Alcohol and perimenopause: What you need to know
Many women notice that alcohol affects them differently in perimenopause. A glass of wine that once felt relaxing may now mean a restless night, a hot flush or feeling flat the next day. Here is what the research shows.
Alcohol can make several common perimenopause symptoms harder to manage, particularly sleep, energy and night sweats.
Alcohol can help you fall asleep faster, but it disrupts sleep in the second half of the night and reduces REM sleep.1 With sleep already affected by hormonal changes and night sweats in perimenopause, this can make a real difference to how rested you feel.
Poorer sleep often means lower energy, more fatigue and lower stress tolerance the next day. Alcohol can also affect mood and anxiety, which many women already find harder to manage during perimenopause.
Research on alcohol and hot flushes has been mixed. However, a large study of women aged 42 to 52 found that drinking more alcohol, more often, was linked with more bothersome hot flushes and night sweats, with the strongest link for night sweats.2 Alcohol also widens blood vessels, which may be one reason some women notice it triggers hot flushes.
Alcohol can affect hormone levels. In a small controlled study, premenopausal women had higher oestrogen levels during a period of drinking about two drinks a day than during a period without alcohol.3 This effect on oestrogen is thought to be one reason alcohol is linked with a higher risk of breast cancer, even at moderate intakes.4
Midlife is an important time to look after your heart and bones, and alcohol can affect both.
Blood pressure: Regular drinking is linked with higher blood pressure over time. The more you drink, the greater the effect, although even small amounts may raise blood pressure slightly.5
Bone health: Drinking more than about two drinks a day is linked with a higher risk of fractures.6 Heavier drinking can also increase how much calcium is lost in urine.7 This matters in perimenopause, as falling oestrogen already speeds up bone loss.
Canada's Guidance on Alcohol and Health describes 1 to 2 standard drinks a week as low risk. At 3 to 6 drinks a week, the risk of several cancers, including breast cancer, increases.4
It is important to know that there is no completely safe amount of alcohol. The guidance notes that no amount or type of alcohol is good for your health, and that drinking less is better.4
Alcohol is often about much more than the drink itself. It can be part of how we socialise, celebrate, unwind or cope with stress, and for some people it is closely linked with mental health. Perimenopause can also be a time of extra pressure and change. There is no judgement here. Noticing why, when and how you drink can be a helpful first step.
If you are wanting to cut back
Small changes can make a difference. Some ideas that may help:
- Alternate each alcoholic drink with water or an alcohol free option.
- Try alcohol free drinks if you enjoy the ritual, and serve them in a wine glass.
- Choose a smaller glass or serve.
- Set a limit before you start. Aiming to reduce by 1 to 2 drinks at a time can help you cut back gradually.
- Eat before and while drinking.
- Plan some alcohol free days each week.
Many of these are also suggested in Canada's guidance on drinking less.4
Support is available
If you are finding it hard to cut back, or are worried about your drinking, you are not alone and support is available. In Alberta, the Addiction Helpline offers free, confidential support 24 hours a day on 1-866-332-2322. You can find more mental health and addiction helplines here. Your GP is also a great place to start.
Want support through perimenopause?
Nula Nutrition can support your nutrition for health through perimenopause and beyond. The approach is always evidence based and tailored to you. Registered dietitian consultations are available for women's health in Calgary and online across Alberta, including Canmore, Banff, Edmonton, and Cochrane.
Ready to get personalised nutrition support?
Book a Free Discovery CallWritten by Madison Hows RD APD
References
1. Ebrahim IO, Shapiro CM, Williams AJ, Fenwick PB. Alcohol and sleep I: effects on normal sleep. Alcohol Clin Exp Res. 2013;37(4):539-549. doi:10.1111/acer.12006
2. Kwon R, Chang Y, Kim Y, et al. Alcohol consumption patterns and risk of early-onset vasomotor symptoms in premenopausal women. Nutrients. 2022;14(11):2276.
3. Reichman ME, Judd JT, Longcope C, et al. Effects of alcohol consumption on plasma and urinary hormone concentrations in premenopausal women. J Natl Cancer Inst. 1993;85(9):722-727. PMID: 8478958
4. Canadian Centre on Substance Use and Addiction. Canada's Guidance on Alcohol and Health: Final Report. 2023.
5. Di Federico S, Filippini T, Whelton PK, et al. Alcohol intake and blood pressure levels: a dose-response meta-analysis of nonexperimental cohort studies. Hypertension. 2023;80. doi:10.1161/HYPERTENSIONAHA.123.21224
6. Kanis JA, Johansson H, Johnell O, et al. Alcohol intake as a risk factor for fracture. Osteoporos Int. 2005;16(7):737-742. PMID: 15455194
7. Rico H. Alcohol and bone disease. Alcohol Alcohol. 1990;25(4):345-352. PMID: 2222569
