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A glass of wine can feel like a well-earned reward after a long day of juggling work and family responsibilities. But while alcohol may feel helpful in the moment, it may worsen some perimenopause and menopause symptoms.
As you age, your body breaks down alcohol more slowly, which can make its effects feel stronger. During perimenopause, alcohol may trigger or worsen symptoms like hot flashes, sleep problems, and mood changes, and it may also increase the risk for certain health concerns.
At the same time, this stage of life often brings added stress and sleep disruptions, which can lead some women to use alcohol as a way to cope or relax.
Keep reading to learn more about alcohol’s effects on the body, so you can decide what feels right for your health and well-being.
Perimenopause is the time leading up to menopause, when periods stop permanently. During this phase, estrogen and progesterone levels fluctuate, which can lead to a range of symptoms, including:
Drinking alcohol may make some perimenopause symptoms worse or harder to manage.
Here’s how alcohol affects some of the most common symptoms of perimenopause.
Many women describe hot flashes and night sweats as intense waves of heat. They’re caused by hormone fluctuations that affect thermoregulation (the body’s temperature control system) and blood vessels. Alcohol may increase the frequency or severity of these symptoms because it has a similar effect on the body.
As you drink, alcohol causes your body temperature to rise. In response, blood vessels under the skin dilate (widen) to release heat. This process can trigger a hot flash.
Not all perimenopausal women will have hot flashes from drinking, but it may help to track your alcohol intake to see if you notice a pattern.
Many women experience insomnia (trouble falling or staying asleep) and other sleep problems during perimenopause, and alcohol can make these symptoms worse.
While having a glass of wine might seem like a quick way to fall asleep, it’s actually more likely to disrupt your sleep and leave you feeling more tired the next day.
Alcohol can make you feel drowsy at first. After a few hours, however, as it wears off, it can create a rebound effect that wakes you up. It can also prevent you from reaching deeper, restorative sleep stages.
Instead of reaching for alcohol before bed, consider other ways to support better sleep, like:
If you feel moody, anxious, or depressed, hormonal changes during perimenopause may play a role. As hormone levels fluctuate, many women notice new or worsening mental health symptoms.
While it may be tempting to use alcohol to cope, it’s unlikely to provide real relief and may worsen emotional symptoms over time.
Alcohol is a depressant (a substance that slows brain activity). It can affect mood, behavior, and self-control. Drinking alcohol regularly may change brain chemistry, which can increase feelings of anxiety or depression as time goes on.
If you’re experiencing low moods and other emotional symptoms, it’s best to explore supportive coping strategies that can improve your quality of life, such as:
Fatigue, hormonal changes, and the daily demands of midlife are just a few of the reasons maintaining a healthy weight may feel more challenging during perimenopause. Adding alcohol to the mix can make it even harder.
One way alcohol can affect weight is by adding extra calories. Even moderate alcohol intake, such as a daily glass of wine, may contribute to gradual weight gain, particularly around the abdomen (belly area).
Alcohol can also increase appetite and affect self-control, making it more likely that you’ll reach for less nutritious food choices after drinking.
If you’ve noticed that alcohol seems to hit harder as you get older, you’re not imagining it. A few drinks might not have affected you much in your 20s, but as you age, even one or two can leave you feeling unwell or with a hangover the next day.
The body becomes less efficient at processing alcohol with age, so it stays in your system longer. Even if you drink the same amount you did five, 10, or 20 years ago, your blood alcohol level is likely to be higher now than it was in the past.
Other changes in the body can add to this effect. Many women lose muscle mass and gain body fat as they age, which can affect how alcohol is distributed in the body and how the liver metabolizes (processes) it. In addition, an enzyme that helps break down alcohol naturally decreases with age.
Noticing a lower alcohol tolerance and stronger side effects as you age is common. These changes, along with the impact on perimenopause, may be reasons to consider cutting back or adjusting your alcohol intake.
Declining estrogen levels during perimenopause may increase the risk of certain health conditions over time, such as:
Alcohol use is also linked to a range of serious health issues, including:
Some of these risks overlap with changes that naturally occur during perimenopause, which may further increase overall health risks.
For example, alcohol can interfere with calcium absorption, which may weaken bones. Osteoporosis is already a concern for menopausal and postmenopausal women, and drinking alcohol can increase this risk.
Heart disease is another area of concern. More than 1 in 3 women will develop heart disease, and declining estrogen levels contribute to this risk. Alcohol can raise blood pressure and cholesterol levels, further increasing the likelihood of heart problems.
In general, the more you drink, the greater the impact on these health risks. Even moderate alcohol intake can worsen some of the changes your body is experiencing in midlife.
In 2023, the World Health Organization (WHO) stated that there is no truly safe level of alcohol consumption. Both the American Heart Association and the American Medical Association recommend that women limit themselves to no more than one drink per day.
Heavy drinking is defined as four or more drinks a day or eight drinks per week.
If you choose to drink, be mindful of your serving size. One drink is often less than it looks.
A standard drink in the U.S. is defined as:
There was a time when moderate drinking was thought to improve heart health or reduce the risk of diabetes, but current evidence no longer supports this.
It’s a good idea to talk with your healthcare provider about your alcohol intake and how it may affect your health, especially during perimenopause.
Research suggests that women may drink more during the menopausal transition. If you want to cut back, here are some strategies to consider:
If you need extra help, reach out to a healthcare provider, therapist, or addiction counselor. Struggling to cut back isn’t your fault. Alcohol is an addictive substance, and many people find it challenging to quit.
The Substance Abuse and Mental Health Services Administration (SAMHSA) offers free resources and a confidential helpline, available 24/7, 365 days a year. You can access information online or call SAMHSA’s National Helpline att 800-662-4357 for help with referrals to local treatment facilities, support groups, and community-based organizations.
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