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Women and Alcohol

It is not being sexist to tell you that the simple fact is that alcohol affects women differently than men. Women can expect substantially more alcohol-caused impairment than men at equivalent levels of consumption.
Women are more sensitive to alcohol:

  • Since, on the average, women are smaller than men, equivalent doses of alcohol produce higher levels of concentration in women's bodies.
  • The average female carries more body fat than the average male, and body fat contains little water. Consequently, most women have less body water to dilute the alcohol, leaving a higher concentration of alcohol in women's bodies.
  • Alcohol dehydrogenase is a metabolizing enzyme that helps the body get alcohol out of its system. Women have less of this enzyme than men, so more of what women drink enters the bloodstream as pure alcohol.
  • Fluctuating hormone levels in women means that the intoxicating effects of alcohol will set in faster when their estrogen levels are higher, premenstrually. Also, alcohol increases the estrogen levels- birth control pills or other medications with estrogen will cause the intoxicating effects to set in at lower levels of BAC.

Fact Sheet: Women and Alcohol

Alcohol Use

  • 77.6% of women age 12 and older reported ever using alcohol, while 60% reported past year use and 45.1% reported using alcohol in the past month.1
  • 82.5% of white women reported ever using alcohol, while 65% reported past year use and 49.7% reported using alcohol in the past month.1
  • 67.9% of black women reported ever using alcohol, while 45.1% reported past year use and 32.3% reported using alcohol in the past month.1
  • 60.8% of Hispanic women reported ever using alcohol, while 48.4% reported past year use and 33.6% reported using alcohol in the past month.1
  • Among current female drinkers, 7.16% of whites, 10.22% of blacks, 22.16% of American Indians/Alaska Native, and 9.03% of Hispanics reported alcohol dependence.2
  • Men and women reported different levels of alcohol involvement. 58.7% of men age 12 and older reported past month alcohol use compared to 45.1% of women, while 23.2% of men age 12 and older reported binge drinking in the past month compared to 8.6% of women.3

Health

  • Women absorb and metabolize alcohol differently than men.4
  • Alcohol consumption is associated with a linear increase in breast cancer incidence in women over the range of consumption reported by most women. A pooled analysis of several studies found breast cancer risk was significantly elevated by 9% for each 10-grams per day increase in alcohol intake for intakes up to 60 grams per day.5
  • Although the mean lifetime dose of alcohol in female alcoholics is only 60% of that in male alcoholics, one study noted that cardiomyopathy (a degenerative disease of the heart muscle) and myopathy (a degenerative disease of skeletal muscle) was as common in female alcoholics as in males. The study concluded that women are more susceptible than men to the toxic effects of alcohol on the heart muscle.6
  • Brain shrinkage in men and women was found to be similar despite significantly shorter periods of alcohol exposure or drinking histories in women.7
  • Women with chronic pancreatitis have shorter drinking histories than that of men. Women with alcoholic hepatitis and cirrhosis were found to have consumed less alcohol per body weight per day than men. These findings indicate that women are more vulnerable to alcoholic liver disease than men.8
  • Although alcohol problems are more common in male trauma patients, women with alcohol problems are just as severely impaired, have at least as many adverse consequences of alcohol use, and have more evidence of alcohol-related physical and psychological harm.9

Suicide

  • One study showed that 40% of alcoholic women attempted to commit suicide, compared to 8.8% of non-alcoholic women.10
  • Younger women who are alcoholics are nearly twice as likely to attempt to commit suicide (50.5%) than older women who are alcoholics (25.5%).10
  • A study of suicides among females in New Mexico found that 65.5% of the decedents had alcohol or drugs present in their blood at the time of autopsy.11

Use During Pregnancy

  • Since 1990 the Dietary Guidelines for Americans have stated that women who are pregnant or planning to become pregnant should not drink alcohol.
  • A national survey found that 58.8% of women age 15-44 drank while pregnant.12
  • 65.8% of pregnant women in their first trimester reported using alcohol, while 56.6% of women in their second trimester and 53.9% of women in their third trimester reported alcohol use.12

Victimization13

  • 57% of female victims of intimate violence (i.e., current or former spouses, boyfriends, etc.) reported that the offender had been drinking at the time of the offense.
  • 62% of female victims of alcohol-related violence reported experiencing some form of injury.

Criminal Behavior14

  • An estimated 4 in 10 women committing violence were perceived by the victim as being under the influence of alcohol and/or drugs at the time of the crime.
  • An estimated 25% of women on probation, 29% of women in local jails, 29% of women in state prisons, and 15% of women in federal prisons had been consuming alcohol at the time of the offense.

Drinking and Driving15

  • Women are less likely than men to be involved in fatal alcohol-related crashes. However, from 1977 to 1997 the number of male drivers involved in alcohol-related fatal traffic crashes decreased 31%, while the number of females drivers involved in alcohol-related fatal crashes has increased 12%.

Moderate Drinking16

  • Moderation is defined as no more than one drink per day for women.
  • One drink is 12 ounces of regular beer, 5 ounces of wine, and 1.5 ounces of 80-proof distilled spirits.

References
1. Substance Abuse and Mental Health Services Administration. (1999). National Household Survey on Drug Abuse: Population Estimates 1998. DHHS Publication No. (SMA) 99-3327. Rockville, MD: U.S. Department of Health and Human Services.
2. National Institute of Alcohol Abuse and Alcoholism. (1998). Drinking in the United States: Main findings from the 1992 National Longitudinal Alcohol Epidemiologic Survey. NIH Publication No. 99-35198. Bethesda, MD: U.S. Department of Health and Human Services.
3. Substance Abuse and Mental Health Services Administration. (1999). Summary of Findings from the 1998 National Household Survey on Drug Abuse. DHHS Publication No. (SMA) 99-3328. Rockville, MD: U.S. Department of Health and Human Services.
4. National Institute on Alcohol Abuse and Alcoholism. (1999). Are women more vulnerable to alcohol effects? Alcohol Alert No. 46. Rockville, MD: U.S. Department of Health and Human Services.
5. Smith-Warner, S. A., Spiegelman, D., Yaun, S., van den Brandt., P. A., Folsom, A. R., Goldbohn, R. A., Graham, S., Holmberg, L., Howe, G. R., Marshall, J. R., Miller, A. B., Potter, J. D., Speizer, F. E., Willett, W. C., Wolk, A., & Hunter, D. J. (1998). Alcohol and breast cancer in women: A pooled analysis of cohort studies. Journal of the American Medical Association, 279(7):535-540.
6. Urbano-Marquez, Estruch, R., Fernandez-Sola, J. Nicolas, J. M., Pare, J. C., & Rubin, E. (1995). The greater risk of alcoholic cardiomyopathy and myopathy in women compared with men. Journal of the American Medical Association, 274(2): 149-154.
7. Mann, K., Batra, A., Gunthner, A., & Schroth, G. (1992). Do women develop alcoholic brain damage more readily than men? Alcohol Clin Exp Res, 16(6):1052-6.
8. Mezey, E., Kolman, C. J., Diehl, A. M., Mitchell, M. C., & Herlong, H. F. (1988). Alcohol and dietary intake in the development of chronic pancreatitus and liver disease in alcoholism. American Journal of Clinical Nutrition, 48(1):148-51.
9. Gentilello, L. M., Rivara, F. P., Donovan, D. M., Villaveces, A., Daranciang, E., Dunn, C. W., & Ries. R. R. (2000). Alcohol problems in women admitted to a level I trauma center: A gender-based comparison. The Journal of Trauma: Injury, Infection, and Critical Care, 48(1):108-114.
10. Lisansky-Gomberg, E. S. (1989). Suicide Risk Among Women with Alcohol Problems. American Journal or Public Health, 79(10):1363-1365.
11. Olson, L., Huyler, F., Lynch, A. A., Fullerton, L., Werenko, D., Sklar, D., & Zumwalt, R. (1999). Guns, alcohol, and intimate violence: The epidemiology of female suicide in New Mexico. Crisis, 20(3):121-6.
12. Substance Abuse and Mental Health Services Administration. (1998). Substance Abuse and Mental Health Statistics Source Book, 1998. DHHS Publication No. (SMA) 98-3170. Rockville, MD: U.S. Department of Health and Human Services.
13. Greenfeld, L. A. (1998). Alcohol and crime: An analysis of national data on the prevalence of alcohol involvement in crime. Washington, DC: U.S. Department of Justice, Bureau of Justice Statistics.
14. Greenfeld, L. A., & Snell, T. L. (1999). Women Offenders. Washington, D.C.: U.S. Department of Justice.
15. Yi, H., Stinson, F. S., Williams, G. D., & Bertolucci, D. (1999). Trends in alcohol-related fatal traffic crashes United States, 1975-97. Surveillance Report #49. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism.
16. Dietary Guidelines for Americans, 2000. United States Department(s) of Agriculture and Health and Human Services.
National Institute on Alcohol Abuse and Alcoholism No. 10 PH 290 October 1990

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