Women and alcohol really don’t mix. The health consequences of drinking alcohol are more serious for women than men.
It’s commonly believed that men can hold their liquor better than women can, but that’s only part of the story. Research shows that alcohol also takes more of a toll on women physically, mentally and socially.
A study by researchers at the University of Michigan School of Public Health and Washington University looked at more than 400 people during a 15-year period to study the long-term effects of alcohol. It found that women who drank heavily reported more difficulty in everyday tasks such as climbing stairs, carrying groceries or taking care of family members, than men did.
“On most of the measures, the women were more seriously disabled than the men,” says Kyle Grazier, Ph.D., associate professor in the department of health management and policy at the University of Michigan and lead author of the study. The study was presented last year at the First World Congress on Women and Mental Health in Berlin.
Study subjects were divided into three groups: those who were alcoholics throughout the whole period, those who were alcoholics at the beginning of the study and those who were not alcoholics. Women were adversely affected by alcohol whether they had been drinking heavily for 20 years or had stopped drinking in the past five years. Alcohol affected the time they spent at work or social activities and, in general, compromised their health more than men.
“It’s very consistent with what other researchers have reported about alcohol having a more accelerated course toward negative effects in women,” says Kathleen Bucholz, Ph.D., who worked on the study with Grazier and is a research professor in the department of psychiatry at Washington University in St. Louis.
Other research has indeed shown that women react to alcohol differently from men in many ways. One of these is that they tend to get intoxicated quicker, even when taking into account the difference in body weight.
According to a report by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), women absorb and metabolize alcohol differently from men. Because they have less body water than men of the same weight, their blood alcohol concentrations are higher after drinking equivalent amounts. While women are less likely to get behind the wheel after drinking, the report said that they have a higher risk of dying in a crash if they do drive.
What’s more, women are more vulnerable to alcohol-related organ damage, trauma and social difficulties. Women who are heavy drinkers tend to develop liver disease more quickly than men, and they may be more vulnerable to alcohol-induced brain damage, according to the report.
There may be other factors that tie in with how alcohol affects women versus men. Women who are alcohol-dependent tend to be using other drugs as well, which could impair their health, according to Carol Boyd, Ph.D., director of the Substance Abuse Research Center and professor of women’s studies at the University of Michigan.
Boyd has conducted studies of college students and their drinking habits and has found that, “When young women drink too much, the consequences are quite notable.” They have more trouble with their grades and miss more classes than their male counterparts, she said. According to the NIAAA report, there is a relationship between how much female college students drink and the incidence of sexual victimization and dating violence.
How much is too much?
Of the estimated 15 million people who abuse alcohol in the United States, nearly one-third of them are women, according to the National Women’s Health Information Center of the U.S. Department of Health and Human Services.
But what constitutes alcohol abuse as opposed to moderate drinking? According to the NIAAA, moderate alcohol use is one drink per day for women, two for men. One drink is equal to a 5-ounce glass of wine, 12 ounces of beer or 1.5 ounces of hard liquor. Boyd, however, has her own rule about how to tell if you’re drinking too much. She calls it the 0-1-2-3 rule and uses it to help women gauge if they’re close to the line of alcohol abuse.
Her 0-1-2-3 rule is this:
- You should not drink if you’re pregnant or have a medical condition that will be made worse by drinking.
- Never have more than one drink an hour.
- Never drink two days in a row.
- Never have more than three drinks in a 24-hour period.
So what about having a glass of wine with dinner every night, which isn’t harmful. There is some leeway in the 0-1-2-3 rule, Boyd says. But because it’s easy for women who drink every day to slip into drinking too much, she advises caution. “If women drink every day, they need to acknowledge it and watch it,” she says.
Women also can ask themselves certain questions to determine if they may have a drinking problem. According to Boyd, if you answer “yes” to two or more of the following, it’s a red flag:
- Have you ever felt you should cut down on your drinking?
- Have people annoyed you by criticizing your drinking?
- Have you ever felt guilty about your drinking?
- Have you ever had an eye-opener, a drink first thing in the morning to steady your nerves?
Other questions might include whether other people have complained about your drinking and whether you have to drink more now than you used to for the same effects. People with more than two positive answers should be prepared to take the next step. “They would need to see somebody about the fact that they possibly have a problem,” says Boyd.