How Does Consumption of Alcoholic Beverages Impact Women?

Gone are those days when you would think excessive alcohol drinking was a man’s problem. The shift in excessive alcohol drinking patterns among women is on the rise particularly in younger age groups. Findings from the 2015 National Survey on Drug Use and Health estimated that about 5.3 million women suffer from Alcohol Use Disorder (AUD).
Women tolerate alcohol differently than men. Do you know why? Perhaps this may be since women have a lower body weight than men, less body water and higher percentage of body fat. In addition, women metabolize alcohol at a slower rate than men, so alcohol may remain in their tissues longer (1). There is evidence from studies that for equivalent doses of alcohol, women are more vulnerable than men to tissue damage and the onset of certain diseases such as cirrhosis of the liver and physical alcohol dependence (2). Heavier alcohol use by women is also thought to increase risk of bone fracture and osteoporosis (3). Furthermore, women can be more vulnerable to physical risks through violence or abuse when intoxicated (4).

But the harms done to women by alcohol are many, and most do not seem to know. You will be surprised to learn this. Consumption of alcoholic beverages is now recognized as a known human carcinogen. This is stated in the Report on Carcinogens by the National Toxicology Program of the US Department of Health and Human Services.

What is more alarming is the fact that alcohol is a risk factor for breast cancer in women. It is estimated that about 2.1 to 4.0% of breast cancers are primarily due to alcohol consumption accounting for 9000–23,000 new invasive breast cancer cases each year. Studies suggest a 7–10% increase in risk for each 10 g (~1 drink) alcohol consumed daily by adult women. And the risk increases for every additional drink they have per day. This raises a clinical and public health concern because nearly half of women of child-bearing age drink alcohol and 15% of drinkers at this age have four or more drinks at a time.

Do Women need to be informed about the association of Alcohol and breast cancer? Definitely? What can be done? Some strategies to consider: – Use mass media advertising campaigns involving television, billboard displays and Transit advertising on modes of public transportation or in public transportation areas), social media platforms to disseminate this information.

Image source: CDC

These can aim at reduction of alcohol consumption in women, influence risk perceptions of women on alcohol consumption and increase their level of awareness on Alcohol as a risk factor for breast cancer.

Another strategy- Make the women aware through their Family Physicians. Family Physicians could screen female patients and provide behavioral counseling and make them aware of association of alcohol with breast cancer. How about using cancer centers to do some outreach to the community? Appropriate staff in these centers could post position papers in peer reviewed journals on how alcohol affects risk of cancer in women.

Yet another strategy would be to have warning labels on alcohol bottles, however this is not easy as it seems, and this is some food for thought I suppose.


1. Plant M. Women and Alcohol: contemporary and historical perspectives. London: Free Association Books, 1997.
2. Kalant H. Absorption, diffusion, distribution and elimination of ethanol: effects on biological membranes. In: Kissin B, Begleiter H, eds. The biology of Alcohol ism, vol 1. Biochemistry. New York: Plenum Press, 1971.
3. Baron JA, Bahman YF, Weiderpass E, et al. Cigarette smoking, Alcohol consumption and risk of hip fracture in women. Arch Int Med 2001; 161:983 ± 90.
4. Jacobs J. The links between substance misuse and domestic violence: current knowledge and debates. London: Alcohol Concern and ISDD, 1998.

My Thoughts on Why Women Drink & Drunkorexia

Alcohol use among women has been increasing at an alarming rate. In fact, according to the JAMA Psychiatry article published in September 2017, there was a 34% increase in high-risk women drinkers and alcohol use disorder (AUD) from 2002 to 2013 compared to a 13% increase in men. This demonstrates that alcohol use among women is a growing public health issue that needs to be addressed. However, with the media, marketing strategies employed by alcohol companies and the normalization of alcohol in our society, addressing this issue is becoming increasingly harder to do.

There are several ways that women are targeted by both the media and marketing strategies which appeal to them to drink. One of the best-known examples of this is the wine company, “MommyJuice”. The marketing strategy behind this brand is that it is stressful to be a mother – to juggle taking care of yourself, your kids, and work – and that even moms need a way to unwind. And what a better way to de-stress than with a glass of MommyJuice? While moms do work incredibly hard (and absolutely need to take time for themselves), is encouraging them to relax with alcohol the best way? Especially when it’s branded in such an insidious way, it appears to be taking advantage of women and their situations.

It is common for kids to have playdates, and while the kids are playing so are the parents who use this as an excuse to socialize and drink. There are potential consequences that can result from an afternoon of drinking such as the safety of both the adults and children and the normalization of alcohol. After the play date, the mom might have to drive herself and her children home. If her inhibitions are impaired from the “mommyjuice”, the potential for car accidents increases. The act of moms drinking during a child’s playdate can also normalize alcohol for the child. If they are constantly around it as a child because their parents drink in front of them, they may be more likely to drink in adolescence and adulthood.

Another example is the Skinnygirl Cocktail line, with the advertising campaign of “Drink Like a Lady.” The marketing strategy here is that women can still drink but without the worry of extra calories. This will appeal to women because of the societal norms regarding appearance. The other day I saw an advertisement for spiked sparkling water – with only 100 calories, the can reads. I was shocked that an innocent beverage such as sparkling water now needs to be spiked to be enjoyed. Even beer companies have been marketing low-calorie options for women. The reaction the alcohol industry is hoping to elicit from women is, “What’s better than being able to indulge in an alcoholic beverage without the guilt from the empty calories that come with it?” The way these brands are being marketed towards women, many of whom are susceptible to succumbing to them because they address issues that affect women, is manipulative.  A quick google search for “low-calorie alcohol” will bring up several articles with suggestions on how to select drinks that will still get you drunk minus the extra calories. Other websites like beer100 offer charts with the caloric content of the different brands of beer. This information is easily accessible, and if the internet says it works, then people believe it.

This leads me into another drinking phenomenon to which I was completely unaware of until recently: Drunkorexia. The name is what it implies; it is a pattern of starvation, excessive exercise or binging and purging in order to consume multiple drinks. This pattern is often seen in women who are concerned about their calorie consumption and body image. Because there is no food in their system, the individual is more susceptible to the effects of alcohol. They will become drunk quicker and are at a higher risk of passing out and of alcohol poisoning. From basic human anatomy differences between women and men, we know that women are more vulnerable to alcohol’s effects. Women tend to have a higher body fat percentage and less body water. Because there is less water in body fat, alcohol is diluted in the blood at a slower rate. Women also have a lower level of alcohol dehydrogenase, which is an enzyme that assists in metabolizing and eliminating alcohol from the body. The bottom line is that women suffer from the effects of alcohol more than men, especially if they are drinking spirits in order to avoid extra calories.

In addition to alcohol companies marketing their products specifically to women, there are several other consumer products that use this as a way to sell products while contributing to the pattern of women and drinking. For example, wine glasses are sold with the mottos “MommyJuice” or “Surviving motherhood one glass at a time” written on them. Cup towels, aprons, magnets, and several other similar products are sold which perpetrate this increasing trend of women who drink. These novelty items are given as gifts, oftentimes as a joke, but they still carry that message that drinking for women is a necessity to cope with the stressors of daily life.


I understand that some people don’t necessarily see this as a problem – they think these products are funny and is meant to be taken as a light-hearted joke or that indulging in alcohol isn’t the worst thing they could be doing – but if they take the time to look at the national trend in high-risk drinking and AUD mentioned earlier, I would hope that they would change their minds. Alcohol companies have noticed this upward trend in the number of women who drink, and are using that information to exacerbate a public health issue. Because drinking is so normalized and engrained within our culture, it is not viewed as a problem and the alcohol industry, unfortunately, takes advantage of this. 

Alcohol and Women: What You Should Know

If you’re reading this, you’re probably familiar with alcohol. Maybe you drink it occasionally, maybe you drink it often. Maybe you’ve never tasted it. The bottom line is, most people are familiar with the substance and to some degree, it’s effects. But if you’re female, you may be surprised to learn that the relationship between alcohol and women has a rocky past—and it is continuing to worsen. Not only do women metabolize alcohol differently than men, but we’re targeted differently, we drink differently, and we now abuse it differently than men.

Women’s prevalence of alcohol abuse has increased at a faster rate than men’s in recent years.

According to a study featured in JAMA, the amount of women reporting alcohol use disorders increased heavily within a period of ten years. From 2001/2002 to 2012/2013, men’s prevalence of alcohol use disorders increased by 13.2%. During the same time frame, women’s prevalence of alcohol use disorders increased by 34.7%.

Reprinted from “Prevalence of 12-Month Alcohol Use, High Risk Drinking, and DSM-IV Alcohol Use Disorder in the United States, 2001-2002 to 2012-2013,” by Bridget F. Grante, S. Patricia Chou, Tulshi D. Saha, et al, 2017, JAMA Psychiatry, 74, p. 911-923.

The difference is staggering. What happened to the culture of drinking among women to cause such an increase? Perhaps the recent uptick in alcohol marketing to females can offer some explanation.

In recent years, women have been specifically targeted by alcohol companies as the ideal consumer.

Doug Beatty, Vice President of Marketing for Colio Estate Wines, explains that “eighty-five percent of the purchase decisions in the twelve- to fifteen- dollar range are ‘female-driven’.” Colio Estates produces a wine called ‘Girls Night Out’ that is marketed to, and made for, women specifically. A quick visit to their website and you can see why women may choose this when making a grocery run: wines such as Red Velvet Cheesecake Macaron, Raspberry Rosé Lemonade, and Pineapple Mango Tango are just a few of their flavored options.

Beatty’s female-focused products are not alone in the market. In recent years, the alcohol market has been inundated with products that target women and feature, promote, or encourage drinking in some way. Of course, these products by themselves are not the sole issue. But combine them with the chemical differences in the way women metabolize alcohol, and we begin to understand why women’s relationship with alcohol is worsening.

Women are biologically different than men, and therefore metabolize alcohol differently.

It is no secret that men and women are biologically different. However, what may be less known is that our sexes also differ in how alcohol is metabolized in our bodies. According to a publication from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), women’s higher liver volume lends to a quicker metabolism of alcohol, as alcohol is processed almost entirely in the liver. Consequently, women typically achieve higher concentrations of alcohol in the blood after drinking equal amounts of alcohol as her male counterpart. Women also suffer from liver disease after a shorter period of exposure and after consuming less.

And lastly, women drink for different reasons than men.

In Dr. George F. Koob’s presentation on Alcohol and the Female Brain, the Director of the NIAAA explains that women drink based on negative reinforcement whereas men drink for positive reinforcement. A seemingly small distinction, the reality is actually stark. What this really means is that while John may drink to have a good time, Jane is most likely drinking to quiet her anxiety, her depression, or even just take the edge off of a bad day. When alcohol becomes the answer to a problem, that is when the true problem takes shape.

Overall, alcohol use can hurt people of all shapes, sizes, races and ages. However, we need to begin having conversations around why the landscape is changing for women—and what we can do to prevent it.

Women and Drinking: The Memes & Some Solutions

The Memes related to women and drinking – are they tapping into the motivation to drink, the negative reinforcement?

Alcoholism, also called dependence on alcohol, is a chronic relapsing disorder that is progressive and has serious detrimental health outcomes. The development of alcoholism is characterized by frequent episodes of intoxication, preoccupation with alcohol, use of alcohol despite adverse consequences, compulsion to seek and consume alcohol and emergence of a negative emotional state in the absence of the drug.

Reinforcement is a process in which a response or behavior is strengthened based on previous experiences. In negative reinforcement, a response or behavior is strengthened by stopping, removing, or avoiding a negative outcome or aversive stimulus. Memes like “shout out to the liver for handling what the heart cannot” or “if you combine wine and dinner the new word is winner” and a text reading “according to chemistry, alcohol is a solution” are tapping into the motivation to drink. Although they are funny sometime, they are also insidious, since they get inside our head and make us want to drink. Experts says that such memes create a strong effect on the mind of an individual as they encourage excessive drinking and promote alcohol as a solution to problems and are portrayed as a way of ‘’escaping reality”. So, people keep drinking for longer periods of time. Researchers also suggest that such memes encourage unwise drinking and trivialize alcohol addiction.



But, there are some methods by which one can stay sober despite all the pervasive messages and drinking environments. The first is the Dory method in which you can remember the top ten ‘bad drinking memories’ where you place them in the back pocket and whip them out whenever you find yourself romanticizing alcohol. One study found that even if you don’t have a time for long work out sessions, just 10 minutes may reduce or eliminate a booze craving for alcohol drinking.


There is also motivational model of alcohol use which suggest that individual differences in sensitivity to the acute subjective effects of alcohol, which may serve as a mechanism underlying alcohol reinforcement and the motivation to consume more alcohol during a drinking episode. The results demonstrate that drinking motives are linked with individual differences in sensitivity to the effects of alcohol, which may serve as a mechanism underlying alcohol reinforcement and the motivation to consume more alcohol during a drinking episode.

Women’s bodies also react differently to the alcohol than men’s bodies. That means women face particular health risks from alcohol.According to one study problems with alcohol increased by nearly 50 percent. Among women, alcohol abuse and dependence increased by 83.7 percent. Among the poor it rose by 65.9 percent. because of the increased drinking among women the prevalence of fetal alcohol syndrome (FAS) in the united states also raised. It was observed to be between 0.5 and 3.0 cases per 1000 by the institute of medicine in 1996 but more recent reports from specific U.S. sites report the prevalence of FAS to be 2 to 7 cases per 1,000 and the prevalence of Fetal alcohol spectrum disorder (FASD) to be as high as 20 to 50 cases per 1,000.





The Biological Differences in How Women and Men Experience Alcohol Use

New research has shown that men and women experience drinking alcohol differently. These findings are a reason to pause and reflect on our drinking habits and norms and to ask ourselves why we drink, how much do we drink and when are we drinking the most. Additionally, advertising firms are quick to exploit our weaknesses in pursuit of profit. There is a surprising parallel between the sharp increase in women’s alcohol use (especially high-risk drinking) and the rise of Skinny Girl brand and Mommy’s Night Out wines and others that are specifically targeting the female drinker [1]. While the occasional drink imbibed responsibly in a social environment is not the target of this blog, it might surprise you to learn of the following biological differences of alcohol use among men and women that could be contributing to potentially harmful drinking-related outcomes.

  1. Women and men drink for different reasons.

Depression and other poor mental health outcomes have long been linked to alcohol use and substance abuse[2]. New research suggests that a driving factor for women to consume alcohol is a negative reinforcement where women are trying to hide or mask an underlying stressor. There is a body of evidence that posits that adolescent girls are twice as more likely as their adolescent boy counterparts to experience depression. Adolescent girls who experience stress-related activities might be more likely to turn to alcohol and drugs in early adulthood to cope[3]. Other research has shown that the association between substance abuse and depression is more pronounced in adolescent girls than adolescent boys [4]. While the exact interaction between women’s mental health and alcohol use is still being explored, evidence suggests that women are more likely to drink if they experience some combination of depression, stress and or anxiety or sexual trauma or sexual abuse [5, 6]. These are examples of negative reinforcement, and they are the primary drivers motivating women to drink.  While men, on average, are more likely to be motivated to drink associated with higher thrill-seeking behaviors, lower inhibitions, and other behaviors that can be categorized as positive reinforcements.

  1. Women and men react differently to alcohol consumption.

On average, men tend to have lower levels of reaction to alcohol consumption compared to women. Studies on women and men’s alcohol behavior suggestion that since men tend to exhibit low alcohol reactivity that they may consume more alcohol to feel its effects and gradually this behavior, if sustained can lead to a higher tolerance and possibly dependence [6].  Women appear to react much quicker to the effects of alcohol. Also, studies comparing the effects of drinking in women and men found that women display greater deficiencies in motor and cognitive skills compared to men when both the women and men had the same amount to drink. This same study also showed that as the participant’s continued to drink over several days that the men developed a tolerance and reacted less strongly to the alcohol whereas the women’s negative reaction and increased sensitivity to alcohol became even more pronounced [7]. 

  1. Women face higher alcohol-related health risks than men.

Women who consume more than one alcoholic beverage a day are at risk for numerous health issues compared to men whose drinking patterns exceed moderate levels. For example, when compared to men, women are more likely to have inflamed livers, have increased risk of heart disease, and have an increased risk of breast cancer. Additionally, while there are several differing opinions and advice on how much alcohol a woman should consume when pregnant, the ruling advice is for pregnant women to avoid alcohol entirely while pregnant or even if they suspect they are pregnant to protect the developing fetus. Some of the biological reasons that women experience more significant health risks than men are due to the fact that on average, women’s body weight is lower compared to men, pound for pound women’s bodies contain less water than men, so women’s blood alcohol level is affected quicker, and estrogen levels influence how women’s livers process alcohol differently than men [8].  

In the US and many other countries around the world, it is the social and cultural norm to drink especially at certain functions or social events like weddings, sporting events, and festivals to name a few. While drinking is often deeply rooted in our norms, it never hurts to have health-related information to guide our decisions and occasionally serve as a barometer for when a fun activity turns into a hazard. Women should be aware of the additional risks that drinking poses for them not necessarily to abstain from alcohol together but to continue to drink responsibly if they so choose.


  1. Grant, B.F., et al., Prevalence of 12-Month Alcohol Use, High-Risk Drinking, and DSM-IV Alcohol Use Disorder in the United States, 2001-2002 to 2012-2013: Results From the National Epidemiologic Survey on Alcohol and Related ConditionsPrevalence of Alcohol Use, High-Risk Drinking, and DSM-IV Alcohol Use DisorderPrevalence of Alcohol Use, High-Risk Drinking, and DSM-IV Alcohol Use Disorder. JAMA Psychiatry, 2017. 74(9): p. 911-923.
  2. Ramsey, S.E., P.A. Engler, and M.D. Stein, Alcohol Use Among Depressed Patients: The Need for Assessment and Intervention. Professional psychology, research and practice, 2005. 36(2): p. 203-207.
  3. Nolen-Hoeksema, S., Gender Differences in Depression. Current Directions in Psychological Science, 2001. 10(5): p. 173-176.
  4. Hallfors, D.D., et al., Which Comes First in Adolescence—Sex and Drugs or Depression? American Journal of Preventive Medicine, 2005. 29(3): p. 163-170.
  5. Poulin, C., et al., Gender differences in the association between substance use and elevated depressive symptoms in a general adolescent population. Addiction, 2005. 100(4): p. 525-35.
  6. Champion, H.L., et al., Adolescent sexual victimization, use of alcohol and other substances, and other health risk behaviors. J Adolesc Health, 2004. 35(4): p. 321-8.
  7. Dougherty, D.M., J.M. Bjork, and R.H. Bennett, Effects of alcohol on rotary pursuit performance: A gender comparison. The Psychological Record, 1998. 48(3): p. 393-405.
  8. NIAA. Women. 2019; Available from: