Alcohol and Menopause | with Dr Lucy Caratti

With the booming conversation around menopause and HRT, it is easy to forget that lifestyle measures are still important during the perimenopausal and menopausal transition.

While HRT is certainly a safe and effective option for those who can and choose to take it, it is not the whole story. One of the more difficult aspects of lifestyle changes that many women face, is that of reducing or eliminating alcohol intake. Our society is very geared towards eating and drinking socially in a certain way that negatively impacts our bodies. Many women, though they often notice the negative effects of alcohol, find it very difficult to address.

Why Reducing Alcohol Is Important

Let’s look at some of the reasons why reducing alcohol intake at this time is so important and something you may like to consider:

1. Worsening of symptoms

Most women going through the perimenopausal or menopausal transition can attest to the fact that having even one cheeky glass of wine can lead to an increase in symptoms, particularly the vasomotor symptoms of menopause, such as hot flushes and sweats. These symptoms occur due to changes in the brain in relation to fluctuating hormone levels. Anything that increases inflammation in the body—including sugar, stress, and alcohol—will make these symptoms worse.

2. Sleep

No one appreciates a full night’s sleep more than a menopausal woman (except perhaps a mum of small children!). Alcohol can disrupt sleep for several reasons. Firstly, as discussed above, vasomotor symptoms can worsen, leading to waking up with a hot flush or covered in sweat. Additionally, the body’s process of metabolising alcohol can affect sleep quality, resulting in restlessness and that dreaded 2am waking. If you do choose to have a drink, it is recommended to have it earlier in the day and ensure you stay adequately hydrated. However, for the best quality sleep, try to skip the wine!

3. Mood

Low mood and anxiety are frequently seen during perimenopause and menopause due to hormonal changes, as well as accompanying stresses regarding self-esteem, body image, and place in society, which are influenced by our culture’s negative view of ageing women. Alcohol is a well-known depressant, so it can worsen these symptoms, in addition to the impact that poor sleep has on mood.

4. Histamine

Women in perimenopause can experience issues with histamine, including an increase in allergies, palpitations, headaches, food intolerances, and heavier, more painful periods. Alcohol, particularly wine, can exacerbate histamine intolerance, reducing the enjoyment of that glass of wine.

5. Liver and gut health

During perimenopause, with hormonal fluctuations, and menopause, when taking HRT, our hormones rely heavily on the liver and gut for metabolism. With HRT, we aim to increase estradiol levels, allowing it to enter the body, interact with estradiol receptors, then be metabolised and eliminated efficiently. This process primarily occurs in the liver, followed by the bowel. If the liver is busy detoxifying alcohol, it cannot effectively metabolise hormones, leading to increased side effects.

6. Breast cancer

A lot of focus is placed on the association between HRT and breast cancer, and many women avoid HRT for this reason. However, did you know that the biggest risk factors for breast cancer are actually lifestyle-related? Alcohol is one of the leading causes, with an extra 27 cases per 1000 women who drink two drinks per day. This is the same risk as less than four hours of exercise per week. Another reason to cut out the booze!

7. Sexual dysfunction

While alcohol can sometimes increase the likelihood of sexual encounters, it often causes difficulties for women in becoming aroused, decreases vaginal lubrication, increases pain during sex, and makes it harder to achieve orgasm. In the long run, it can also have a negative impact on libido.

8. Bone density

Long-term alcohol use in women has been shown to negatively affect bone formation, leading to decreased bone density and an increased risk of fractures. With bone and muscle mass being key factors in a long and healthy life, this is a crucial reason to reduce alcohol intake.

The positives of reducing alcohol intake

With all that doom and gloom, let’s focus on the positives of reducing alcohol intake. Reducing or eliminating alcohol gives us an opportunity to connect with loved ones in different ways and opens the door to other beneficial, healthier lifestyle choices. Think of it as a great opportunity to go for a hike with friends or a walk on the beach with your partner. Better sleep, no hangover... sounds pretty good to me!

Dr Lucy Caratti can work with your regular GP to support you with specialised and specific women's health care.

Dr Lucy Caratti is a highly qualified Integrative Doctor with 15 years of clinical experience and an expert in women's health, particularly issues like perimenopause, menopause, gut health, metabolic diseases, and hormonal imbalances.