Women, Hormones, Menopause, and Alcohol Abuse
October 9th, 2008 |
A GoodTherapy.org Featured Column written by Mary Ellen Barnes, Ph.D. & Ed Wilson, Ph.D., MAC
Click here to contact Mary Ellen and/or see her Profile
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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.
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);
2. heavy smoking;
3. poor nutrition;
4. chronic stress to the body – including excessive athletic training.
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 Mary Ellen Barnes, Ph.D. & Ed Wilson, Ph.D., MAC. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry.
19 comments so far
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.