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Does Alcohol Affect Women Differently?

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How Alcohol Affects Women and Men Differently

Alcohol misuse is the third-leading preventable cause of death in the United States, following only tobacco use and poor diet plus lack of exercise. It ranks fourth among preventable causes of death globally. Alcohol is cited as the cause of about 95,000 U.S. deaths annually, with men dying at approximately two and a half times the rate of women.

The effects a woman experiences from drinking alcohol differ from those for men, according to Women’s Health Research at the Yale School of Medicine. Women seem more susceptible than men to many of the adverse effects of using alcohol. Due to gender differences in body composition, the concentration of alcohol tends to be higher in the blood of women than in that of men who drink the same amount. Women get drunk faster, too.

There is even research, cited below, suggesting that when it comes to negative consequences of alcohol use, women are more vulnerable than men to organ damage, trauma due to interpersonal violence, and traffic accidents.

Biological Differences

Alcohol primarily affects women more intensely and extremely than men because women’s bodies dilute and metabolize alcohol differently.

Alcohol-Diluting Ability

Fat retains alcohol, and water dilutes it. Proportionately, women’s bodies contain more fat and less water than men’s bodies. Specifically, according to a report from Creighton University, the average total body content of water in women is 52%, while that of men is 61%. This exposes the organs of female bodies to greater alcohol concentrations and for greater lengths of time than the organs of male bodies.

Alcohol-Metabolization Ability

Alcohol dehydrogenase is an enzyme responsible for breaking alcohol down before it enters the bloodstream. Women have less of this enzyme than men. This means men break down alcohol more quickly and, therefore, that the blood-alcohol levels are higher in women than in men drinking equivalent amounts of alcohol. This difference occurs even when adjusting for body weight. The result is that a single drink for women has the same effects as two drinks for men.

On the flip side, the Creighton University report notes, women seem to eliminate alcohol from their bloodstreams more quickly than men do. Since alcohol is almost entirely metabolized in the liver, this difference may be due to women’s higher liver volume per unit of lean body mass.

Hormonal Aspects

Unlike a woman’s, the susceptibility of a man to become drunk does not change significantly at particular times of the month. Premenstrual hormonal changes cause a woman to become intoxicated more quickly in the days right before her period. Additionally, alcohol raises estrogen levels, and medicines containing estrogen, such as birth control pills, increase intoxication.

Habitual Differences

In the United States, more men than women drink alcohol, according to the Centers for Disease Control and Prevention (CDC). Almost 59% of adult men reported drinking alcohol in the past 30 days, compared with 47% of adult women.

Men are more prone to become dependent on alcohol, and they are almost twice as likely to binge drink; this is defined as drinking at least five drinks per occasion on five or more days in a month. However, women endanger their health by binge drinking, too. The CDC notes that about 13% of adult women report binge drinking, about 18% of women of child-bearing age (18-44) binge drink, and binge drinking in high school is more common among females than males.

Study on Binge Drinking and Traumatic Stress in Females vs. Males

Binge drinking is a relatively reliable predictor of alcohol dependence, while repeated binge drinking episodes are common characteristics of alcohol use disorder.

In a study that the VA Portland Health Care System and Oregon Health & Sciences University conducted on mice in 2018, researchers found that males and females with a history of binge drinking reacted differently to traumatic stress.. They’re hopeful that the research results could have implications for how humans react to both excessive drinking and traumatic stress.

The researchers note that stress can turn recreational alcohol use into excessive alcohol use, and post-traumatic stress disorder (PTSD) in particular has been linked with the development of alcohol use disorders. The male mice in the study were more likely than the females to drink alcohol instead of water after experiencing stress. Among people with a PTSD diagnosis, 28% of women have a concurrent alcohol use disorder.

Health and Safety Risks

According to research, women are more prone than men to problems resulting from alcohol use. These include trauma, organ damage, legal problems, and interpersonal problems.

Liver Damage

It takes less time and less alcohol consumption for women to develop alcohol-induced liver disease than it does for men. What’s more, women are more susceptible to developing alcoholic hepatitis and even dying from cirrhosis. According to animal research, the increased risk of liver damage in females may be connected to certain physiological effects of estrogen.

Brain Damage

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reported that, according to brain scans, women may be more susceptible to alcohol-induced brain damage. Using magnetic resonance imaging (MRI,) researchers discovered that a particular region of the brain involved in the coordination of several brain functions was smaller in alcoholic women than in both nonalcoholic women and alcoholic men, even when accounting for differences in head size.

Another study, which calculated the different utilization of metabolic energy in various regions of the brain, showed alcoholic and nonalcoholic men had significant differences from one another in this utilization, while such differences didn’t exist as much in women. While this doesn’t indicate that women are more vulnerable to brain damage from alcohol use than men, the female alcoholic subjects in the study reported less extreme alcohol use than the male ones.

Heart Disease

The NIAAA also notes that research has revealed that both men and women who drink one or two alcoholic beverages daily have a lower death rate due to coronary heart disease than both those who drink alcohol more heavily and those who abstain from alcohol entirely. Moreover, both men and women who drink heavily have similar rates of cardiomyopathy, or alcohol-related heart muscle disease, even though women drink 60% less alcohol than men over their lifetime.

Breast Cancer

Numerous studies have found an increased risk of breast cancer due to moderate-to-heavy consumption of alcohol. One more recent study reported by the NIAAA, however, found that consumption of up to one alcoholic drink per day did not increase breast cancer risk at all, and most women report drinking no more than that amount.

Violent Victimization

According to a survey of women in college, there was a significant correlation between how much alcohol the female college students studied drank per week and their sexual victimization experiences. Another study found that young women in high school who drank alcohol within the last year were found more likely to be victimized with dating violence, such as shoving, punching or kicking, than female students who abstained from alcohol.

In more research reported by the NIAAA, in cases of heavy premarital drinking by both partners, was predictably higher in the first year of marriage. In some of the studies reviewed, a wife’s problem drinking was associated with husband-to-wife aggression no matter the husband’s drinking habits.

Traffic Crashes

Women are less likely to drive after drinking than men and are involved in fewer alcohol-related collisions. However, the relative risk of driver fatalities from alcohol-related crashes is higher among women than men, even accounting for differences in blood-alcohol concentrations. Meanwhile, in laboratory studies, researchers found potential differences among genders in how alcohol influences driving performance.

The lower rates of drinking and driving among women could be due to their statistically lower risk tolerance and likelihood of having an acceptable view of drinking and driving behavior. In 1990, a nationwide survey found that 27% of men believed that consuming one or two drinks prior to driving was acceptable behavior, while only 17% of women agreed. Attitudes affecting drivers’ behavior may have changed substantially over the past three decades, though, since there’s a consistently increasing number of female drivers involved in fatal automobile crashes year over year.

Risk Factors

Several factors could increase the risk of alcohol dependence or abuse among women.

Genetic Factors

There’s still ongoing debate about how much genetic factors influence the risk to women for alcoholism. According to one survey of over 2,000 female twins, rates of alcohol consumption were more highly correlated among identical twins than fraternal ones. Other studies have verified these results among both male and female pairs of twins. No statistically notable differences have yet been found, however, between pairs of twins where one is a boy and the other is a girl.

In studies of women adopted at birth, there’s a notable correlation between alcoholism in an adoptee’s biological parents and an adoptee’s own alcoholism. Moreover, antisocial personality traits, such as aggressiveness in an adoptee’s biological parents, may also predict alcoholism in the adoptee; this, too, is independent of the adoptee’s gender.

Relationships between genetic factors and environmental factors in alcoholism still require more study. Researchers are presently studying laboratory animals in an effort to identify genetic factors that may contribute to differences in alcohol sensitivity between women and men.

Age of Initiating Drinking

Despite prior studies finding that women tended to initiate drinking at older ages than men, that difference has all but vanished. With that in mind, consider that, according to a big nationwide survey, over 40% of people who began drinking before the age of 15 received a diagnosis of alcohol dependence at some point in their lives, while among those who started drinking at age 20 or older, lifetime alcohol dependence dropped to around 10%. The annual rate of this decline was relatively equal among women and men.

Age of the Drinker

Older women have a slower metabolism, less tolerance for alcohol, and even less body water than younger women, making them generally more vulnerable to the health and safety risks of alcohol consumption.


Another large survey of the general population revealed that women who reported childhood sexual abuse were more likely to develop alcohol-related problems, like household accidents or family discord, than other women; they were also more likely to develop one or more alcohol-dependence symptoms. In a different study, women undergoing treatment for alcoholism had a much greater likelihood of reporting sexual abuse from their childhoods, as well as verbal aggression or violence from their fathers, than women generally.

Different researchers have drawn different conclusions from their studies on this subject, however. One set of researchers relied on court records rather than women’s memories of their childhood sexual or physical abuse. They found that a history of childhood neglect significantly predicted how many alcohol-related symptoms a woman experienced. However, they did not find same correlation between a history of childhood abuse and the number of these symptoms. These findings were independent of alcohol or other drug problems (AOD problems) among the parents as well as of age, race, or childhood poverty.

A link has also been found between adulthood physical abuse and the use of alcohol among women and issues related to that. In one study, researchers found that many more women in treatment for alcoholism experienced extreme partner violence (such as threatening with a weapon, punching, or kicking) than other women in the community. What’s more, even among females in the community not undergoing alcoholism treatment, those with AOD problems reported much greater rates of extreme partner violence than those women without such problems. While this evidence shows a clear correlation between AOD problems among women and their victimization by physical or sexual violence, it does not demonstrate a causal relationship between the two.

Alcohol use and abuse don’t just affect the women who directly experience them but their families and friends as well. Drinking alcohol can impact a woman’s career and relationships as well as her health and safety. What’s more, as science has now shown, alcohol affects women differently from men. That means treatment for a woman’s alcohol-related concerns must also be different than such treatment for men.

If you are a woman struggling with alcohol use, we can help. Reach out to us at Liberty Bay Recovery Center to speak with one of our recovery experts about how you can get the treatment you need.