Women, Hormones, Menopause, and Alcohol Abuse
October 9th, 2008
In our teens, 20s and 30s, our ovaries and adrenal glands produce a form of estrogen called estrodiol. Later, during our mid to late 40s and early 50s, our ovaries begin producing less estrogen, leaving more of the work to our adrenal glands. As the adrenal glands take over the job, estrogen drops, spikes and drops again—rather erratically. At this point, many women report that they start to get forgetful and experience “foggy thinking” and moodiness. That’s because our brains work better when estrogen levels are steady. These are the first signs of menopause and, sometimes, the beginning of escalating alcohol consumption as a means of easing various unfamiliar discomforts. While normal menopause is a gradual process that starts between the ages of 45 and 55, there are a number of things that can lead to this whole process starting earlier than normal, in other words – premature menopause. Sometimes these are a result of lifestyle choices that include the following: 1. heavy drinking (defined as more than 1 glass of wine, 12 ozs. of beer, or 1.5 oz. of liquor daily); Indeed, heavy alcohol consumption alone may hasten the onset of menopause by as much as five years. As we reach full menopause, our estrogen production will have dropped by 75%-90% and we normally start experiencing other menopausal symptoms – hot flashes, tiredness, and difficulty sleeping. Many of us also experience a drop in libido (sexual desire) which can continue well beyond menopause. Unfortunately drinking alcohol at this stage of life causes more problems than it solves. For example, alcohol itself can trigger hot flashes and increase sleep disruptions. For those of us in midlife who are already experiencing hot flashes and sleep problems (because of the night sweats that accompany hot flashes), alcohol only compounds the problem. Additionally, Jasmine Lew, a researcher at the Howard Hughes Medical Institute, has found links between the amount of alcohol women consumed and a higher risk of cancer. In particular, Lew and her colleagues found that alcohol increased the risk for the most common types of postmenopausal breast cancer. And the more we drank, the higher the risk, so, while drinking one serving of alcohol resulted in only a 7% increase of risk, drinking three servings of alcohol per day resulted in as high as 51% increase in risk. Further problems occur in the area of bone density because alcohol increases the amount of calcium excreted in the urine, causing a calcium deficiency and eventually osteoporosis. And of course heavy drinking increases our risk of liver disease, falls, DUIs, and motor vehicle accidents. So what are we to do? Peri-menopause, menopause, and post menopause are clearly times of risk for those of us who find we are drinking too much. With that in mind, if you are over 40 you should consider hormonal shifts as a contributing factor in any change in your alcohol use. It should also be a consideration if you become concerned about alcohol abuse and seek help. Look for a program that will address all of the possible contributory factors, not one that consigns you to a “disease” model as well an unnecessary and inappropriate “lifelong recovery.” For more information about Mary Ellen Barnes, Ph.D. & Ed Wilson, Ph.D., MAC visit http://www.non12step.com ©Copyright 2008 by Edward Wilson, Ph.D., MAC, therapist in Rolling Hills Estates, CA. All Rights Reserved. 33 Comments | Click here to leave a comment.
A GoodTherapy.org Featured Column written by Mary Ellen Barnes, Ph.D. & Ed Wilson, Ph.D., MAC
Over the past decade research has found that for many women the onset of alcohol abuse coincides with changes in hormone levels – changes that many women are unaware of in the early stages. When this is combined with other stresses in their lives – job changes, health concerns, children leaving home – women can find themselves abusing alcohol for the first time in their lives.
2. heavy smoking;
3. poor nutrition;
4. chronic stress to the body – including excessive athletic training.
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Comments
I think drinking any organic tea or lemon tea helps in reducing alcohol binging. It worked for my sister who had an early menopause. She used to find herself drunk some nights at home and she realised she would end up an alcoholic if she didnt thwart the urge to drink. She bought 4 varieties of tea and always had ice lemon tea in the fridge. When a martini beckoned her she used to drink tea and hey it worked!!
Sorry, I disagree.
I drank for 30 yrs before menopause. Kept my weight very low & basically used liquor to get me through 2 extremely bad marriages.
It wasn’t until menopause that all those yrs of drinking Alcohol paid me back, badly. I was hit severely with permanent Grand Mal Seizures.
Perhaps you should be advising many, of the derogatory health effects that all alcohol is capable of dishing out, at any time, to anyone, without warning at all !!!
We need our Governments to pass mandatory ruling, for Health Warning Labels on all liquor containers!
Otherwise, whats going to happen to our youth?
While your experience is unfortunate, Ms.Gibbs, it’s never helpful to generalize from your own situation to everyone else. Afterall, as you admit, you chose to use and abuse alcohol and eventually you had that choice come back to haunt you. “Alcohol” didn’t do it to you, you did it to yourself, and there are no lack of warnings around.
What happens to our youth depends to a great extent on the provision of accurate information – including the posative effects of appropriate alcohol consumption – the broadening of cultural sanctions agains alcohol abuse (MADD has done a pretty good job of de-glorifying drunk driving) and so on.
It isn’t in the least helpful to demonize alcohol or to pretend that we are helpless victums.
It always frightens me when people use alcohol or any drug to cover over other problems which are going on in their lives. I find it interesting that women who may have previously never drank before in their lives turn to this at this stage. I wonder why it is that so many turn to this- because it is so affordable, accessible?
It rarely the women who never drank, Dale. Most commonly it’s women whose alcohol use has been in the healthy range. Various changes result in reversable alcohol abuse that tends to creep up on people whenever major life changes occur. The real problem is that underlying factors never get addressed, or people’s justified conceptions of “treatment” are so awful that problems grow until they aren’t so easily fixed. And, after all, it isn’t just alcohol – it’s also food, inactivity, smoking, and a dozen other things we use to avoid the discomfort and anxiety of actually taking care of ourselves.
I am in my fifties and am entering into that menopausal stage of my life. It is sad. I do not even feel like myself anymore and do not want to have to resort to HRT because of the health concerns over that. I do find myself wanting more than ever to have a drink or to find some comfort or solace in something because of how down I have been feeling. I have a wonderful husband who supports me a great deal but I see how it could be easy or tempting for other women going through this to resort to unhealthy habits in order to dull some of the emotional pain and the physical upheavel and has seemed to be such a part of this process for me.
I find that the majority of the women we work with have a hormonal component to their alcohol abuse. This is frequently true with women we see about other coouter-productive habits too. HTR has it’s problems, of course, and we don’t make recommends beyond the idea that each woman needs to evaluate all of her own factors in consultation with a really good endocrinologist (unhappily, it can nearly impossible to find one of those). As with many medical considerations these days, the research and the popular assumptions are frequently at odds and none of us should rely on the misinformation that is “common knowledge” – a situation we are all too familiar with.
But I am sure that there are people out there who are using this as an easy excuse to drink too much and wreck havoc in their lives. This is not the right choice either. The fact of the matter is that if you are feeling these urges you must meet with your doctor or therapist and design a plan that will help you get through this stage of your life without resorting to behaviors that will be even more destructive in the long term.
We agree with you – and we’re not suggesting excusing, simply saying that this is a stage when alcohol abuse tends to occur, just as it does with retirement, divorce, loss of a spouse, and so on. It’s also a time to be very careful about doing your own research since doctors know as little about hormone issues as they do about alcohol abuse, and most of what they think they know is usually wrong.
It seems that it would be much easier for women to pick up on addictive behaviors. It is almost as if we are the sex who is always looking to someone or something else for comfort and that for some of us this may just be what happens to give us comfort at a certain stage in our lives. I do not mean this in a sexist manner at all but there would be some who would suggest that many women are just more prone to picking up this habit due to things that are just out of our control.
Our clients, two-thirds of whom are women, are mostly smart, competent, otherwise successful people who’ve gotten sidetracked by their alcohol abuse. The primary contributing factors are usually boredom and lonliness with “events” – perimenopause, job loss, death, retirement, and end to child rearing – being triggering events. Hormonal shifts obviously wear more heavily on women, though men have their less obvious factors here, as job loss does on men, but the real problems are surprisingly equal and far more “developmentally” related than gender based. Many of our clients are “too old” emotionally and psychologically for their chronologic age and isolation is the real problem.
And, yes, people who are isolated tend towards alcohol abuse for the temporary relief it provides, along with relief from anxiety and other
dis-eases (not diseases) that it brings. Part of the solution is always correctly defining the problem and not limping people into an “alcoholic” catagory which merely reinforces the alcohol abuse and subsequent helplessness model that does plague women more than men..
It’s sad to think we have to rely on alcohol to get us by. I agree that most alcohol assumption is due to some kind of problem, whether is conscious or unconscious. I am 38 and about to hit peri-menopause. I am already seeing signs of peri-menopause in myself. I would hate to think that menopause will tempt me to drink more.
Dr. Barnes,
I enjoyed your article titled “Women, Hormones, Menopause, and Alcohol Abuse.
I am and have been experiencing the wonders of perimenoupause for about nine years now. I am 49 years of age currently. About 7 years ago I unwittingly started increasing my alcohol use to medicate the side effects of perimenoupause such as depression, insomnia, confusion, forgetfulness, the inability to focus, extreme anxiety, random uncontrollable tears, and irritability on the scale that begs whether anything short of an exorcism would be appropriate. My alcohol intake escalated from social drinking to professional binge drinking in about a year’s time.
During this past year (2008), I completed an aversion therapy treatment program and I have been sober for 8 months now. I am grateful to not be experiencing the side effects of alcohol abuse in addition to the side effects of perimenopause, but I am still suffering all of the symptoms referenced above. I worry that the side effects of perimenopause pose a risk to my sobriety. Lately, I have had the desire to drink, so I can “escape” the insanity I feel inside. I know that the alcohol is not the answer and have been able to resist the urge thus far. I have to say that I was a little surprised to discover how upset and anxious I feel at times now that alcohol is out of the equation.
I live in Houston, TX and I am currently searching for a MD that specializes in women’s hormonal issues. To no avail, my family practice doctor has addressed this situation with blood tests that indicate that my hormonal levels are within the normal range and prescribing antidepressants. On the flip side, I know that HRT is controversial because of potential health risks and there are many experts that advise against the use of hormone replacements.
There are two things I do know:
1.I DON’T AND HAVE NOT FELT NORMAL IN YEARS AND IT IS GETTING WORSE!!!!!! Therapy will not balance my hormone levels and admitting that I am powerless over the amount of estrogen or the lack there of in body is not going to help.
2.It is not a fair ask of women to spend years up to say 15 years feeling and acting like a lunatic not withstanding the hot flashes, etc.
Do you have more published research about the links of perimenopause/menopause and the increased use of alcohol? I would be most interested in reading it. I need a healthy answer to the symptoms I have been experiencing and want to do anything I can to do assist other women in not falling into the alcohol trap I did because of my lack of education on the effects of perimenopause.
Unhappily there isn’t much research that we’ve been able to find. What we have found is that it’s an issue for the majority of our women clients. At this point, we are the only alcohol program that even considers what is in reality a pervasive factor. But then, all other programs are based on male models.
We do have experience with an excellent, world class, endocrinologist who works with our clients. I’d be glad to discuss our work with him if you’d care to call. 888-541-6350
I have been using alcohol in the evenings to try and forget/avoid my issues (been doing this for 2 years or so) – just found out at age 43 my FSH level is 69.2 – doctor says I am in menoupause. What is causing what? I had been on Zoloft for 5 years, but felt it was not really working the past 1-2 years. I have worked out at the gym since age 18, but since turning 40 it does not seem to matter. I have gained 20 pounds in the last 2 years – even with exercise. Sex drive has been poor and it use to be wonderful. I thought it was because of body image issues. I just do not know where to go from here. Any advice?
Actually, what you are describing are the “presenting problems” of most of our women clients, and they are generally interrelated in complicated and frustrating ways. Additionally, there are usually other issues that are also simmering in the mix and these too need to be addressed.
Obviously I can’t reduce what we do over five days and 15-20 hours of individual focused attention into a few paragraphs, but the basis is to subtract as many variables as possible (for example, alcohol is a far better depressent that Zoloft is an anti-depressent so the Zoloft isn’t going to help much, if at all). Hormone levels can also be determined (and again, alcohol abuse tends to hasten the on-set of menoupause by five years in many women) and the various possibilities weighed (HRT has its risks, but so does not using HRT).
These are the sorts of starting points we look at – establish base lines, track and record just about everything. alter one or two variables and see what happens, and so on, over a three to six month period. In reality, you need to become your own best and most interesting research project.
Solutions tend to be complex at first, but they settle into routines fairly quickly and are a lot easier to live with than the constant roller coaster of alcohol, emotions, physical symptoms, etc.
One thing is certain, simplistic “solutions” like “working your program” aren’t going to fix anything.
As always, feel free to contact us about your specific situation.
Hi there Mary Ellen and Ed,
What a delight to find your published article on the web as I continue my ongoing research into all that is peri-menopausal. I had all the testing by Dr. O and was hopeful to hear that I’m hormonally “balanced” with the exception of escalated Cortisol levels. Medication prescribed made me absolutely sick to my stomach, so I discontinued. The depression symptoms continue to effect my work and my relationships…more isolation than ever before. Tired all the time. No interest in my once active lifestyle. Alcohol consumption neither increasing nor decreasing. The amazing thing is that noone seems to notice these huge changes but ME…and it makes me feel even more disconnected, as if I’m just going through the motions of life, but without any interest in the process. Time for some follow up visits with you both!
I was fascinated to read your blog. I am 51 and have struggled with increasing alcohol consumption for several years. It escalated this past year until I felt I could no longer control the drinking (I was drinking daily, anywhere from 3-4 drinks per day). I attended AA and a little over two months ago quit drinking entirely.
Since then I have noticed the following: an immediate cessation of daily night sweats, no more hot flashes, a return of my libido to what had been my ‘normal’ level, and I have resumed my periods which had ceased about 18 months ago.
Nowhere had I heard of the connection between menopause and alcohol, but I can assure you, there is one! I did a Google search, wondering if there was any information and found your blog as well as some other articles of note.
I am a professional in a position of responsibility and also a wife and mother. Though I clearly had a serious drinking problem, my work or family relationships did not suffer (I suspect my health did!). I have a very hard time relating to the AA group and I think I may become an AA dropout! I remain convinced I should not drink and am committed to that. It actually hasn’t been that difficult, and now that I feel so much better, it is more than worth giving up the pleasure of alcohol!
I encourage you in your work and only wish you were located near me! Thanks for your blog.
The menopause-alcohol connection is interesting.
Mary Ellen, you said “At this point, we are the only alcohol program that even considers what is in reality a pervasive factor.But then, all other programs are based on male models.” Do you think the link hasn’t been researched by many because it relates to women alone?
Marie, I want to wish you all the best. Congratulations on doing so well with quitting.
Modification of lifestyle issues like a healthy diet, light exercise to improve blood circulation level can help regulate the changes in their body and an active and healthy lifestyle is the key to biological and physiological health which is why there are women who never even had symptoms. I guess women should stop worrying about perimenopausal and menopausal symptoms because the more they worry the worst it gets. Take it easy because it’s a natural process every woman should go through and understanding the symptoms will definitely help them cope and adapt to it.
Wow, I finally found some people who have been having the same problems as me. I’ve struggled with alcohol for years to the point where it became a daily routine. I would find myself going to the liquor store even though I didn’t want to. My hot flashes and night sweats and depression are all driving me nuts. I’m trying to stay away from alcohol and it really is hard, but I have become more and more concerned about my health. There has to be some help somewhere.
my daughter found this site for me and i have found it quite enlightening. looking back i see that i started menopause at around 38 i am not sure when exactly my drinking started to become a problem but it did for a number of years i did eventually kick it but now that i am 52 and having major problems again have started back again. i wasn’t aware that the two were related i just thought i was going mad. any ideas to help me through and stop again would be much appreciated. i have made an appointment with a doctor that i am hopeful will give me some guidence as the past 4 doctors i have seen have been useless one even laughed at me.
Interesting article. I found it while looking for something else – a reason why I lost interest in alcohol after beginning hormone replacement. For 20-25 years, my husband and I would regularly split a bottle of red wine in the evenings. After I began hormone replacement (estradiol and medroxyprogesterone) at the age of 51, I noticed that my glass of wine went pretty much untouched and I’d end up pouring it out at the end of the night. Where before, I had a strong craving for my half-bottle of wine every evening, I would now forget to drink it or even have a slight aversion at the thought of drinking it. This phenomenon coincided exactly with the day I started taking hormones. Just thought it was odd. Good, but odd.
Just had to comment on a previous comment – Lance Chambers, I’m assuming you’re a man. Must be nice to know you’ll never have to go through the ‘natural process’ of menopause.:-) I thought much the same way as you before I actually experienced it. When, for instance, I’d hear older women gripe about hot flashes, I’d think to myself ‘What a bunch of drama queens! So you get warm for a minute – how awful could that really be?’. Well, I can tell you now first-hand – it’s much more miserable than I would ever have imagined. I’m thankful for the experience, though, because it reminded me how important it is to refrain from judging others, and especially to refrain from preaching to them, if I have not had the experience of walking in their shoes.
This is pretty exciting news for me! Thank you all for writing! I’m 52 now and have been drinking daily for at least 4 years. Previous to that, not more than a few times a year. It’s interesting that this could have something to do with my hormones. It’s very weird to have my mind hijacked from my values at this time in my life, like a bad joke. A very bad joke. Now I have a thread to follow. Thank you, thank you, thank you!!!
Ladies: this is whats up: RAW FOOD DIET (and i mean try to go as close to 100% raw as you can) WATER, WATER, WATER, EXERCISE, SLEEP. your menopause symptom will disappear.
WOW! I’m so glad I found this site and the comments. I am a 43 yr. old woman, diagnosed with breast cancer at the age of 37(no family history). I am currently in surgical menopause due to a full hysterectomy and am experiencing EVERY symptom. I exercise on average 5 times a week, burning 800 calories each session. I eat very healthy, however, drink approx. 4 glasses of wine a day. I did not realize that increased alcohol intake can be due to menapause. I have never had to worry about weight issues before, but am now dealing with belly fat, etc. I’m sure it’s the wine, but don’t want/can’t give it up. Any suggestions…AA?
AA is almost never the solution for anyone, especially not women or those who, like you, are abusing alcohol as compared to being alcohol dependent.
What you do want to do is identify what you’re using the alcohol for and what will work better for you. This will be individual and there are no universals or magic and it will take some detective work on your part and Naltrexone may help during the 3-6 month research period.
But stay away from magic, cults, and sure fire solutions.
Pumpkin:
Belly fat at/after menapause is, unfortunately normal. If you are taking in more calories than you are burning, those calories are going to get stored as fat and since your estrogen is gone, you won’t tend to store it around your hips, butt or thighs like women normally do. It stores more like men’s fat does now. A glass of wine can be around 150 calories, so you are taking in a lot of extra calories.
Lots of women start drinking more during menopause because it helps them feel better with all the symptoms. The trouble is, once you get through it, you will be stuck with a real drinking problem and it won’t just go away because the menopause symptoms went away. 4 glasses of wine a night is nearly a bottle a night and the recommended levels for women are maybe 1 glass a night.
I am assuming you can’t do HRT because of the breast cancer, but you probably can take an SSRI antidepressant, which can help some symptoms, or a tranquilizer, which can help also. Also there are ways to help alleviate hot flashes with diet. Just google it – many women find certain foods make hot flashes worse – spicy foods and caffiene are big ones. Some supplements can help also.
As far as going to AA, I don’t think it will help that much unless you find a really good womens only meeting. If you go to a regular AA meeting, the vast majority of the people there did not develop their problems during menopause and you are not going to relate to them or them to you. The 12 steps of AA have nothing to do with menopause related aclhol abuse – they were developed by men for men with long-standing drinking problems and just are not very applicable to your situation.
You might look at Moderation Management or the Harm Reduction Network online for tools to moderate your drinking. Also, as Dr. Wilson (above) suggested look at what you are really medicating with the wine and deal with it directly rather than with wine.
The last two messages have incorrect views of AA. The twelve steps are applicable to all types of addictions. The fact that menopause related alcohol problems in women are more prevalent will result in these problems being discussed at more AA meetings. In addition, AA is not for men only, and most groups do have women only meetings. It is certainly worth a try.
Regarding AA, remember that AA’s “success” is about 3% of those who try it. Not good odds. Unless you fit the adherents’ profile, arrested emotional development at or before the age of 12, you won’t find anything you need.
And you have to sign up for a label and false “powerlessness”.
It’s a good program to stay far far away from….
Understanding, of course, that effective treatment is different for every woman, I have found that regular acupuncture treatments help me greatly with depression, anxiety, energy, focus and sleep disturbances. Even with acupuncture, however, I have found it necessary to cut the red wine back to a rare event rather than a daily occurrence (which it had become over the last few years) as it just exacerbated all of the problems mentioned on this thread, and very nearly cost me a dear relationship due to the volatility of my moods. I’ve also just started with a cortisol management remedy to supplement the acupuncture.
OMG! WE NEED A SUPORT GROUP i am 54 started drinking at 50 this past year i have been way out of control binge drinking anything i can get my hands on i did not drink until my children grew up and menapause started full force it seems i do this 1 day aweek and feel awful about what i am doing to my body and mind i also have graves and thyriod problems
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