Alcohol Effects on Female Hormones During Perimenopause
Learn how alcohol affects female hormones during perimenopause. Discover how alcohol impacts the liver, cardiovascular system, estrogen, cortisol, blood sugar, and breast cancer in women.

Alcohol Effects on Female Hormones During Perimenopause
Sober October is here, so I thought that it would be appropriate to write about how alcohol impacts women’s hormones, especially during menopause. As women age, their bodies go through significant hormonal changes, particularly during perimenopause and menopause. After 40, many women begin noticing hormone levels shifts, especially with estrogen, progesterone, and cortisol. While these changes are natural, lifestyle factors, including alcohol consumption, can have a profound impact on hormone balance. Alcohol affects female hormones during perimenopause in many way. In this blog, we’ll explore how alcohol affects the hormonal health of women over 40, its influence on menopause symptoms.
How many times have I heard from women that they can not drink alcohol as they age? The older we get, the less alcohol we can drink. I experience this myself. I felt a massive shift in alcohol intake when I entered 45. I started to feel hungover after only one glass of wine. My body was saying that it was time to take a break from it. Talking to my female friends, I discovered that they also have the same experience, so I decided to dig into it and see what was the culprit and, why women during perimenopause have a hard time metabolizing alcohol, and what impact alcohol has on female hormones during this transition. Simply alcohol affects female hormones during perimenopause and menopause differently.

Why do Women Can’t Tolerate Alcohol in Peri and Menopause Like They Used to?
Many women can not tolerate alcohol anymore during peri- and menopause because alcohol affects female hormones during perimenopause changes. This can be attributed to many physiological and hormonal changes occurring during this time.
Women during this time undergo a lot of changes, such as hormonal changes, where the fluctuating and declining levels of estrogen and progesterone can affect how alcohol is metabolized. Estrogen, in particular, influences the dehydrogenase enzyme, which breaks down alcohol in the liver. Estrogen drops during this time as well, and lower estrogen levels can lead to slower alcohol metabolism, causing alcohol to remain in the system longer.
As women age, muscle mass often decreases, and body fat increases. Alcohol is water-soluble, and because fat contains less water than muscle, a higher body fat percentage means alcohol becomes more concentrated in the bloodstream.
The liver’s efficiency in processing alcohol can also decline with age, making it harder for the body to metabolize alcohol quickly and efficiently.
One of the biggest issues during peri- and menopause is not getting a good quality sleep. Women experience hot flashes when the estrogen declines and alcohol can exacerbate these sleep issues, leading to poorer sleep quality and increased fatigue, making the effects of alcohol more pronounced.
Hormonal changes also have a significant impact on can on mood and mental health, making women more susceptible to anxiety and depression. A known side effects of alcohol are anxiety and depression.
Many women in peri- and menopause may be on medications (e.g., hormone replacement therapy, antidepressants) that can interact with alcohol, affecting its metabolism and tolerance.
During peri and menopause (that starts around age 35-50) the ovaries produce less estrogen. Postmenopausal women primarily produce estrogen through the aromatization of androgens from the adrenal glands and peripheral tissues.
Estrogen is a powerful hormone that influences multiple systems: neuroendocrine, skeletal, adipogenesis, and cardiovascular. 17β-estradiol (E2) is the most potent estrogen in premenopausal women and can contribute to disorders like cancer, osteoporosis, cardiovascular diseases, hypertension, cognitive and behavioral alterations, immune disorders, and neurodegenerative metabolic disorders (such as obesity and diabetes).

Why is Alcohol not Recommended for Women?
Alcohol is often not recommended for women, especially in excess, due to several health risks:
- Increased Risk of Breast Cancer: Studies have shown a link between alcohol consumption and an increased risk of breast cancer. Even moderate drinking can elevate this risk due to the way alcohol affects estrogen levels in the body.
- Lower Alcohol Tolerance: Women generally have a lower tolerance for alcohol compared to men. They often have lower body water content and different levels of alcohol-metabolizing enzymes. This leads to higher blood alcohol concentrations after drinking women than when men drink the same amount as men. Alcohol affects female hormones during perimenopause differently and this especially happens during that time- we cannot metabolized alcohol the same way lie when we were younger.
- Impact on Fertility and Pregnancy: Alcohol can affect fertility and is particularly harmful during pregnancy. It can lead to miscarriage, premature birth, and fetal alcohol spectrum disorders, which can cause developmental issues in the baby.
- Hormonal Fluctuations: Alcohol can exacerbate the symptoms of hormonal fluctuations experienced during menstrual cycles, pregnancy, and menopause, leading to worsened mood swings, anxiety, and sleep disturbances.
- Liver Health: Women are more susceptible to alcohol-induced liver damage, such as hepatitis, cirrhosis, and fatty liver, often at lower levels of consumption than men.
- Heart Health: Excessive drinking increases the risk of heart disease, stroke, and hypertension and women may be more sensitive to these risks.
- Bone Health: Heavy alcohol consumption can interfere with calcium metabolism and bone health, increasing the risk of osteoporosis and fractures, particularly in postmenopausal women.
- Mental Health: Alcohol can worsen mental health conditions such as depression and anxiety, which women may be more prone to due to hormonal changes and other factors.
- Weight Gain: Alcoholic beverages are often high in calories and can contribute to weight gain, which can have additional health implications, such as increased risk of diabetes and cardiovascular disease.
Now, I will get into more details about each one of those health risks.
How Alcohol Impact Hormonal Health
- Heart and Breast Health:
- Postmenopausal Women: About 78.8% report regular alcohol use (~4.8 drinks per week).
- Estradiol Levels: Abstainers have lower estradiol levels (100.8 +/- 12.1 pmol/liter) compared to alcohol users (162.6 +/- 11.9 pmol/liter).
- Cardiovascular Disease: Moderate alcohol consumption can increase circulating estrogen, potentially protecting against cardiovascular disease.
- Breast Cancer: Increased estrogen from alcohol consumption, combined with decreased sex hormone-binding globulin (SHBG), raises breast cancer risk. In general, drinking multiple drinks a day every day increases breast cancer risk. Studies have shown that 4-13 increases in breast cancer for every 10 grams of alcohol intake. Every country has different amounts of alcohol in its drinks. The more alcohol people drink, the greater the risk of cancer. Red wine acts as an aromatase inhibitor, leading to higher free testosterone and lower SHBG levels in healthy premenopausal women. Red wine, grapes, and grape juice are nutritional aromatase inhibitors.
- Estrogen Levels:
- Increase in Estrogen: Alcohol consumption can raise estrogen levels. This is particularly concerning because higher estrogen levels are associated with an increased risk of breast cancer.
- Menstrual Cycle Disruptions: Elevated estrogen levels due to alcohol can lead to irregular menstrual cycles, causing changes in cycle length, flow, and symptoms.
- Progesterone:
- Decrease in Progesterone: Alcohol lowers progesterone levels, which usually disrupts the delicate balance between estrogen and progesterone. This imbalance can lead to premenstrual syndrome (PMS) symptoms and estrogen dominance.
- Testosterone:
- Lower Testosterone Levels: Alcohol can affect testosterone levels, which can impact libido and sexual function in women.
- Cortisol:
- Increase in Cortisol: Alcohol consumption can lead to elevated cortisol levels, the body’s primary stress hormone. High cortisol levels can contribute to increased stress, anxiety, weight gain, and other health issues.
- Insulin:
- Insulin Sensitivity: Alcohol can impact insulin sensitivity and blood sugar levels. Drinking alcohol every day or multiple times a week can cause insulin resistance, and type 2 diabetes.
- Growth Hormone:
- Reduction in Growth Hormone: Alcohol reduces the secretion of growth hormone, which is responsible for cell repair, muscle growth, and overall metabolism. This reduction can impact physical recovery and aging.
- Thyroid Hormones:
- Disruption of Thyroid Function: Alcohol can interfere with thyroid function, leading to imbalances in thyroid hormones. This can affect metabolism, energy levels, and overall health.
- Menopause:
- Worsening of Symptoms: Alcohol affects female hormones during perimenopause perimenopause and menopause and can worsen symptoms like hot flashes, night sweats, water retention, and mood swings.

Liver and Alcohol
The liver is very important for having healthy hormones. At the same time, this organ is most significantly impacted by excessive alcohol consumption because it is responsible for metabolizing and detoxifying alcohol. Chronic alcohol use can lead to various liver diseases and conditions. You can’t properly metabolize used hormones when your liver is impacted. When you drink, the liver only focuses on detoxifying alcohol instead of removing other toxins from your body. You can also develop fatty liver, which is an alcohol-related disease. You can also develop liver fibrosis, alcohol hepatitis, liver failure, or liver cancer. In a nutshell, if your liver is not working properly, your hormones are out of whack, so you are only masturbation symptoms of peri and menopause.
The liver’s vital roles include:
- Detoxifying harmful substances.
- Producing bile for digestion.
- Regulating blood clotting.
- Storing vitamins and minerals.
When the liver is damaged by excessive alcohol consumption, these functions can be compromised, leading to a wide range of health problems.
While the liver is the most directly and severely affected organ, excessive alcohol consumption also impacts other organs and systems in the body, including the brain, heart, pancreas, and gastrointestinal system. Reducing or eliminating alcohol intake can help prevent or mitigate these adverse effects and promote overall health.
Alcohol and Gut Microbiome
Alcohol disrupts the gut-brain axis function. The gut and brain communicate through nerve connections, neurons, nerve cells, and chemical signaling. The liver communicates with the brain – the gut, liver, and brain axis. Any alcohol will disrupt the microbiome (the bacteria that live in your gut. The bacteria talk to the brain and signal the release of serotonin, etc). Alcohol kills the bacteria in the gut and increases inflammation. Consequently, the gut lining is disrupted, and you can develop a “leaky gut” where the bad bacteria from partially broken down food can pass through the bloodstream. Thiscan trigger autoimmunity disorders.
Also, most importantly for our hormones, alcohol negatively impacts the estrobolome, a bacteria in the gut responsible for metabolizing and modulating estrogen levels. If imbalanced, this can lead to Estrogen dominance.
Alcohol and Estrogen Dominance
Too much alcohol can lead to estrogen dominance, which can have various health implications.
Understanding Estrogen Dominance
Estrogen dominance happens when there is too much estrogen relative to progesterone in the body. This hormonal imbalance can lead to various health issues, including weight gain, breast tenderness, heavy periods, mood swings, and an increased risk of certain cancers.
Drinking contributes to increasing the conversion of androgens to estrogen through aromatization, leading to higher circulating estrogen levels. This creates an imbalance between estrogen and progesterone. At the same time, it impairs liver function and reduces its ability to clear excess estrogen from the body.
Conditions such as polycystic ovary syndrome (PCOS), endometriosis, breast cancer, and fibroids can be exacerbated by estrogen dominance.

Alcohol, Estrogen, and Heart Health
- Cardiovascular Disease:
- Moderate alcohol consumption can increase estrogen levels, which may offer some protection against cardiovascular disease. The increased risk of breast cancer often outweighs this benefit, especially postmenopausally.
- Blood Pressure:
- Excessive alcohol can raise blood pressure and contribute to hypertension, a risk factor for cardiovascular disease.
What Happens to the Thyroid When Women Drink Too Much Alcohol
Excessive alcohol consumption can have several adverse effects on the thyroid gland and its function, leading to various health issues.
- Reduced Thyroid Hormone Production: Chronic alcohol use can suppress the thyroid gland’s ability to produce thyroid hormones (T3 and T4). This can lead to hypothyroidism, a condition characterized by an underactive thyroid.
- Altered Hormone Levels: Alcohol can interfere with the balance of thyroid hormones in the bloodstream. It can reduce free T3 and T4 levels, the active forms of thyroid hormones, impacting metabolism and energy levels.
- Impact on the Hypothalamic-Pituitary-Thyroid (HPT) Axis: Alcohol can disrupt the HPT axis, which regulates thyroid hormone production. This disruption can lead to imbalances in thyroid-stimulating hormone (TSH) levels, affecting overall thyroid function.
- Thyroid Inflammation: Chronic alcohol consumption can cause inflammation of the thyroid gland, known as thyroiditis. This inflammation can impair the gland’s ability to function properly and produce hormones.
- Autoimmune Thyroid Disease: Excessive alcohol intake can contribute to the development of autoimmune thyroid diseases, such as Hashimoto’s thyroiditis and Graves’ disease. These conditions occur when the immune system mistakenly attacks the thyroid gland, leading to hypothyroidism or hyperthyroidism (overactive thyroid).
- Metabolic Impact: Since thyroid hormones play a crucial role in regulating metabolism, any disruption in thyroid function caused by alcohol can lead to metabolic imbalances. This can result in symptoms like weight gain, fatigue, and difficulty regulating body temperature.
- Increased Risk of Goiter: Chronic alcohol consumption can increase the risk of developing a goiter, an enlarged thyroid gland. This can occur due to iodine deficiency exacerbated by alcohol or due to the gland’s compensatory response to impaired hormone production.
- Impaired Conversion of T4 to T3: Alcohol can affect the liver, where a significant portion of the conversion of T4 (thyroxine) to T3 (triiodothyronine) takes place. Impaired liver function due to alcohol can lead to reduced conversion efficiency, resulting in lower levels of active thyroid hormone.

Alcohol Abuse in Women – Cortisol-Related Problems
Alcohol abuse can significantly impact cortisol levels in women, leading to a variety of health problems. Cortisol, often referred to as the “stress hormone,” plays a crucial role in the body’s response to stress, metabolism, and immune function.
Cortisol is produced by the adrenal glands and is vital for several bodily functions, such as:
- Regulation of Metabolism: Helps control blood sugar levels and metabolism of fats, proteins, and carbohydrates.
- Immune Response: Modulates inflammation and the immune response.
- Stress Response: Part of the body’s fight-or-flight response, preparing the body to handle stressful situations.
Impact of Alcohol on Cortisol Levels
Alcohol consumption increases cortisol production and stimulates the hypothalamic-pituitary-adrenal (HPA) axis, increasing cortisol production. Chronic alcohol abuse keeps the body in a state of heightened stress, causing persistently elevated cortisol levels. Alcohol disrupts circadian rhythm because cortisol levels fluctuate throughout the day, peaking in the morning and declining at night. Alcohol disrupts this rhythm, leading to abnormal cortisol patterns. Alcohol also can impair the liver’s ability to clear cortisol from the bloodstream, contributing to elevated levels.
Elevated cortisol levels lead to weight gain, especially in the abdomen. They can also lead to insulin resistance, which can lead to type 2 diabetes and metabolic disorders and suppress immune system functions.
Persistent high cortisol levels are linked to mood disorders such as depression and anxiety. Alcohol abuse can exacerbate these conditions, creating a vicious cycle of stress and drinking.
Elevated cortisol increases blood pressure and contributes to the development of hypertension, which is a significant risk factor for cardiovascular diseases.
High cortisol levels can lead to decreased bone density, increasing the risk of osteoporosis.

Alcohol and Blood Sugar Levels
Drinking alcohol has complex effects on blood sugar levels, influencing them in many ways:
- Initial Blood Sugar Rise:
- Alcoholic Beverages with Sugar: Drinks like cocktails, sweet wines, and liqueurs contain added sugars, which can cause an initial increase in blood sugar levels.
- Hypoglycemia Risk:
- Alcohol’s Impact on Liver: Alcohol consumption may disturb the liver’s ability to release glucose into the bloodstream. This is very important for individuals with diabetes who are on insulin or other glucose-lowering medications.
- Hypoglycemia: Drinking alcohol can increase the risk of hypoglycemia (low blood sugar) because alcohol inhibits gluconeogenesis (the production of new glucose) in the liver, especially if consumed on an empty stomach.
- Delayed Hypoglycemia:
- Delayed Effect: The risk of hypoglycemia can occur several hours after drinking alcohol, which can be particularly dangerous if drinking before bedtime or without food.
- Increased Risk of Type 2 Diabetes:
- Heavy Drinking: Chronic heavy alcohol consumption contributes to insulin resistance and increases the risk of developing type 2 diabetes. This effect is due to alcohol’s impact on the liver, fat distribution, and overall metabolism.
- Impact on Appetite and Weight:
- Increased Appetite: Alcohol increases appetite and leads to overeating, which can affect blood sugar control and contribute to weight gain. Alcohol is just an empty calorie without any nutritional value to your diet. So, you basically drink your calories and add too many to your daily calorie intake.
Practical Tips for Managing Alcohol and Hormonal Health After 40
- Limit Alcohol Intake:
- Moderation is key. For women over 40, limiting alcohol to one drink per day or fewer can help mitigate some of its negative effects on hormones. Consider having alcohol-free days during the week to give your body time to recover.
- Choose Wisely:
- Certain drinks, like red wine, are considered to have some health benefits due to their antioxidant content. However, it’s essential to be mindful of portion size and frequency. Avoid sugary cocktails and high-alcohol drinks, which can spike blood sugar and exacerbate hormonal imbalances.
- Support Liver Health:
- Supporting liver health is essential for hormone balance. Drink plenty of water, take liver-supporting supplements such as milk thistle, eat a diet rich in cruciferous vegetables (such as broccoli and kale), and consider reducing your overall alcohol intake to support your liver’s detoxification processes.
- Manage Stress and Sleep:
- Since alcohol can increase cortisol levels and disrupt sleep, it’s important to adopt stress management practices such as yoga, walking, meditation, or deep breathing exercises. Prioritize sleep hygiene to ensure you get enough restful sleep, even when hormonal changes make it difficult.
- Track Symptoms:
- Keep a journal to track how your body responds to alcohol. This can help you identify patterns and adjust your intake accordingly. Pay attention to how alcohol affects your mood, sleep, hot flashes, and overall energy levels.

For women over 40, the relationship between alcohol and hormones becomes more complex. Alcohol affects female hormones during perimenopause has lots of bad consequences for your health.. Having a drink now and then is not going to cause any radical health issues, but when you drink every day and multiple alcoholic drinks a day, it will. With estrogen dominance, declining progesterone, and fluctuating cortisol levels, alcohol can disrupt hormonal balance and exacerbate menopausal symptoms. While occasional, moderate consumption may not cause significant harm, it’s important to be mindful of how alcohol affects your body as you age. Learn how to say no to alcohol and you will see how dramatically your health and life will improve.
More About Women Hormones
Organ Meats: Nutritional Benefits For Hormone Health
Seed Cycling for Hormonal Balance
Keeping Your Sexuality Active As You Age
How to Boost Your Energy with This Adrenal Cocktail Recipe
How To Increase Progesterone Levels Naturally
Refrences:
How Alcohol Affects Your Body – Georgia Strait. ttps://georgiastraitwomensclinic.ca/how-alcohol-affects-your-body/
Strong Bones: The Essential Role of Vitamin D and Calcium. ttps://101-health.com/building-strong-bones-the-essential-role-of-vitamin-d-and-calcium/
https://pubmed.ncbi.nlm.nih.gov/36310188
https://pubmed.ncbi.nlm.nih.gov/37332052
https://pubmed.ncbi.nlm.nih.gov/32582503
https://pubmed.ncbi.nlm.nih.gov/34762198
https://pubmed.ncbi.nlm.nih.gov/37244646
https://pubmed.ncbi.nlm.nih.gov/34059235
https://pubmed.ncbi.nlm.nih.gov/32609894
https://pubmed.ncbi.nlm.nih.gov/32714716
https://pubmed.ncbi.nlm.nih.gov/33318628
https://pubmed.ncbi.nlm.nih.gov/37577447
https://pubmed.ncbi.nlm.nih.gov/10609275
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