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Understanding the Health Effects of Drinking Alcohol in Women

Women drinking alcohol in Nigeria

While the problems of women and alcohol have long been known, up until about 1990, we considered these predominantly disorders of men. In fact, men were five times as likely to have an alcohol use disorder in their lifetime as women. However, over the last three decades, we've seen this gender gap closing, such that men are twice as likely as women to have an alcohol use disorder in the course of their lifetime. 

Between 2001 and 2012, there was a 16% increase in the prevalence of women who drink alcohol, a 58% increase in women's high-risk drinking compared to a 16% increase in men, and an 84% increase in women's one-year prevalence of an alcohol use disorder compared to a 35% increase in men. 

We know that women now initiate their use of alcohol at lower ages compared to those born in previous generations. They advance more rapidly from their first regular use to their first treatment episode, often while using lower quantities of alcohol for shorter periods of time, and yet they average more medical, psychiatric, and social consequences.

We call this the telescoping effect of alcohol. Binge drinking is defined in women as four or more standard drinks in one drinking episode, typically over two hours. In men, it's defined as five or more standard drinks in one drinking episode, typically over two hours. 

So this leads to the question, what is a standard drink? A standard drink contains 14 grams of alcohol, and that is typically in 12 ounces of beer, 5 ounces of wine, and one and a half ounces of spirits. 

The Department of Agriculture sets what they consider to be safe drinking limits or nutritional guidelines for alcohol intake, and that includes one standard drink per day, or seven in a week for women, two standard drinks per day, or 14 in a week for men. 

However, over the last 10 years or so, there's been accumulating research that shows even drinking at those limits may in fact pose longer-term health risks. 

Women binge drinking

According to the Centers for Disease Control and Prevention, 13% of adult women binge drink, but it's higher in younger women. 18% of women of childbearing ages, meaning approximately 18 to 44, binge drink. And in high school girls, we see a higher rate, which is 15%. 

In 2017 to 2019, it was the first time that young girls exceeded boys in binge drinking. There is no safe level of alcohol during pregnancy. Alcohol can cause negative consequences for the pregnancy itself, and also infants that are born that have been exposed during fetal development to alcohol are at higher risk of developing fetal alcohol spectrum disorders. 

There are many health risks posed to both women and men of alcohol use, including low doses of alcohol consumed daily. These things include liver disease, multiple different kinds of cancers, including cancer of the mouth, the esophagus, stomach, and the colon. This also includes breast cancer for women.

It includes cardiovascular disease, and it includes brain health and cognition. Alcohol is a depressant, and it can affect sleep. When people withdraw from alcohol, it can create anxiety-related symptoms. 

Women are twice as likely to have depression, twice as likely to have anxiety, three times as likely to have post-traumatic stress disorder, and anywhere from three to 10 times as likely to have an eating disorder. Also, having any of these mental health disorders can also pose a risk for developing an alcohol use disorder at some time in your life. 

We have seen an increase of alcohol consumption during the COVID-19 pandemic, and we have seen rising rates of alcohol consumption both in the Nigeria and also in other countries globally. 

In response to stress, we have seen in other natural disasters and terrorist attacks that people often will increase their alcohol consumption, sometimes as a means to manage stress. We have seen that women have had 41% more heavy drinking days during the pandemic than before the pandemic. 

In addition, we've also seen as women's psychological distress to the pandemic has increased, so has their consumption, and we do not see that same relationship with men.

It's important for women to educate themselves about alcohol and their own family history and personal history and the health risks that they have. In addition, if you're a young woman or an adolescent, defer or delay using alcohol as far as you can into your 20s, because that too will lower your risk of having an alcohol use disorder. If you do drink alcohol, it's important that you minimize the amount that you drink, both in terms of quantity and frequency. 

Stay within at least the recommended guidelines by the Department of Agriculture, which is no more than one standard drink in a day, no more than seven in a week. If you have other mental health conditions, such as depression or anxiety, you may wish to eliminate alcohol completely because alcohol can pose a risk to all of those other disorders. 

Another thing you can do is to develop healthy ways to cope with stress. Yoga, meditation, mindfulness, exercise, that can enable you to use those healthy coping strategies rather than turning to alcohol when you have stress or very intense emotion. 

We have many effective treatments for alcohol use disorders, and these include medication and behavioral therapies, individual, group, and family therapies, as well as mutual support treatments such as Alcoholics Anonymous, or AA, and also relapse prevention therapies. We also have three FDA approved medications for alcohol use disorder. 

Women provide 95% of caregiving in Nigeria and globally. Women often cite lack of child care or financial resources as barriers and obstacles to their getting treatment. Family members, such as children and other loved ones, can be powerful motivators for seeking treatment and getting well. 

Lady binge

For many women, gender-responsive therapies will be helpful and effective. In advanced countries like United States at McLean and Mass General Brigham, with the support of funding through the NIH National Institute on Drug Abuse, they have developed a gender-responsive group therapy for women with alcohol use and other substance use disorders called the Women's Recovery Group, or the WRG. The Women's Recovery Group is based on research that shows that it's an effective approach for treating women with alcohol use and other substance problems. 

There are many resources available that you can access at multiple different websites, including the NIH website, as well as that of the CDC, and also the United States Substance Abuse and Mental Health Services Administration website.

Closing Thought 

We know that alcohol use, binge drinking, and alcohol use disorders are really on the rise amongst women in the Nigeria and in other countries. 

It's really important for women to educate themselves about drinking and the health effects. If women have more knowledge, they can also make decisions about their own health and well-being. There are many treatment resources that you can use to get well and stay well and to live a healthy life.

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