Alcohol. It’s one of the world’s best-loved beverages and favorite mind-altering substances. Humans have been imbibing it for at least 10 millennia – the first booze dating back to 7,000 BCE in China. And we had receptors for metabolizing the stuff before humans even stood up on two legs.
It’s embedded into the social fabrics and religious practices of cultures worldwide, and it’s been used medicinally and even as a beverage when potable water wasn’t available, for example on long sea voyages. We use it to invoke the spirits, to make offerings, and as part of our community and family gatherings, and in daily and bigger life celebrations.
And at the end of a long day or a long week, a relaxing drink can be something to look forward to. And no wonder, it gives us a major dopamine rush – which is why it initially may make us feel good, and also makes us want more.
But does drinking always or even usually leave us feeling great? Are there longer term harms that might outweigh the benefits of that form of immediate relaxation and gratification? After all, globally, alcohol use is the fifth leading risk factor for premature death and disability among people between the ages of 15 and 49, excessive alcohol consumption in the United States between 2011 and 2015 accounted for 93,296 deaths (255 per day) annually, and is the third leading preventable cause of death in the United States.
As we enter the New Year, it’s a super common time to reflect on, consider, and make decisions about which aspects of our lifestyles we want to carry into this next year. It’s also a very common time for folks to take a dry period, especially after the holidays which are commonly a time when we let it all go for a minute!
It’s also a much more important topic than many of us might realize. Alcohol consumption starts young – including amongst our teenage daughters. Research has revealed that 22% of middle school girls and 50% of twelfth grade girls had consumed alcohol within 30 days of having been surveyed. Due to changes in our physiology in menopause, we are not only less tolerant of alcohol, as I’ll discuss more, but we actually want to drink more, are more susceptible to the immediate rewards, but are also more susceptible to negative impacts – and we are more likely to become alcoholic even if we’ve not previously struggled with an alcohol problem. In fact, at all ages, women have a lower overall tolerance of alcohol, are at greater risks from the long-term adverse effects of alcohol,, and have a lower threshold to becoming alcoholics than do men.
Further, a 2015 analysis by scientists at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, found that longstanding gaps between how much men and women drink – and the associated alcohol-related harms – might be narrowing in the United States, with women drinking more days per month than in the past, and the rate was trending up for women while trending down for men, and the pandemic exacerbated this trend – driving a lot of women to drink for stress relief at the end of day.
So is it also possible that something that’s been part of our history for so long, and has been touted to have such health benefits, especially red wine, could be – well – not so good for us? Are there important facts about how alcohol affects women to consider – or reconsider – both generally and uniquely at various stages in our life cycles, from puberty through our 20s to 40s, and in menopause?
That’s exactly what I’ll be exploring with you on this latest episode of On Health, where we’ll talk about the unique effects of alcohol not only directly on women’s hormonal, heart, and bone health, but on our moods, gut health and microbiome, and circadian rhythm – all of which have an impact on our total and hormonal health as well. We’ll talk about how much a drink really is, how alcohol impacts us at different ages, and if you are going to drink, what you can do to minimize the impact and possible damage with types of alcohol, amounts, and just a few specific supplements that have a body of evidence to support in prevention of alcohol-related breast cancer, which we’ll also discuss.
Whether you intend to continue to enjoy your glass of wine to relax each evening, are having a sober curious moment, simply considering or taking a break from drinking right now, or just want to know everything you can to keep your brain, hormones, gut, and heart healthy – this episode will give you food for thought and some important information to consider as you reflect intentionally on whether to include alcohol in your lifestyle at all, and if so, how much is really okay to drink. It is not about judging your choice whatsoever – it’s about helping you find what’s best for you, with the information that can help you answer that question, which may be one that evolves over different phases of your life or based on your unique body and health.
Many of us drink because we like the feeling we get when we’re slightly buzzed – we feel more relaxed, more socially comfortable, even braver, and many of the common troubling daily anxieties most of us know all too well, fall away. But most of us also recognize that we don’t feel that great after a night of drinking. We feel more depressed, foggy, irritable, and often feel puffy and wonder why we drank it! And as we get older – that might mean just a glass of wine.
Unlike in past decades, where pressure to drink in social settings was high, now it’s just as cool to say you’re not drinking, you’re sober curious, or sober if that’s the case for you as it is for so many (and congrats if it is, and hang in there if you’re still struggling – I know so many wonderful people who have crossed that river and are living happily and healthily on the other side). I hope that by the end of this episode you feel empowered to make the most informed decisions about drinking, and that it will give you tools to not feel pressured to drink – ever – if you don’t want to or even if you do want to but know it’s not the best choice for you, and to drink with more control and in ways that protect your health to the best extent possible, if you do.
What is Alcohol?
First, let’s define what alcohol is – and what constitutes a drink – because a pour is not ‘just’ a pour.
When we’re talking about the alcohol we drink as a beverage we’re referring to ethanol (ETOH), a volatile organic liquid, produced by the natural fermentation of sugars. Alcohol is water and fat soluble, and since our cells are water and fat, it is easily absorbed into virtually all the cells in our bodies – and there’s no nicer way to put it but alcohol and its breakdown products act as cellular toxins – including to our brain cells, which not only affects our moods and behaviors (think impulsivity!) but affects our brain’s hormonal signaling – and this is significant – because ovarian, thyroid, and adrenal gland function all start in the brain, in the hypothalamus and pituitary to be exact.
Weirdly, as Andrew Huberman describes it, the feeling of being inebriated is the by-product of being exposed to the poison, acetyl-alcohol, which is the major metabolic product of alcohol breakdown – and because it is able to cross the blood-brain barrier (BBB) and which makes us feel tipsy or drunk – because it affects the areas of the brain, especially the frontal cortex, which is our executive function control center, and with it reducing our social inhibitions – we talk louder, speak more freely without as much thought, or act more impulsively, and also affects our memory storage – so we might not even fully remember what we did or said! And get this – the reduction in our inhibitions may not only lead to impulsive behaviors in the moment, but may increase impulsivity even when we’re not drinking! But we’ll save the brain impacts of alcohol for another episode. Today I want to focus on hormonal impacts and how that affects our menstrual cycles, fertility, menopause, and also how our various lifecycles affect our alcohol intake and tolerance. We’ll also talk about the relationship between alcohol and PCOS, endometriosis, and breast cancer.
How Much is ‘a Drink’
What qualifies as a drink is really important because it’s easy to drink a lot more than you might think you are – a pour and a defined amount are very different – and the effects of alcohol are related to the amount ingested.
In the US, a drink is defined as:
- 12 ounces of beer,
- 5 ounces of wine, or
- 1.5 ounces of hard liquor
Any of these in the US delivers about 14 g of alcohol per serving. This varies per country based on different concentrations of alcohols in different drinks, and the sizes of the pour. So for example, a beer has slightly less alcohol in Japan, whereas hard alcohol can be significantly higher in Russia, according to studies that compare alcohol amounts and concentrations.
Women and men metabolize alcohol at different rates, so If you give a woman and a man of the same weight, the same amount of alcohol over the same stretch of time, the woman will have a higher blood alcohol concentration. Women also eliminate alcohol more slowly than men. The physiologic differences, among others that we’ll discuss, contribute to women’s higher susceptibility to alcohol-related liver and heart disease, and negative impacts on not just mood, but brain health.
Because of our different metabolism and risks, established recommended upper limits of alcohol intake are lower for women than men.
- Moderate drinking is defined as ≤1 drink per day (
- Binge drinking = / > 4 drinks any one time
- Heavy drinking: >3 drinks per day or >7 drinks per week
For many women alcohol, even in a moderate amount or less, may be too much. And as you’ll soon learn, at various phases in our lives, we have different tolerance, and certain ethnic groups, for example Asians and Ashkenazi Jews, have genetic polymorphisms that profoundly reduce alcohol tolerance so that even a little feels like a lot.
Further, women are more likely to be on the Pill, HRT, antidepressants, anti-anxiety and other medications which have not been adequately factored into the already very limited studies that have been done on women and alcohol.
Isn’t Drinking in Moderation Good For You?
In her book, Food Politics: How the Food Industry Influences Nutrition and Health, Marion Nestle, Phd, former Senior Nutrition Policy Advisor in the US Department of Health and Human Services, laid out just how we’ve been sold a bill of goods that alcohol is ‘good for us’ since the 1990s – the French Paradox.
The French Paradox is the idea that people in cultures where wine is taken daily with meals live longer. While yes, there are cultures in which alcohol consumption is part of daily life, and people live well even into their 90s. But the common denominator is not the alcohol – it’s a complex set of factors including diet, community, daily walking, specific anti-aging polyphenols people are ingesting in their foods and beverages (for example, the milk from animals grazing on fields rich in specific plants), and more.
In fact, the French Paradox became the justification for massive branding campaigns used by the alcohol industry in the US to revitalize wine sales – which it robustly did, along with sales of fois gras! And even while prominent nutritionists like Marion Nestle called the French paradox out as a hoax, the concept of red wine being good for us stuck and has persisted.
What’s truly astonishing is that alcohol intake has been subjected to only two randomized trials one year or longer in length so our understanding of its health effects remains incredibly limited. A safe amount has not been established – and there’s no ‘healthy’ amount – it’s a luxury, not part of a healthy diet or lifestyle – and in fact, some experts challenge the view that there is a safe dose of alcohol at all, and suggest complete abstinence or optimal health.
Are there any positive effects of alcohol? There are some studies that suggest that in small amounts in menopause there may be some advantages for bone health and also insulin sensitivity, as I’ll discuss, but as you’ll learn this data is counterbalanced by data on harms. What about Resveratrol? Resveratrol is a polyphenol that is found in red wine that may act an antioxidant and cellular protectant – but even if it is beneficial, which is questionable based on the research, less harmful and actually healthful sources include grapes, peanuts, cocoa, and blueberries, bilberries, and cranberries – or in supplement form.
But that still doesn’t mean it’s healthful, especially as a regular weekly thing. There is literally no study that can prove that drinking in any amount is more healthful than not drinking at all, and for women, having even just 1-3 drinks per week, and when I say drinks I mean in the measured amounts I’ve told you, has been implicated in some specific risks which I’ll talk about.
For example, according to a recent study published in the journal Nature Communications, even moderate chronic alcohol intake, that is 1-2 drinks per day regularly, can cause adverse changes in brain structure and connectivity. These findings are consistent with research on early middle-aged adult moderate drinkers that showed smaller brain volumes associated with moderate alcohol consumption in men and women. And studies have shown even drinking just 1-3 drinks per week does increase women’s breast cancer risk.
Overall, good quality research on women, alcohol, hormones, and health is scant. Where we do have data, it’s wildly contradictory due to study sizes, study quality, and whether women’s hormones or cycle phase were adequately assessed. We have to extrapolate from what we know from the research that does exist, and use this in conjunction with our own inner awareness asking ourselves, honestly, how does it really make you feel? Is it worth it? And we need to be at least knowledgeable about potentially hidden harms, so we can make the best choices for ourselves.
That all said, for most healthy women with low risk for the problems alcohol is most likely to contribute to or cause, 1 to 2 drinks per week, in the pour sizes I’ve discussed, is probably not a problem. And if you’re wondering, I have a drink once in a while, rarely more than once in a month, not so much because I know the data – but because drinking makes me feel truly terrible, probably based on my own ethnic background and also now being in menopause.
Alcohol and Hormones
So let’s talk first about alcohol and our hormones. The hormones I’ll focus on today are estrogen, progesterone, and testosterone. I’ll also touch on cortisol and insulin because they strongly influence our well-being and impact our overall female hormone production and levels.
Hormones are chemical messengers that control and coordinate the functions of all tissues and organs. Each hormone is secreted from a particular gland and distributed throughout the body to act on tissues at different sites. Two areas of the brain, the hypothalamus and the pituitary, release hormones, as do glands in other parts of the body, such as the thyroid, adrenal glands, ovaries, and pancreas.
The proper functioning of most of our body systems relies on the finely tuned release of hormones, in the proper amounts, and the health of the cells that receive the hormones so the chemical signaling can trigger the functions those hormones and cells are responsible for, which in the big picture includes the production and use of energy, growth and reproduction, bone , brain, and heart health, weight and metabolism, and more.
Alcohol has been shown to alter and impair the functions of the hormone-releasing glands as well as that of the target tissues. Animal studies have shown that acute alcohol administration affects the release of hormones from the hypothalamus and pituitary. Several studies point to an alcohol-induced rise in natural and also synthetic estrogen levels in women, likely due to an increased rate of aromatization of testosterone or a decreased rate of oxidation of estradiol to estrone. This increase in estrogen is more pronounced in women on synthetic hormones (oral contraceptives, including progestin-based forms, and menopausal replacement therapy, or MRT) and in menopausal women. Moderate alcohol consumption has also been linked, in some studies, to decreased progesterone levels in pre-menopausal women and to increases in DHEA-S and testosterone levels.
We also have to take the impact of alcohol on our inner ecosystem into account – because our hormonal health doesn’t occur solely in the HPO (hypothalamic-pituitary-ovarian) axis – our gut, circadian rhythm, metabolic, and hepatic detoxification pathways are also involved in our hormone health and levels, our menstrual cycle regularity, our ease through menopause, and in the underlying contributing factors to PCOS, fertility challenges, endometriosis, and more.
Alcohol is also a known circadian rhythm disruptor. Your circadian rhythm, which I talk about extensively in my books Hormone Intelligence and The Adrenal Thyroid Revolution, is a centrally controlled time-keeping system located in the suprachiasmatic nucleus (SCN) of the hypothalamus that synchronizes biological rhythms in response to external cues, such as daylight, and converts these cues into neuronal and hormonal signals that affect the entire body’s physiological and metabolic processes including the flow of our hormonal activities – like when we ovulate, menstruate, produce and utilize estrogen, progesterone, insulin, cortisol, etc.
Acute drinking – even just a glass of wine for some women – can act as a significant enough circadian rhythm disruptor to noticeably affect a good night’s sleep as can chronic (regular) moderate drinking. Even having just a couple of drinks raises cortisol levels within a few hours. Heavy drinking and binge drinking can all throw your circadian rhythm into chaos. So one of my first recommendations in my medical practice for women struggling with sleep challenges? Ditch the alcohol. And interestingly, red wine seems to come up as one of the biggest culprits in sleep disturbance.
Alcohol affects our gut health in numerous ways and as I also talk about in Hormone Intelligence, and in other podcast episodes, your microbiome powerfully influences your hormone health. Alcohol induces changes in the composition and functioning of the gastrointestinal microbiota and also causes intestinal hyperpermeability (leaky gut), which can cause chronic, systemic inflammation. Both dysbiosis and leaky gut have been implicated as possible underlying or contributing causes of polycystic ovary syndrome (PCOS), endometriosis, depression and anxiety, sleep problems, metabolic syndrome, diabetes, cardiovascular disease, and dementia. Alcohol also negatively affects liver function which leads to disruption in the breakdown and elimination of estrogen, one of the main reasons that studies show that moderate to heavier drinking plays a major role in elevated estrogen levels.
Alcohol is also pro-inflammatory, both through its direct toxicity to the cells leading to oxidative stress, through inflammatory reactions in the liver, and through it causing leaky gut. Inflammation is an underlying cause or contributing factor – in many hormonal problems: menstrual pain, depression, anxiety, PMS, endometriosis, PCOS, infertility, menopausal symptoms, diabetes, heart disease, and dementia.
Both hypoglycemia (low blood sugar) and hyperglycemia (elevated blood sugar) are associated with not just hormonal problems like anovulation, fertility problems, and PCOS, but also anxiety, depression, diabetes, heart disease, and dementia. Alcohol has a complex relationship with blood sugar and insulin. On the one hand, several studies have looked at the impact of alcohol intake on blood sugar balance and interestingly, light to moderate drinking has been found to have antihyperglycemic – or blood sugar lowering – effects. For example, an Israeli study found that one glass of wine per day (red or white) reduced fasting blood sugar by almost 20 mg/dL. A 2005 meta-analysis of 15 cohort studies also found a decreased risk for diabetes among light to moderate drinkers and a meta-analysis of 14 studies also found that in nondiabetic patients, compared with controls, alcohol consumption was associated with reduced hemoglobin A1c and fasting insulin concentrations in women, but not consistently. A randomized crossover trial in 51 postmenopausal females found that, compared with no alcohol consumption, 30 grams of alcohol per day (two drinks) for eight weeks lowered serum insulin levels while leaving glucose levels unchanged and thus improved insulin sensitivity. Triglyceride levels also decreased.
Clinical trials have shown that light to moderate drinking is associated with higher adiponectin levels, a fat cell hormone which directly improves insulin sensitivity. However, this data doesn’t take demographics into account, and interestingly, most light to moderate wine consumers are also of a higher socioeconomic status with greater access to better health care, healthy food, less stress, and are more likely to exercise regularly.
But the effects of alcohol intake on blood sugar aren’t all good – the brain depends on glucose for energy, and interferes with the brain getting adequate amounts of energy both immediately after moderate and binge drinking. Even brief periods of low glucose levels (hypoglycemia) can damage the brain. Severe hypoglycemia can occur in just 6 to 36 hours after binge drinking. Drinking without eating further aggravates this, but even in well-nourished people, alcohol can disrupt blood sugar levels. Conversely, chronic heavy drinking is a direct risk factor for developing diabetes, because it leads to hyperglycemia, or excessively elevated blood sugar.
Alcohol is also an ‘antinutrient’ meaning that it not only provides no nutrition, it uses up important nutrients like B-vitamins, and detoxification chemicals, like NAC, in the process of mopping up of alcohol-induced cellular toxicity. This happens with any amount of drinking to some extent, and more with regular or heavy drinking, and binge drinking.
Alcohol has multiple effects on the hypothalamic-pituitary-thyroid axis as well as functioning of the thyroid gland. In alcoholics, significant suppression of T4 and T3 have been found, likely due to liver damage, as T4 is converted to T3 in the liver, as well as due to direct damage to the thyroid gland where T4 is produced, as is T3 to a lesser extent. It’s unclear how much the thyroid is impacted by moderate alcohol intake or binge drinking, and I was unable to find studies on this generally, or in women.
The data is really tricky, even as an MD deeply trained in reading and analyzing research papers; the conflicting information is enough to make me have to read and reread multiple times just to make sense of it. Just how much we have to drink to impair our cellular function and microbiome is complex – and just how much and in which direction (increased or decreased) various hormones are impacted gets very complex.
Why is the data so variable? There are a number of reasons. One, it’s difficult to compare alcohol amounts with studies done in different countries, or with a wide variety of beverages, some of which may also be reported in grams, and other simply in number of drinks per week. Secondly, many of the study conditions don’t match real-life conditions – in many studies women are asked to drink far more than most women typically do in one setting, over an extended period of time (i.e. 2-3 glasses/night) often above upper limit recommended amounts per day or week, and women are often asked to fast overnight for example, before or after drinking.
Also, it’s really important to emphasize that slight shifts in hormone levels, even if these are occurring, do not represent the complexity of what is happening in the HPO axis, and that these hormone shifts also do not necessarily represent clinically relevant meaning. That means we can have small shifts in our hormone levels – we do all the time – but that doesn’t necessarily translate to hormonal or gynecologic conditions, or even symptoms.
I’m going to break all of this down by life cycles, which generally coincides with similar age ranges for females, and within these life cycles, address impact by amount of alcohol intake when that data is available. All the while, I’ll be giving you my interpretation of what to do with all of this information to make the best decisions for yourself.
Alcohol and Puberty
Little research on the physiological effects of alcohol consumption during puberty has focused on human females. Studies done on teens and young women show that moderate to heavy drinking, and binge drinking, can interfere with the onset of puberty, and also with the establishment of menstrual cycle regularity, and consequently, bone development and growth – with the growth spurt being interfered with. This may be due to early interference with the pulsatile secretion of hypothalamic gonadotropin-releasing hormone (GnRH) which comes on board during puberty and stimulates the synthesis and release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) by the pituitary gland, and or it may have to do with the impact of alcohol on glucose, though the mechanisms are not fully worked out. One study found that estrogen levels were depressed among adolescent girls ages 12 to 18 for as long as 2 weeks after drinking moderately .
Also, estrogen’s role in bone maturation raises the question of whether alcohol use during adolescence has long-term effects on bone health. Alcohol consumption in adolescence and the teen years is known to affect growth and body composition, possibly due to changing food intake patterns during times of alcohol consumption.
Alcohol and Your Menstrual Cycles
As a quick reminder, we begin to menstruate between 10 and 16 years old, with most of us beginning between 12 and 14. The menstrual cycle occurs about every 24–35 days in otherwise healthy women in our reproductive years. It has two main phases: follicular and luteal. The follicular phase begins with the first day of the period (day 1 of the menstrual cycle) and ends with ovulation. The follicular phase is characterized by relatively steady levels of ovarian estrogen, with an increase in estrogen just before ovulation, when an ovum is released. The luteal phase, which is typically 14 give or take 2 days long, follows ovulation and is characterized by rising progesterone and estrogen levels and progesterone dominance.
In females, alcohol use, even in amounts insufficient to cause major organ damage, may disrupt the delicate balance necessary for maintaining healthy hormonal cycles, Alcohol use in premenopausal women, even in moderate amounts, has been linked in some studies to irregular menstrual cycles, anovulation, early menopause, and early onset of hot flashes before menopause, with 60% of heavy drinkers experiencing some menstrual cycle disruption, but even up to 50% of moderate or social drinkers having disturbances in their reproductive hormones and menstrual cycle compared to occasional drinkers.
However, the data on how much alcohol intake specifically causes what hormone imbalances is wildly variable and inconsistent and some studies, particularly with light to moderate alcohol intake, show no shifts in FSH, LH, estrogen, progesterone, testosterone, or menstrual cycle length or regularity or into changes in our menstrual cycle health, length, or ovulation.
For example, one major study involving pre-menopausal women looked at 34 women across six consecutive menstrual cycles. They were randomized to two groups, and a cross-over design was used. The women drank 30 g of ethanol each evening for three consecutive cycles and no alcohol for the other three. All food and alcohol were provided by the study. Blood work showed that alcohol consumption was associated with a rise in the levels of plasma DHEA-S during the follicular phase; estrone, estradiol and urinary estradiol around ovulation, and urinary estrone, estradiol and estriol in the luteal phase.
In another study, estradiol levels were measured twice in women over a 12-month span of time. Women with consistently high serum estradiol levels also had higher alcohol intake (~ 93 g/week ), whereas women whose intake was about one-third of this had lower serum estradiol levels.
Similar findings were not replicated in another study in which no variations in estrogen levels were found, though drinking pattern was less clear and the average amount women drank was < 51 g of alcohol per week, which is consistent with other studies that have shown increases in estrogen levels with more moderate drinking only, and more significantly with heavy alcohol intake.
One study also found higher levels of alcohol-induced estrogen elevation in women on oral contraceptives, again thought to be due to alcohol’s impact on hepatic metabolism of estrogen, but also possibly due to an enzyme that is induced by the synthetic progestins contained within some oral contraceptives.
Is there a better or worse time to drink during our menstrual cycles? To date, there is no strong evidence that women’s physiologic response to alcohol intake varies across the menstrual cycle, nor is there evidence that we want to drink more or less at different phases of the menstrual cycle – but again – the data is very limited.
One report states that women may eliminate alcohol more rapidly and also achieve a slightly lower mean BAL (blood alcohol level) during the luteal phase, possibly due to slower gastrointestinal transit time during this phase, leading to slower alcohol absorption. Yet another study suggested that the effect of alcohol on reproductive hormone levels may be most evident in situations where gonadotropin levels are high, namely around the midpoint of the menstrual cycle, and that the alcohol-induced rises in estrogen are due to increased enzymatic breakdown of alcohol in the liver which leads to accumulation of estradiol.
Based on a review of menstruation and 40 years of literature, done in 2016, what’s really interesting that the authors conclude that of the limited number of studies that exist on whether we tend to drink differently across our menstrual cycles (i.e. more or less premenstrually or during other phases), the answer remains unclear, at least statistically. Some studies suggest we’re more inclined to drink premenstrually which I think is what most of us would intuitively expect – but other studies show no change or even a decreased alcohol intake premenstrually.
It would truly take days to review the literature and data with you – and even if I did, we’d still be left scratching our heads as to what’s really happening – but suffice it to say, with moderate, binge, and heavy drinking – something’s going on and it’s generally not good for us. So what’s my summary?
We need to start educating our daughters at a young age on the potential long-term consequences of moderate, heavy, and binge-drinking, and if they are going to drink, teach them how to drink responsibly and more safely and protectively for their health. This is commonly done in European countries, along with better practices on safe sex. Early education has much more successful outcomes than our ‘pretend it’s not happening’ approach here in the US.
The research data suggests that there’s no need to modify your drinking habits based on where you are in your menstrual cycle, provided that you're drinking lightly to moderately. You personally may notice some variations across your cycle – you may notice that PMS symptoms create the desire to have a drink to relax, or that your mood or sleep is more affected by alcohol premenstrually, especially if you have PMS. Of course, let those symptoms be your guide as well.
And overall, when it comes to menstrual cycle regularity, ovulation,, and menstrual health, 1-3 drinks/week is probably not going to affect your hormone balance or menstrual cycle health at all. However, I do still consider this on the high side for drinking, recommend all women who drink to make sure you’re getting a multivitamin with folic acid or methylfolate to protect against alcohol-induced DNA and methylation changes, and if you do have menstrual problems – PMS, painful periods, sleep problems, gut problems etc, keep in mind that abstaining remains your best bet.
Okay, that’s a lot to think about so far. Stay tuned for the next episode where I cover alcohol and all things women’s conditions: fertility, PCOS, endometriosis, what to know about alcohol in menopause, alcohol and breast cancer risk, and how to drink more protectively if you do choose to enjoy this ancient beverage in your modern life.
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