohol. So it stays in our system longer and heightens our sensitivity to it.
And if you think about it, alcohol is broken down (metabolized) in our liver. This is the same place where all of our hormones are metabolized. Our liver is one busy organ! In fact, it performs more than 500 vital functions every day, including regulating our blood sugar and removing waste products. Perimenopausal women are pushing their liver to the limits every day. Adding alcohol to the mix is definitely not helpful.
Finally, as we enter perimenopause and our estrogen levels drop, our bodies become more susceptible to oxidative stress, inflammation, and damage. Some researchers believe that the decline in estrogen during perimenopause leaves us more vulnerable to the harmful impact of alcohol.
Alcohol and perimenopause symptoms
You may have heard that moderate drinking can be beneficial for the heart. And who doesn’t enjoy winding down with a glass of wine at the end of the day? While some women may experience temporary relief from drinking alcohol during perimenopause, this isn’t the case for most women.
Excessive alcohol consumption disrupts hormonal balance, resulting in a decrease in testosterone and progesterone levels, as well as an increase in estradiol and follicle-stimulating hormone (FSH) levels.
These hormonal imbalances can contribute to irregular menstrual cycles, fertility issues, decreased libido, and other related problems. Additionally, alcohol elevates endogenous hormones, such as estrogen and testosterone, which can impact breast tissue growth and increase the risk of breast cancer.
When the liver is trying to metabolize the poisonous alcohol in our bodies, it doesn’t have the capacity to deal with all these hormone imbalances. As a result, estrogen may not get metabolized and can be reabsorbed into our bodies. Further exacerbating the hormonal imbalance.
It’s no surprise than that alcohol can worsen many of our perimenopausal symptoms, like hot flashes and night sweats, sleep disturbances, low mood and anxiety, brain fog and weight gain. It also depletes our bodies of crucial nutrients like magnesium.
Alcohol and Depression
It’s quite common for women to experience new or intensified feelings of anxiety and depression during perimenopause. Alcohol only intensifies these symptoms. Perimenopausal women are also vulnerable to depression. Again, excessive drinking can only worsen the situation.
We know our changing hormone levels during perimenopause can have a significant impact on mood. Since alcohol is a depressant, the initial boost you may feel from a glass of wine can ultimately leave you feeling even more down in the long run.
Alcohol and other health risks
As women enter their menopausal years, the risk of heart disease, stroke, and osteoporosis increase. Heavy drinking is also associated with heart disease and irreversible bone mass loss. It doesn’t take a rocket scientist to figure out that if we drink heavily during perimenopause, we’re increasing our risk for these life threatening health conditions.
Heavy drinking is also associated with health risks like cancer (including breast cancer), organ damage (including the brain, nerves, heart, and liver) and an elevated risk of accidents resulting in bone fractures.
It’s really important that we are mindful of these risks and prioritize our overall well-being during this stage of life.
How much can you drink during perimenopause?
I’ve just thrown a whole bunch of research at you about why we shouldn’t drink – during perimenopause or maybe ever. But the truth is that I’m not likely to stop. So if I’m determined to cut down my alcohol consumption, how much can I safely drink each week? Enquiring minds want to know.
According to the North American Menopause Society (NAMS), to avoid an increased chance of cancer, stroke and other health conditions, we should have no more than two drinks per day.**
What constitutes one drink?
According to National Institute on Alcohol Abuse and Alcoholism (NIAA) one standard drink is:
5 fluid oz (one glass) of wine (about 12% alcohol).
12 fluid oz (usually one can or bottle) of regular beer (about 5% alcohol).
1.5 fluid oz (one shot) of 80-proof distilled spirits.
Get out your jigger and measure to be sure. Most wine glasses hold waaaaaay more than a 5 oz pour.
How to drink better in perimenopause
Here’s few tips to help you drink better in perimenopause:
– Moderation is key so don’t binge drink,
– Plan alcohol free days – my alcohol free days are Sunday – Thursday,
– Drink lots of water,
– Support your liver – it’s already doing way too much work,
– Consider alcohol free alternatives.
Alcohol free alternatives
Lucky for us, there are a ton of great alcohol free options out there right now. Available in your grocery store or online, you can find a ton of sophisticated flavors that are almost just as good as their cocktail alternatives.
These are great for me because I associate having a drink with fun, social events. This way I can still cruise the room, drink in hand, without doing damage to my liver or hormones. I can still be the life of the party and wake up the next morning, hangover free and ready to take on the day.
As always when it comes to alcohol or anything truly decadent and indulgent, moderation is key. Even though I’m inspired (and a little jealous) of my girlfriends who have managed to give up drinking, I’m realistically not going to stop enjoying a few drinks here and there. I really do love it.
But I am going to try and dial it back, because the way I felt on Sunday morning is not something I want to repeat.
You have to figure out what’s best for you. Every woman is different. And every woman’s perimenopause journey is too. Moderate drinking, like one drink per day, can boost the health of some women during menopause. And for others it only makes our symptoms worse.
If you have questions, it’s always important to talk to your doctor.