How Alcohol Affects Women Differently than Men

By Geoffrey Booth, Medical Director, LifeSync Malibu

There is no argument that alcohol abuse and addiction can have devastating effects on any person, regardless of gender. Indeed, both sexes suffer from the disease of alcoholism, albeit in slightly different ways. The unique effects of alcohol, when comparing women versus men, are hardwired into each gender’s physiology. Our bodies simply metabolize alcohol differently.

Women happen to be more vulnerable to the effects of alcohol. Because of a woman’s smaller size and higher fat content, it takes less alcohol for them to become intoxicated than it does for a man, and longer for alcohol to be metabolized. Where a man’s liver is able to metabolize and process one alcoholic drink per hour, it takes twice as long for a woman’s liver to process that same amount.

Simply put, alcohol affects women differently than men. This basic fact impacts the risk of a woman acquiring an alcohol use disorder and the health effects that follow. In addition, a woman’s treatment needs will differ as well. The more that recovery plans address these gender differences, the more effective treatment will be.

How Alcohol Affects Women vs. Men

When the Centers for Disease Control published guidelines for safe alcohol use they made sure to differentiate between the sexes. Those guidelines stipulate that it is considered safe for a man to drink up to two alcoholic beverages per day, however, that is reduced to one alcoholic beverage per day for women. This difference is based on pure science, acknowledging the metabolic differences between men and women.

Alcohol use disorder looks different in women in various ways, including:

• Women have a higher fat content and lower overall body weight, and produce less of the enzyme, dehydrogenase, which helps break alcohol down. Because of these differences, women will register a higher blood alcohol level than men.

• Women will sustain more liver, heart, and brain damage due to alcoholism than men.

• Women become alcoholics faster than men, but more men become alcoholics.

• Women are more apt to have a co-occurring mental health disorder than men.

• Women who have experienced trauma or abuse are more likely to develop an alcohol use disorder.

Alcohol Use Disorder on the Rise Among Women

Rates of women engaging in high-risk drinking have increased by about 60%, according to a 2017 study published by the Journal of American Medical Association (JAMA). The study compared self-reported drinking habits from the years 2002 and 2013. The study also revealed that alcohol use disorders among women have increased 87% since the earlier study. 

The study cites more women in the workplace as a major contributing factor to the increase in alcohol abuse. Professional women may attend more business-related functions that encourage alcohol consumption than in the past. In addition, changing cultural norms have made social drinking in women more acceptable.

Female Alcoholics More Prone to Co-Occurring Depression

There is a strong link between alcoholism and comorbid depression in both men and women. However, depression affects far more women than men, possibly resulting in a higher incidence of this dual diagnosis in women. According to The Journal of Psychiatry and Neuroscience, depression rates in women are 1.7-fold higher than in men and are 2.2-fold higher in women under the age of 25. Reasons for the higher depression rates among women include:

• Hormonal differences. Women may experience more intense mood swings as a result of their biology such as hormonal fluctuations.

• Socioeconomic disadvantages. Women are likely to earn less money and be responsible for the bulk of childrearing responsibilities, thus limiting their career options and leading to economic disadvantages that can result in depression.

• Women are more sensitive. When it comes to relationship problems, women tend to be more sensitive.

Both men and women who struggle with depression may be prone to self-medicating with alcohol to numb the symptoms of sadness and despair. With higher rates of depression among women, the use of alcohol to mitigate symptoms is, therefore, proportionately higher.

Social Aspects to Consider

No matter how much society favors equality between the sexes, the fact remains that women still take on the majority of childrearing and household chores. Women attempt to manage these responsibilities while also working full-time jobs, and the resulting stress levels can lead to alcohol abuse. 

When it becomes evident that a woman has acquired a drinking problem, they may not even attempt to get treatment. They may feel they couldn’t possibly take an extended period away from their responsibilities to go to treatment. Parenting responsibilities are a significant barrier to women getting the help they need.

Other barriers to treatment that a woman might encounter include fear of stigma, risk of losing their job, lack of financial resources, and privacy concerns. These roadblocks can be somewhat mitigated by recovery programs that are tailored for women and their unique needs.

Recovery Needs for Women with Alcohol Use Disorder

Because alcohol affects women differently than men, a treatment program should also be tailored for the unique needs of women. The emotional needs of women are one of them. In a recovery program, it is important that the woman feels valued. A feeling of connection with the team and peers in recovery is also essential for building a sense of trust.

Treatment elements can also be adjusted to adapt to women’s needs. For example, having group sessions and classes that are women-only is likely to make a woman feel more relaxed and willing to participate. In the sessions, delving into the women-specific issues, such as balancing parenting demands with recovery efforts, can also be very helpful.

About the Author

Geoffrey A. Booth, M.D. is the Medical Director of LifeSync Malibu, a Rehabs Malibu exclusive rehabilitation program located in the heart of Malibu. Dr. Booth has treated thousands of addicts over the years and now has dedicated most of his clinical time to providing medical care and detoxification to clients who suffer from substance abuse. He is committed to helping them establish the foundations for long-term sobriety. While not working, Dr. Booth has a rich personal life filled with activities surrounded by friends and family.