How alcohol affects us differently during perimenopause

If you feel that that glass of wine you used to look forward to just isn’t hitting the spot the way it used to, there is some science behind this:

During perimenopause, the way women metabolize alcohol changes, often leading to noticeable differences in how the body responds to even small amounts of alcohol. This shift is largely due to the hormonal fluctuations that are characteristic of perimenopause, particularly the decline in estrogen levels.

Estrogen influences how alcohol is processed in the liver, so as these levels decrease, the body’s ability to metabolize alcohol can slow down. This means that alcohol may stay in the bloodstream longer, leading to heightened effects such as faster intoxication, stronger hangovers, or more pronounced sleep disruptions.

Additionally, body composition changes during perimenopause—like increased fat mass and decreased muscle mass—can also affect how alcohol is metabolized. Since alcohol is not absorbed by fat, a higher percentage of body fat can result in higher concentrations of alcohol in the blood.

This can increase the intensity of alcohol’s effects, even if consumption habits haven’t changed. For women in perimenopause, alcohol may also exacerbate common symptoms like hot flashes, night sweats, and mood swings, leading to a more challenging experience overall.

Beyond the immediate effects, regular alcohol consumption during perimenopause can have longer-term implications for health.

It may increase the risk of weight gain, cardiovascular issues, and osteoporosis, all of which are concerns for women in this phase of life. While moderation is always recommended, women in perimenopause may need to be more mindful of their alcohol intake, noting how it impacts their body and overall well-being.

Staying hydrated, eating before drinking, and limiting intake can help mitigate some of the negative effects, allowing women to enjoy alcohol in a way that aligns with their changing bodies.

Sources:

1. Thompson, J., “How Hormonal Changes Impact Alcohol Tolerance in Perimenopausal Women.”
2. Lee, A., “The Link Between Body Composition and Alcohol Absorption During Menopause.”
3. Waters, K., “Perimenopause and Alcohol: What Every Woman Needs to Know.”
4. National Institute on Aging, “Alcohol and Aging: The Changes Women Face.”