Perimenopause and Alcohol: Why wine and I are no longer friends

Ladies, don’t get mad at me. I don’t think this one is going to make me very popular but alcohol use in perimenopause is our topic du jour.

I’m sure many can relate to reaching for a glass of wine, or beverage of choice, at the end of a long and stressful day. Alcohol can feel like a great way to unwind, act as a social lubricant or “help” with sleep, but is this glass (or two) helping or harming us?

With the holiday season behind us, it may be time to reassess our relationship with alcohol as we strive to create healthier habits in the new year. 

Why we reach for alcohol in perimenopause:

We see this cultural narrative of “coffee in the morning, wine in the evening” perpetuated everywhere. Our lives are set up in a way that the daily expectations and stressors can often feel unmanageable. We work hard and have more on our plates. At the end of a long day, gosh darn it, we feel we’ve earned that drink. Alcohol has been glamourized and promoted as a societal norm for as long as I can remember. Mommy wine clubs, mama juice,  wine down, it’s five o’clock somewhere, stay calm and drink wine, do any of these sound familiar? 

On top of it all, we are told to find time for relaxation and self-care, which feels like one other unattainable goal on our never-ending to-do lists. Reaching for a drink is easy, I get it. But what if alcohol is actually making things worse?

I know I sound all “doom and gloom ” but hopefully, by the end, you won’t feel discouraged. Even knowing the information I’m about to share with you, I still choose to indulge every once in a while. I am just aware that when I do, I may have crappy sleep, lower mood and increased anxiety the next day. It turns out I am not alone in my lowered intolerance to alcohol.

What is alcohol intolerance and how does it relate to perimenopause?

With age, our ability to retain water is lowered and we have less of the enzyme needed to break down alcohol (womp womp). These fun changes make us more sensitive to the effects of alcohol. Hello hangovers, even after 2 drinks (talk about a buzz kill). 

Some women feel they become “allergic” to wine overnight. This is most likely thanks to our body’s poor job metabolizing alcohol causing histamine to be released. Flushed cheeks and pounding headaches, anyone?

For many women, their mood, insomnia, brain fog, hot flashes and other perimenopausal symptoms worsen with alcohol intake. It seems pretty counterintuitive that we’re reaching for alcohol to help us when it could be the thing causing us more grief. 

What alcohol actually does to our bodies:

First off, alcohol is a toxin and a known carcinogen (causes cancer). It increases our risk of 7 types of cancer. It messes with our gut, liver, endocrine (hormonal system) and brain, all of which are pretty darn important for basic human function, let alone feeling our best.

Now let’s get a little technical and break each of these down a bit. 

The gut is more than just an organ that digests food. It plays a role in our immune system, inflammation, metabolism, mood and brain function. Alcohol interferes with the proper functioning of the gut leading to problems in everything listed above.

The liver is the only way for us to get rid of alcohol so if it is tied up doing this it can’t keep up with its other important jobs like detoxing, managing blood sugar, helping digestion, metabolism and blood clotting.

Our hormonal system is involved in everything. It impacts our nervous system and how we manage stress, our immune system, our moods and psychological issues, reproductive issues, bone health and thyroid problems. Heavy alcohol use in the long term causes problems in every one of these processes. People who drink even low amounts of alcohol produce more cortisol (our stress hormone) and end up feeling more stressed and anxious when not drinking. Wait what?! The thing we are using to decompress is making us feel worse? Not cool!

Some studies have shown possible health benefits with low to moderate alcohol use such as a lowered risk of heart disease, stroke and diabetes, though other researchers are skeptical. A new study showed that chronic low amounts (1-2 drinks a day) is bad for the brain. Not to mention the terrible headaches and brain fog that can follow the morning after drinking.

Alcohol, sleep and perimenopause:

Many people still believe that a little nightcap will help them sleep. Alcohol acts as a sedative and can help you fall asleep faster but it does not keep you asleep. You end up having poor quality of sleep which can leave you more tired and anxious the next day. The worsening of perimenopausal symptoms, as discussed previously, can also contribute to poor sleep, which is basically the opposite of what we are striving for.

How to offset alcohol in perimenopause:

Everything in moderation is a good motto but difficult to follow if you’re among the women who now find themselves intolerant to alcohol. Just like everything in life, there is no one size fits all approach. We all need to consider our individual experiences when evaluating whether alcohol is taking more than it’s giving to us.

Actionable steps to manage alcohol more effectively:

• Follow the 80/20 rule, aka limit or take out alcohol completely most of the time. Try to save it for special occasions. Sometimes it is hard to know the impact something is having on us until we completely remove it. Taking a 30-day break could help you see how good you can feel without it. Who is up for doing a “dry February” (insert hand-up emoji)?
• Hydrate! Experts agree to aim for 1 to 2 glasses of water for every alcoholic drink and don’t skimp on the electrolytes! Alcohol is a diuretic, meaning it removes fluid from our bodies by making us pee. Couple that with our already lower water volume and you can end up pretty dehydrated the next day.
• If you are planning on having several drinks then eat BEFORE drinking. Eating before drinking slows the absorption of alcohol which will prevent you from getting intoxicated too quickly.
• Try to stop drinking at least 3 hours before bed, but preferably more, to help with sleep.
• Choose lower sugar options to help with blood sugar control and cravings. Be mindful of the empty calories that come along with alcoholic beverages.
• Find a fun, non-alcoholic alternative. My husband and I used to love unwinding with a nice craft beer. Since my sleep sucks when we split even one tall can, we have found an alternative. We buy special non-caffeinated teas and have them in nice mugs, split a kombucha or even a carbonated drink and have made that our ritual, most of the time. Mocktails anyone?

Conclusion:

Lastly, DON’T STRESS. Enjoy your drinks when you choose to have them.  Connecting with friends and family is important. Deciding to have a drink and then stressing about it is exactly 37.5% worse for your health. Full disclosure, I totally made that last statistic up. In all seriousness, you are now armed with information to make the best decision for YOU. Let moderation be your goal. 

If you find you are reaching for alcohol to deal with perimenopause symptoms, there may be a better solution. We would be more than happy to connect with you and assess your individualized needs. Cheers!

References

1. Andréasson, S., Chikritzhs, T., Dangardt, F., Holder, H., Naimi, T. &  Stockwell, T. (2014).       Evidence of health effects of “moderate” alcohol consumption: Reasons for skepticism and public health implications. Alcohol Research Report 2014. Alcohol_and_society_2014_en.pdf
2. Canadian Cancer Society. (2023). Some sobering facts about alcohol and cancer risk. https://cancer.ca/en/cancer-information/reduce-your-risk/limit-alcohol/some-sobering-facts-about-alcohol-and-cancer-risk (accessed December 2022)
3. Chiva-Blanch, G. & Badimon, L. (2019). Benefits and Risks of Moderate Alcohol Consumption on Cardiovascular Disease: Current Findings and Controversies. Nutrients, 30;12(1):108.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7020057/
4. Daviet, R., Aydogan, G., Jagannathan, K., Spilka, N., Koellinger, P., Kranzler, H., Nave. … Weatherill, R. (2022). Associations between alcohol consumption and gray and white matter volumes in UK Biobank. Nature Communications, 13 (1175). https://www.nature.com/articles/s41467-022-28735-5
5. Huberman, A. (Host). (2022, August 25). What alcohol does to your body, brain and health. (No. 86). [Audio podcast Episode]. In Huberman Lab https://podcastnotes.org/huberman-lab/episode-86-what-alcohol-does-to-your-body-brain-health-huberman-lab/
6. Inkelis, S., Hasler, B., & Baker, F. (2020). Sleep and alcohol use in women. Alcohol Research,  40(2): 13  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359817/
7. Jardim, N. (Host). (2022, December 5). Women, Hormones and Alcohol with podcast guest Brooke Scheller (No. 281). [Audio podcast episode]. In The Period Party https://nicolejardim.com/podcasts/women-hormones-alcohol-brooke-scheller/
8. Kalra, A., Yetisku, l., Wehrle C. & Tuma, F. (2022). Physiology, Liver. StatPearls https://www.ncbi.nlm.nih.gov/books/NBK535438/ (accessed December 2022)
9. National Institute on Alcohol Abuse and Alcoholism. (2022). Alcohol flush reaction. https://www.niaaa.nih.gov/publications/alcohol-flush-reaction (accessed December 2022)
10. Newson,L. (2021). Managing menopause beyond HRT. Balance.https://www.balance-menopause.com/menopause-library/managing-menopause-beyond-hrt/
11. Rusyn, I. & Batalle, R. (2013). Alcohol and toxicity. Journal of Hepatology, 59(2):387-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959903/
12. Synder, M. (Host). (2022, February 22). To drink or not to drink? Why drinking as we get older is hard on our hormones. (No. 345). [Audio podcast episode]. In Essentially You. https://drmariza.com/345-why-drinking-as-we-get-older-is-hard-on-our-hormones/
13. Velaz, A. (2020). Why Alcohol Affects Women More in Menopause. Endocrine Web. https://www.endocrineweb.com/menopause-alcohol
14. Featured image by freepik