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Menopause: Universally experienced by women, but not often discussed in the mainstream. It marks the end of a woman’s menstruation, and it can have a host of biological and neurological side effects. Little known among these is a greater susceptibility to alcohol misuse and negative health effects from alcohol.
“We have several women in our program now who became addicted to alcohol just before or just after menopause,” says Sara Miller, a Ria Health recovery coach. And this can be confusing. A lot of people assume alcoholism, or alcohol use disorder (AUD), arises earlier in life—and it usually does. Some studies have indicated that AUD is genetic, while other studies have shown that people who start drinking at a young age are more likely to develop the disorder. But not everyone with AUD fits into these categories, including some menopausal women who have suddenly found themselves turning to alcohol.
What Causes Middle-Aged Women to Drink More?
The most likely culprit: depression.
Most researchers who’ve studied this topic point to a higher risk of depression in menopausal women, as depression and AUD often go hand in hand. A 2010 review of research found that the risk of depression is especially high for women in perimenopause, or the several years before the ovaries stop releasing eggs.
Why do women in and approaching menopause get depressed? There are a few theories:
- Decline in estrogen. Perimenopause marks the beginning of a decline in estrogen, and estrogen affects levels of feel-good hormones like dopamine, serotonin, and endorphins. So, this theory goes, as estrogen levels fall, the risk of depression goes up.
- Estrogen’s domino effect. In this theory, estrogen plays an indirect role. With the decline in estrogen comes hot flashes and night sweats, which disrupt sleep and thereby cause mood changes.
- Life changes. With age comes health problems, the death of a loved one, having to care for an aging parent, or retiring from work. Any of these changes can contribute to depression or anxiety, which is another condition that often co-occurs with AUD.
- All of the above. It’s possible that all of these factors combined can lead to depression.
“A lot of menopausal women with depression aren’t treated for it because it’s confusing,” says Miller. “‘Why am I depressed in my fifties when I wasn’t depressed before?’ they ask themselves.” But, as we discussed in another post on anxiety, it’s important to treat both the alcohol misuse and the mood disorder in order to have a better chance of improving either one.
Older Women’s Drinking Is on the Rise
One 2017 study found that binge drinking rates remained stable for men 60 years and older between 1997 and 2014. But women 60 years and older binge drank at steadily higher rates over that same time period; their rates increased by an average of 3.7 percent each year. Researchers are keeping a closer eye on these numbers as the U.S. population continues to age.
Why Is Menopause and Alcohol a Serious Public Health Issue?
Every increase in women’s rates has much more serious consequences, as women drinkers are much more susceptible than men to long-term negative effects of alcohol.
If you take a woman and a man that are the same weight and give them the same amount of alcohol over the same period of time, the woman will have a higher blood alcohol level. That’s because women and men metabolize alcohol differently. This biological difference contributes to women’s higher susceptibility to alcohol-attributable liver disease, heart disease, and brain damage. Even when women drink less alcohol less often, they are more likely to get sick.
This gender difference becomes more pronounced with age. Especially in women, an amount of alcohol that may have had little effect when you’re younger—say, one or two drinks—can make you feel drunk after menopause. That makes postmenopausal women even more susceptible to alcohol-related problems than men or premenopausal women, which makes it that much more important for menopausal women with alcohol addiction to seek help. And with the advances in science, medicine and technology—getting help for alcohol dependence is more convenient and more effective than ever before.
Have you or a loved one found yourself starting to drink more just before or after menopause? As always, we’re here to help.
John E. Mendelson, MD is the co-founder and chief medical officer of Ria Health