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Why drinking alcohol affects women more than men

Why drinking alcohol affects women more than men
A man, for example, can be a heavy drinker for 20 to 30 years and have moderate difficulties, but a woman can be a heavy drinker for only five years and develop moderate health issues, says Dr Manish Machave, Consulting Obstetrician, Gynaecologist & Gynaecological Endoscopic Surgeon, Ruby Hall Clinic, Pune

Indian Express
Written by Dr Manish Machave
June 16, 2023

New Delhi – Men and women differ dramatically not merely in their proclivity for alcohol misuse but also in their physiological response to alcohol. Epidemiological evidence suggests that nearly 20 per cent of adult males have alcohol abuse or suffer from alcoholism-related complications. On the other hand, only about 6 per cent of adult females are alcoholic or abuse alcohol on a regular basis. Yet they suffer more health consequences.

How do physiological differences between men and women affect alcohol metabolism?

Alcohol is mainly detoxified by alcohol dehydrogenase (ADH) and mitochondrial aldehyde dehydrogenase (ALDH2) in the liver, which are different in both men and women. Also, women may be more sensitive to the ethanol metabolic product acetaldehyde-induced cardiac contractile depression, which may contribute to the sex difference in alcoholic cardiomyopathy.

Why are women more vulnerable to developing brain health issues, heart attacks and liver disease from prolonged alcohol consumption?

The consequences associated with heavy drinking are accelerated in women. A man, for example, can be a heavy drinker for 20 to 30 years and have moderate difficulties, but a woman can be a heavy drinker for only five years and have moderate problems.

Women are more at risk of developing a drinking problem later in life. They are also at a greater risk of developing alcohol-related health problems as they get older due their physiology. Scientists have discovered that women produce smaller quantities of an enzyme called alcohol dehydrogenase (ADH), which is released in the liver and breaks down alcohol in the body.

Meanwhile, alcohol is absorbed by fat and dispersed by water. Women have a more severe physiological response to alcohol due to their naturally larger amounts of body fat and lower levels of body water.

That’s why women achieve higher levels of alcohol in their blood after drinking equivalent amounts of alcohol as men.

What are the severe consequences of alcohol use during pregnancy, including the risks of miscarriage, stillbirth, pre-term birth and foetal alcohol spectrum disorders (FASDs)?