Alcohol and the Menopause: What Every Woman Should Know

How Alcohol Affects Hormones

Alcohol may temporarily influence hormone levels. Oestrogen, the primary female sex hormone, fluctuates during the perimenopausal years (the years leading up to menopause) before eventually stabilising at lower levels postmenopause. Alcohol can temporarily impact how the body processes oestrogens. Possible temporary increases in oestrogen are just one of a number of theories linking alcohol intake to an increase in the risk of breast cancer. More studies are needed to give more information on exactly how alcohol has a hormonal impact, though, and we lack data telling us how volume and types of alcohol impact, and for how long they have to be consumed before there is a hormonal effect.

Alcohol and Menopause Symptoms

Let’s take a closer look at how alcohol consumption can influence specific menopause symptoms:

1. Hot Flushes and Night Sweats

Research is mixed. Most studies suggest that alcohol can trigger hot flushes. However, the type of alcohol and individual tolerance levels can matter. For many women, especially those who are already sensitive to alcohol’s effects, even small amounts can dilate blood vessels and worsen flushing.

2. Sleep Disturbances

Menopausal women often struggle with insomnia or poor sleep, and alcohol typically makes this worse. While alcohol may help people fall asleep faster, it disrupts the sleep cycle, particularly REM sleep, the stage associated with deep, restorative rest. As oestrogen and progesterone levels decline, women may become more sensitive to these disruptions, leading to increased fatigue and irritability. So many symptoms of the menopause – psychological, cognitive, and some physical can feel worse if sleep is poor, so there is a wider impact than on just sleep itself.

3. Mood and Mental Health

Fluctuating and decreasing hormone levels during menopause can contribute to anxiety, depression, and mood swings. Alcohol is a central nervous system depressant, and while it might initially seem to relieve stress or anxiety, it can exacerbate mental health problems in the long term. Regular alcohol use is linked to increased risk of depression and cognitive decline, both of which may already be concerns for menopausal women. Cognitive and psychological symptoms are also made worse by a lack of sleep, as mentioned above.

4. Weight Gain and Metabolism

Weight gain is a common complaint during menopause, with redistribution of fat around the middle. Alcohol contributes extra calories with little nutritional value, and it may slow metabolism and impair fat burning. Women are more prone to weight gain as muscle mass decreases with age, and alcohol consumption can make managing a healthy weight more difficult.

5. Bone Health

Osteoporosis becomes a significant concern post-menopause due to the drop in oestrogen. Excessive drinking is harmful and can lead to reduced bone formation and a higher risk of fractures. Drinking 3 units of alcohol a day or more can significantly impact bone density and fracture risk, and the more you drink, the greater the risk. Becoming unsteady when under the influence of alcohol then adds to the risk of falls, and this too can increase the risk of fractures.

6. Heart health

Drinking alcohol regularly can impact blood lipids, or blood fats.  Raised cholesterol and other types of blood fat, such as triglycerides and low-density lipoproteins, then increase the risk of heart disease and stroke. This is important as the risk of heart disease also increases in the menopause transition as the body loses the protective effects of oestrogen.

7. Brain health

Alcohol can temporarily decrease cognitive function, including memory and concentration. Cognitive function is also impacted by the menopause and changing oestrogen levels for many women, and alcohol can make these symptoms worse. The effects are usually temporary, but chronic, regular drinking may increase the risk of dementia.

What Is Safe Drinking?

The NHS advises that to keep health risks from alcohol at a low level, if you drink most weeks:

• Men and women are advised not to drink more than 14 units a week on a regular basis
• Spread your drinking over 3 or more days if you regularly drink as much as 14 units a week
• If you want to cut down, try to have several drink-free days each week

Should Women Avoid Alcohol Altogether During Menopause?

Not necessarily. Every woman’s experience of menopause is unique. Some may find that a glass of wine helps them relax and enhances social enjoyment without noticeable side effects. Others might find that alcohol worsens their symptoms or leads to poor sleep or mood instability.

The key is self-awareness and moderation. Pay attention to how your body responds. Keep a journal if needed to track alcohol intake and symptoms. It can be empowering to notice patterns, such as worse sleep or more hot flushes after drinking, and make informed choices based on your own experience.

When to Speak to a Doctor

If you find yourself relying on alcohol to cope with menopausal symptoms like anxiety, insomnia, or depression, it may be time to talk to a healthcare provider. There are safer, more effective treatments available—including hormone replacement therapy (HRT), lifestyle changes (nutrition, exercise), cognitive-behavioral therapy (CBT), and medications.

Additionally, if you have a family history of breast cancer, osteoporosis, or liver disease, you should be especially cautious with alcohol. Your doctor can help you weigh the risks and benefits based on your personal health history.

Final Thoughts

Menopause is a significant life transition, and navigating it well often requires adjusting multiple lifestyle factors—diet, exercise, stress, and yes, alcohol consumption. While moderate drinking might be safe for some women, others may benefit from cutting back or abstaining altogether.

By staying informed, listening to your body, and seeking support when needed, you can make empowered choices that support your health and well-being during menopause and beyond.

Further Reading

Read Alana Kirk’s story here:  “Drinking less alcohol has transformed my wellbeing in the menopause”

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.