How Does Alcohol Affect Men and Women Differently?

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Too much alcohol can take a toll on your health, regardless of your sex or gender identity. After all, it has toxic effects on your body, and it can interfere with many of your organs’ processes. But why does it seem to impact men and women so differently? 

Below, we’ll cover the effects of alcohol on men versus women, along with what to know if you are transgender or nonbinary.

The Health Effects of Alcohol on Men vs. Women

older couple standing outdoors smiling at each other
Photo by Matheus Bertelli on Pexels

Here are some ways that alcohol can affect men’s and women’s health. 

Cancer Risk 

Heavy alcohol use can increase the risk of certain types of cancer for all people.1 These include:

  • Head and neck cancer
  • Esophageal cancer 
  • Liver cancer

Drinking releases a molecule called acetaldehyde in the body, which can damage your DNA—and this risk doesn’t change with sex or gender.2 That said, alcohol has also been linked to certain cancers that disproportionately impact women and men:

  • For men, this includes prostate cancer.
  • For women, this includes breast cancer.3

Read more: Alcohol and Cancer Risk

Liver Disease

You might already know that drinking too much can affect liver health. But research shows that women may be more vulnerable to cirrhosis and other alcohol-related liver diseases than men.4

Read more: Early Signs of Liver Damage From Alcohol 

Heart Disease

Heavy drinking can impact anyone’s heart health, as it can lead to hypertension, heart disease, and stroke. With that being said, some research suggests that heavy drinking can have a greater impact on women’s cardiovascular health than men’s.5

Read more: Alcohol and Heart Disease 

Reproductive Health

Here’s what you should know about alcohol and your reproductive health:

Women’s Reproductive Health

Pregnancy is a significant concern when it comes to alcohol and women’s health. If you’re pregnant, alcohol can put your health and the baby’s health at risk—and there is no known safe amount to drink while pregnant.6

Aside from that, alcohol can disrupt your hormonal balance by unnaturally increasing your estrogen levels and reducing your progesterone. Heavy drinking may also impact your menstrual cycle and disrupt some of the functions of your uterus and ovaries.

Men’s Reproductive Health

If you’re a male, heavy, chronic drinking can disrupt your hormonal balance. It can also impact sperm quality,7 and even lead to erectile dysfunction.8

Risk of Injury 

One of the most troubling ways that alcohol impacts health is how it leads people into risky (and potentially injury-inducing) behavior. 

According to the Centers for Disease Control and Prevention (CDC), men are:

  • 50 percent more likely to be intoxicated as a driver in a fatal motor vehicle crash.
  • More likely to die by suicide and be drinking prior to it.
  • More likely to end up in the hospital due to alcohol-related causes.9

Women may face:

  • Higher rates of injury with increased alcohol use from all causes aside from traffic.10 

Read more: Alcohol-Related Injuries

Overall Mortality

Women and men both can face mortality from alcohol use, but it isn’t an even split. Statistics from a review in Alcohol Research showed that three percent of all women’s deaths and eight percent of all men’s deaths were due to alcohol in 2016.11 

Read more:

Alcohol and Women’s Health

Alcohol and Men’s Health

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The Difference Between Male and Female Alcohol Consumption

man and woman in similar clothes drinking one cocktail with two straws
Photo by cottonbro on Pexels

The effects of alcohol are different for women and men because, in general, male bodies tend to be able to handle larger amounts of it. You can see this reflected in standard guidelines such as:

  • Moderate drinking, which is defined as up to one drink per day for women, and up to two drinks per day for men. 
  • Binge drinking, which is defined as five or more drinks within two hours for men, and four or more drinks in the same period for women.

So, why does binge drinking require a smaller amount of alcohol for women than men? 

It comes down to the female body and alcohol metabolism. Women typically have a smaller body mass and less total hydration in their bodies.12 This means that fewer drinks can lead to a higher blood alcohol concentration compared to men.

Why can men drink more than women? 

On the other hand, men’s bodies handle alcohol a bit better. They have more body mass, more water in their bodies, and higher levels of the enzymes that break down alcohol, known as alcohol dehydrogenases.13

How the COVID Era Shifted Drinking Patterns

While men typically drink more than women, COVID-19 seemed to bring about a shift.

An earlier look at pandemic drinking found that women’s heavy drinking was up 41 percent from the spring of 2019 to the spring of 2020.14 And as a whole, it seems like the gap between women’s and men’s alcohol use could be starting to close. 

One study from Drug and Alcohol Dependence surveyed people in May 2020 and again in March 2021. They found that although men typically drank more than women throughout the pandemic, women’s rates of alcohol use stayed stable while men’s rates began to decline.15 

For Transgender and Nonbinary People

So, what does this all mean if you’re transgender or nonbinary? 

Some of the trends in alcohol and its effects are dependent on social and emotional factors—such as societal pressures, mental health, and who you surround yourself with. 

Other things tend to tie in more to biological sex. These include the reproductive health effects, cancer risk, liver disease, and cardiovascular risk. And the amount you can drink without feeling adverse effects also depends on biological sex and body mass.

In any case, you can get a feel for how alcohol affects you by looking at the big picture of these factors. Consider your size, sex, and current profile of health. And if you have any questions, a physician can help you gain a deeper understanding of how alcohol may impact your unique body.

Resources for Alcohol Abuse

Whether you’re a woman, man, or nonbinary, too much alcohol can harm your well-being. The good news is that if you’re worried about how much you or someone you love is drinking, there are more flexible ways to get help than ever. 

For comprehensive alcohol treatment from the comfort of your home, Ria Health can help. As a first step, you can learn more about Ria’s program, or take our alcohol use assessment to figure out if your drinking is normal. And if you’re ready to get started, you can get in touch with a team member today.


Have questions about online alcohol treatment?

or call (800) 504-5360

Written By:
Alicia Schultz
Alicia is a Minnesota-based freelancer who writes for Ria Health and various other brands in the health and wellness space. Beyond addiction and recovery, she also covers topics relating to general well-being, mindfulness, fitness, mental health, and more. When she’s not writing, you can find her relaxing with her three-legged cat, trying new workout routines, and spending time with her loved ones.
Reviewed By:
Evan O'Donnell
Evan O’Donnell is an NYC-based content strategist with four years’ experience writing and editing in the recovery space. He has conducted research in sound, cognition, and community building, has a background in independent music marketing, and continues to work as a composer. Evan is a deep believer in fact-based, empathic communication—within business, arts, academia, or any space where words drive action or change lives.

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