Regardless of gender, excessive alcohol use can have negative health risks and harmful consequences. However, due to a woman’s unique physiological and hormonal variables, women are generally more susceptible to the effects of alcohol than men.1,2
Even though men typically drink more frequently and consume higher amounts, women are more likely to absorb and metabolize alcohol because of the differences in their body structures and chemistry.1 This means the effects of alcohol will usually last longer for women and they are more susceptible to the detrimental health effects associated with alcohol use and alcoholism.1
Learn more about the risks associated with female alcohol use so that you can prevent or minimize the detrimental short- and long-term health risks.
Alcohol Use, Abuse and Alcoholism in Women
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), women are the fastest-growing population of alcohol users in the U.S.3 Furthermore, 13% of females reported binge drinking (meaning they have 4 or more drinks in about 2 hours) around 4 times per month.1,4 While binge drinking doesn’t mean a person has an alcohol use disorder (or AUD, the diagnostic term used to describe alcoholism or alcohol addiction), a woman’s chance of developing one is significantly increased with binge or heavy drinking.5
In 2019, 4% of the overall female population and 8% of women between the ages of 18 and 25 had an AUD.1 The younger a person starts drinking, the more likely they are to become addicted. 5 One survey indicates that 1 in 5 girls and teenagers (aged 12 to 20) report that they’ve had at least 1 drink in the past month.5 Another survey reported that 32% of high school girls consumed alcohol, as compared with 26% of their male peers. Sadly, alcohol abuse is responsible for more than 27,000 deaths in girls and women each year.1
How Does Alcohol Affect Women Differently Than Men?
Women who drink may not be aware that alcohol affects their bodies differently than men and often in more harmful ways. Women are more likely than men to experience long-term negative health effects from excessive alcohol use.1 This occurs for a number of physiological and psychological reasons. For one, their bodies contain less water and more fat than men’s bodies.6 Since fat does not absorb alcohol, women absorb more alcohol pound for pound than men do and end up with a higher blood alcohol concentration (BAC).6
In addition, women’s bodies take a longer time to metabolize alcohol.6 This is due to differences in gastric acid activity and reduced levels of gastric alcohol dehydrogenase—a digestive enzyme that helps to break down alcohol.6 This is why women become intoxicated more quickly after drinking the same amount of alcohol as men.6
Men typically consume alcohol to enhance positive feelings and women more frequently drink in response to negative emotions, anxiety or stress.7,8 In addition to trauma, abuse, social isolation and prolonged stress, negative affect (a state of emotional distress characterized by “bad” feelings such as anxiety, fear, anger, irritability, and sadness) are all predictive of alcohol misuse and associated with increasing rates of alcohol use disorder in women.7,8
Indeed, stress may play a significant role in initiating and maintaining alcohol use in women.9 In one study, women who had two or more past year stressful life events were 4 times more likely to have a new onset AUD, vs. men, who were only 2.5 times more likely to have a new onset AUD.9
Effects of Alcohol Use on Women
In general, for both men and women, chronic drinking carries with it an increased risk of long-term detrimental health effects. However, research has shown that women have a higher chance of developing alcohol-related health issues, both earlier and at lower levels of use than men do.10 Below are some ways in which alcohol use, abuse and alcoholism can affect women’s mental and physical health.
Some studies have suggested that it’s more common for women struggling with alcoholism to experience “increased psychiatric comorbidity,” which means that they have both an addiction and a mental health condition (like anxiety, depression, or bipolar disorder).
Both men and women who abuse alcohol display an increased likelihood of “other substance abuse, antisocial personality disorder, phobic disorder, major depression, panic disorder, and somatization compared with the general population,” according to one study.11 However, 65% of women who abused alcohol were more likely to have these conditions, as opposed to 44% of men who abused alcohol.12
Other studies have also shown that women who abuse alcohol are more likely to suffer from anxiety and depression, but it does not appear that alcohol use always causes these conditions.13 Rather, 66% of women reported they had these disorders prior to developing an alcohol addiction.13 Other studies have noted an association between alcohol abuse and an increased frequency of post-traumatic stress disorder and eating disorders in women.14
Women are more likely than men to suffer from increased physical health concerns when consuming less amounts of alcohol.14 For example, women are more susceptible to liver disease with less alcohol consumption than men, and women have a faster progression to cirrhosis over a shorter time period. According to NIAAA, the death rates of women struggling with alcoholism are 50% to 100% higher than men.15 This includes death not only due to liver disease but also due to suicide, heart disease, accidents attributed to alcohol use, and stroke.15
Additionally, drinking even 1 drink a day is associated with a higher risk of breast cancer.14 Alcohol use may also increase the risk of cancers of the mouth, throat, esophagus, liver, and colon for both sexes. 1,16
Although women and men are both at risk of experiencing neurological problems due to alcohol use, research has shown that women have an increased risk of causing brain damage more quickly from alcoholism than men.10
Reproductive Issues and Pregnancy
Abusing alcohol while pregnant is dangerous for you and your unborn baby.10 In fact, alcohol use during pregnancy is a highly preventable cause of birth defects and developmental disabilities.17
No amount of alcohol use during pregnancy is safe—even moderate drinking is associated with lifelong developmental issues such as problems with learning and behavior.10,18 Women who are pregnant and use alcohol also increase the risk of fetal alcohol syndrome, a harmful condition that affects the developing fetus and can result in a range of negative health effects, such as brain development problems, low birth weight, and abnormal facial features.18
Women may also be more affected by alcohol if they use birth control pills, during menstruation, or when they are ovulating because their slower alcohol metabolism leads to a higher BAC.14 Alcohol abuse may also cause amenorrhea, the lack of menstruation, or anovulation, a lack of ovulation.14 If you are considering fertility treatments, it’s advisable to stop drinking. Studies have found that women who did not abuse alcohol while receiving treatments for fertility had twice the chance of conceiving as women who used alcohol during the treatments.14
Risk Factors that May Contribute to AUD in Women
Many risk factors influence the development of AUD in both men and women such as genetic factors like a family history of alcoholism.19
Another risk factor is how early in life a person starts drinking.20 The risk of developing an AUD at some point in life quadruples for those who start drinking on or before age 14 versus age 18, and the factors motivating a person to start drinking differ based on sex.21 Adolescent boys are more likely to be influenced by risk-taking behaviors and girls more likely to consume alcohol for its anxiety-reducing properties.21
While studies examining risk factors for alcoholism in women have had mixed results, victimization appears to be a significant risk factor.20 Victimization is a broad term used to describe the presence of any abuse in a woman’s life, whether it occurs early in childhood through parental violence or neglect or later on through partner violence, especially as severe physical abuse.20
Other risk factors for increased female alcohol consumption and AUD include:5
- Family members (such as parents or siblings) with drug or alcohol issues.
- A significant other who misuses drugs and/or drinks excessively.
- Building a tolerance and needing more and more of the substance to get the same high.
- A history of depression or childhood sexual or physical abuse.
- Lesbians and bisexual women are at higher risk for drug abuse, binge drinking and heavy drinking compared with other women.
Alcoholism Treatment for Women
While traditional alcoholism treatment doesn’t typically place importance on gender differences that can factor into addiction, some evidence shows that treatment that better supports women struggling with alcoholism may be more effective. The National Institute on Drug Abuse (NIDA) reports that gender-related substance abuse treatment must consider not just biological differences but also social and environmental factors, as women are more likely to suffer from certain life circumstances than men.22
For example, NIDA says that physical and sexual trauma leading to the development of PTSD seems to be more common in substance-abusing women than in men.22 Other co-occurring disorders, such as depression and anxiety, may also be more common in women than in men and should be screened accordingly.23Alcoholism treatment for women should also take into account potentially unique circumstances and issues such as gender roles, economic resources and financial independence, parenting concerns, childcare, and pregnancy.22, 23
Some studies have shown that women-only treatment groups may be beneficial.23 However, therapists should take into account the fact that some women may display hostility toward other women due to gender stereotypes or because “women may see other women as a threat to their relationships and engage in competitive behavior in the group process.”23 More studies are needed to fully confirm the benefits of same-gender treatment, but limited research has shown that most women tend to feel more comfortable talking about certain issues, such as relationships and abuse, with other women than with men.23
The therapist and the environment in which therapy takes place can also affect your success in your treatment journey. This may be because women seem to benefit more from different types of supportive therapy. In addition, it can be helpful if the therapist possess specific characteristics—such as warmth, empathy, and staying connected during treatment difficulties—that can make a difference in how females respond to treatment.23 A supportive, compassionate, and nurturing therapeutic environment is important for women, especially when a therapist takes a more traditional, confrontational approach to treatment.23
The relational model approach is a treatment method that you may wish to ask about should you start considering rehab. This method is based on different factors that seem to play a bigger role in women with addictions, such as cultural concerns and the importance of relationships.23 It emphasizes that women are more likely to place more value on relationships and affiliations with others during treatment than men.
Some women suffer more pain from disconnection and develop more mental health consequences from the lack of connection to others, so building healthy relationships during treatment can be beneficial for your recovery.23 Therefore, it’s beneficial that a counselor remembers the importance of trust and acknowledges that they are often the first person in line to help you build a healthy, trusting relationship in your new clean and sober life.23
Seek Treatment For Alcoholism
If you’re ready to chat with someone today about treatment, American Addiction Centers’ (AAC) admissions navigators are available 24/7 to discuss your options today. As the leader in addiction treatment, AAC specializes in helping people recover from alcohol addiction.
If you are looking for more information about alcohol addiction, our facilities, or want to learn more about what is covered under your insurance, call our hotline 1-888-685-5770 at any time. Our admissions navigators are ready to chat with you about starting your path toward recovery today. All calls are 100% confidential. Or, fill out the form below to instantly verify your insurance for treatment at an AAC facility.
. Centers for Disease Control and Prevention. (2020). Excessive alcohol use is a risk to women’s health.
. National Institute on Alcohol Abuse and Alcoholism. (2020). The Endocrine System and Alcohol Drinking in Females. Alcohol Research: Current Reviews, Vol 40 No 2.
. Alcohol Research: Current Reviews. (2020). Women and alcohol.
. Centers for Disease Control and Prevention. (2019). Binge drinking.
. Office on Women’s Health. (2018). Alcohol use disorder, substance use disorder, and addiction.
. Fama, R., Le Berre, A. P., & Sullivan, E. V. (2020). Alcohol’s unique effects on cognition in women: A 2020 (re)view to envision future research and treatment. Alcohol Research: Current Reviews, 40(2), 03.
. Becker, J.B., Perry, A.N. & Westenbroek, C. (2012). Sex differences in the neural mechanisms mediating addiction: a new synthesis and hypothesis. Biol Sex Differ 3,14.
. National Institute on Alcohol Abuse and Alcoholism. (2020). The Role of Stress, Trauma, and Negative Affect in Alcohol Misuse and Alcohol Use Disorder in Women. Alcohol Research: Current Reviews, Vol 40 No 2.
. MacKenzie R. Peltier, Terril L. Verplaetse, Yann S. Mineur, Ismene L. Petrakis, Kelly P. Cosgrove, et. al. (2019). Sex differences in stress-related alcohol use. Neurobiology of Stress, Volume 10.
. National Institute on Alcohol Abuse and Alcoholism. (2020). Women and alcohol.
. Fein G. (2015). Psychiatric Comorbidity in Alcohol Dependence. Neuropsychology review, 25(4), 456–475.
. Monica L Zilberman, MD, PhD1, Hermano Tavares, MD, PhD1, Sheila B Blume, MD2, Nady el-Guebaly, MD, FRCPC. (2003). Substance Use Disorders: Sex Differences and Psychiatric Comorbidities. Can J Psychiatry, Vol 48, No 1.
. Bradley, K. A., Badrinath, S., Bush, K., Boyd-Wickizer, J., & Anawalt, B. (1998). Medical risks for women who drink alcohol. Journal of General Internal Medicine, 13(9), 627–639.
. Institute of Alcohol Studies. (2017). The effects of alcohol on women.
. National Institute on Alcohol Abuse and Alcoholism. (1990). Alcohol and Women.
. National Institute on Drug Abuse. (2020). Substance use in women research report: Sex and gender differences in substance use.
. National Institute on Alcohol Abuse and Alcoholism. (2020). Maternal Substance Use: Consequences, Identification, and Interventions. Alcohol Research: Current Reviews, Vol 40 No 2.
. American College of Obstetricians and Gynecologists. (2020). FAQs: Alcohol and women.
. Gilbertson, R., Prather, R., & Nixon, S. J. (2008). The role of selected factors in the development and consequences of alcohol dependence. Alcohol Research & Health: The Journal of the National Institute on Alcohol Abuse and Alcoholism, 31(4), 389–399.
. National Institute on Alcohol Abuse and Alcoholism. (1999). Are women more vulnerable to alcohol’s effects?
. National Institute on Alcohol Abuse and Alcoholism. (2020). Sex Differences in the Neurobiology of Alcohol Use Disorder. Alcohol Research: Current Reviews, Vol 40 No 2.
. National Institute on Drug Abuse. (2018). Principles of drug addiction treatment: A research-based guide (third edition): What are the unique needs of women with substance use disorders?
. Center for Substance Abuse Treatment. (2009). Substance abuse treatment: Addressing the specific needs of women. (Treatment Improvement Protocol (TIP) Series, No. 51.) Chapter 7: Substance abuse treatment for women. Substance Abuse and Mental Health Services Administration.