How Does Alcohol Affect Men and Women Differently?

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Sex and gender play a role in how we consume, process, and react to alcohol. Some of these differences are biological, while others are social—relating to mainstream attitudes about gender roles.

Males and females differ in how they metabolize alcohol, which results in varying effects on short- and long-term health. Gender identity also affects how men and women—including transgender individuals—use and misuse alcohol.

In this blog post, we explore the societal and biological differences between male and female alcohol consumption, including how gender identity influences the likelihood that a person will misuse alcohol. Read on to learn more about the effects of alcohol on men vs women, as well as tips to help people of all sexes and genders have a safer relationship with alcohol.

Does Sex or Gender Affect How Much You Drink?

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In this post, we’ll address both sex and gender as distinct entities. Here, sex will refer to a person’s biological gender assigned at birth, while gender will refer to an individual’s personal identity. Both have an impact on how a person consumes alcohol, and how they are affected by it.

Historically, household surveys show men are significantly more likely to use alcohol than women. The gap appears to be shrinking, but men still show a higher likelihood of using alcohol in the past year. As of 2018, 7.6 percent of men over the age of 18 had alcohol use disorder (AUD), vs 4.1 percent of women. Men also continue to show higher rates of binge drinking.

However, alcohol misuse among women is on the rise. Between 2003 and 2013 alone, high-risk drinking among women increased nearly 58 percent. This may reflect a shift in cultural attitudes towards gender and alcohol, especially among the millennial generation.

Transgender adults—people who identify with and live as a gender different from the biological sex they were assigned at birth—are more likely to abuse substances like alcohol than the general population. In some studies, male-to-female (MTF) transgender people were more likely to abuse substances than female-to-male (FTM) transgender people. These higher rates among trans individuals may be linked to trauma and discrimination.

The Effects of Alcohol on Men vs Women

Gender identity may affect how much you drink, and your likelihood of alcohol misuse. But biological sex also has a significant impact on how a person’s body metabolizes alcohol. Using and abusing alcohol has different short- and long-term effects on male and female biology.

Short-Term Effects

Females appear to absorb and metabolize alcohol faster than males. Researchers believe this is because females have less water in their bodies than males. As a result, females achieve a higher blood alcohol concentration (BAC) than males after consuming fewer drinks.

However, females also appear to eliminate alcohol from their blood faster than males. This may be due to differences in liver size. Females have a higher liver volume per lean body mass than males, helping them detoxify their blood faster.

Long-Term Effects

Heavy drinking has long-term effects on both male and female bodies, but these effects may differ depending on biological sex.

Liver Disease

Because alcohol is metabolized by the liver, excess drinking can have detrimental effects on liver health. While this can impact both males and females, females are more likely to experience cirrhosis and other alcohol-related liver diseases than males.

Heart Disease

Moderate drinking (i.e. one standard drink per day for women; two standard drinks per day for men) is associated with a lower risk of cardiovascular disease for both males and females. However, drinking more than this can increase the risk of heart disease for both sexes. And females are at greater risk of damage to the heart muscle from alcohol misuse.


Alcohol increases the risk of certain types of cancers for both sexes. Males are slightly more likely to get colorectal, liver, and kidney cancers than females, according to global cancer data. However, females have significantly higher risk of breast cancer than males, and heavy drinking may increase this risk.


Both males and females should cut back on alcohol when trying to conceive a child. Heavy drinking can affect sperm count and quality, as well as disrupt ovulation. And it’s well known that drinking alcohol while pregnant increases the risk of miscarriage, stillbirth, premature delivery, and Fetal Alcohol Syndrome (FAS).


While excessive drinking is dangerous for both sexes, males consistently have higher rates of alcohol-related hospitalizations and deaths than females. Males are more likely than females to commit suicide, and more likely to have been drinking prior to committing suicide. They are also more likely to have been driving while intoxicated in fatal motor-vehicle traffic accidents.

Tips to Help Men and Women Drink More Safely

While alcohol affects everyone differently depending on sex and gender identity, people of all genders can take action to curb the risks associated with drinking alcohol. Some tips for safer drinking include:

  • Do not exceed one standard drink per day for females or two standard drinks per day for males.
  • Eat a meal before drinking—an empty stomach absorbs alcohol faster than a full one.
  • Alternate alcoholic drinks with non-alcoholic drinks to pace your alcohol consumption.
  • Appoint a designated driver when going out drinking, and never drive drunk.
  • Avoid having sex while intoxicated; drunk sex is not consensual sex.
  • Do not drink at all if you are pregnant or trying to become pregnant.

Both men and women should also be familiar with the signs and symptoms of an alcohol use disorder, which can affect anyone of any sex or gender. Signs of an alcohol problem include drinking more than intended, failing to cut down on drinking, craving alcohol, continuing to drink despite it causing problems in your life, and growing tolerance to the effects of alcohol.

If you’re concerned about how much you are drinking, take our alcohol use survey, or schedule a call with a member of our team today. Our science-backed, online program can help you cut back or quit from anywhere, 100 percent from your smartphone. Learn more about how it works.

Written By:
Ria Health Team
Our experienced team is committed to transforming alcohol addiction treatment.
Reviewed By:
Evan O'Donnell
Writer specializing in targeted, informative content. Dedicated to making the abstract accessible.
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