Why Alcohol Affects You More As You Age

Why age and alcohol don’t mix

There’s a reason that our alcohol tolerance gets lower as we grow older, and it’s worse for women than it is for men.

“As we age, we lose total water volume and are thus less able to dilute the impact of alcohol in our system,” explained Cathleen Morrow, M.D., chair and associate professor of community and family medicine at Dartmouth Hitchcock Medical Center. “Women are already more at risk due to their smaller size and lower levels of enzymes that metabolize alcohol compared to men.”

Unfortunately, the already low levels of these enzymes continue to decrease as women age, meaning that alcohol is metabolized (changed into a form your body can use) much more slowly.

Alcohol and menopause

Beyond causing hangovers more easily, drinking alcohol has a laundry list of other downsides for women in perimenopause or transitioning to menopause.

“Mood swings, sleep disruption and hot flashes are some of the more common and troubling symptoms of this time period that can all be [made worse] by alcohol,” explained Morrow. The good news: She’s had patients who saw these symptoms improve when they eliminated alcohol.

While drinking may help some people fall asleep, it ultimately leads to a less restful night’s sleep, which can be debilitating when combined with other menopause symptoms.

“The metabolism of alcohol continues as you sleep and is directly related to sleep disruption, often leading to early awakening and poorer overall quality of sleep,” Morrow said. “This issue is tough for patients, because many say they cannot get to sleep without their evening nightcaps, but there is plenty of data that reveals that alcohol is not helpful for sleep.”

It’s no secret that unwanted weight gain can be a reality of menopause. Not only does an increase in body fat continue to slow down the metabolization of alcohol, but drinking alcohol, in turn, increases body fat.

“It is very common for women to gain weight during menopause — a function of metabolic slowing as we age — and chronic regular alcohol use can certainly contribute to the overall gain,” Morrow said. “I always remind women about the ‘empty’ calories of alcohol. If you have two glasses of wine per night, that’s an additional 225 or so calories. If you are drinking two beers a night, that’s about 300 plus calories, and though that might not sound like a lot, it adds up.”

If you were thinking it’s enough to swap out dessert for a cocktail to account for the added calories, think again. There’s evidence that alcohol affects your stress-response pathways, activating your fight-or-flight response and increasing your cortisol (your primary stress hormone) levels. High cortisol levels not only contribute to insomnia, but can also increase belly fat and cause you to stress-eat junk food, which just keeps the cycle going — a particularly cruel side effect because many of us reach for a drink to combat stress.

Alcohol is a depressant, which is why it can initially help you snooze — but that means it can also worsen mood swings. Women prone to or experiencing depression should consider minimizing or avoiding alcohol, advised Juliana Kling, M.D., M.P.H., assistant director of the Women’s Health Center at the Mayo Clinic.

Additionally, around the age of menopause, women start to have increased risk of cancer, heart disease and other negative health outcomes. Alcohol only increases the risks even further, Kling said, adding, “It is advised that women be mindful of their alcohol intake.”