Why women are more prone to serious complications from drinking alcohol

While it’s no surprise that heavy drinking comes with health consequences, women in particular are more prone to serious complications from alcohol — including an increased risk of alcohol-related death, according to a new study.

The study, published in the journal Alcoholism: Clinical and Experimental Research, looked at the death certificates of Americans 16 and older from 1999 to 2017. The researchers found that not only were there nearly 1 million alcohol-related deaths in that time period, but that the number of alcohol-related deaths per year of people 16 and older doubled (from 35,914 to 72,558 deaths per year).

Women in particular are being affected: The researchers found that the largest annual increase of alcohol-related deaths occurred among non-Hispanic white women.

Drinking alcohol can cause long-term health problems in women. (Photo: Getty Images)
Drinking alcohol can cause long-term health problems in women. (Photo: Getty Images)

That’s even more alarming considering the number of women who are drinking alcohol and abusing alcohol is on the rise, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

“Historically, the most protective factor for women was that it was less normative for women to drink a lot,” Keith Humphreys, PhD, a professor of psychiatry and behavioral sciences studying alcohol consumption at Stanford University and who was not involved in the study, tells Yahoo Lifestyle. “That was changed largely by alcohol companies. Enormous amounts of women were targeted in advertising and it worked — and now women drink much more and now they’re dying much more.”

The health consequences of drinking

Even though men are not only more likely to drink alcohol but also more of it, alcohol hits women harder. The Centers for Disease Control and Prevention (CDC) says that “gender differences in body structure and chemistry cause women to absorb more alcohol, and take longer to break it down and remove [metabolize] it from their bodies,” adding, “These differences also make it more likely that drinking will cause long-term health problems in women than men.”

Excessive alcohol use can lead to several health issues over time — and women are particularly affected. “The risk of cirrhosis and other alcohol-related liver diseases is higher for women than for men,” according to the CDC. Drinking too much alcohol can also affect the brain, causing shrinkage and memory loss. According to the CDC, “research suggests that women are more vulnerable than men to the brain damaging effects of excessive alcohol use, and the damage tends to appear with shorter periods of excessive drinking for women than for men.”

Heavy drinking also impacts heart health. The CDC states that studies show women who drink excessively have a higher risk of damaging the heart muscle than men, “even for women drinking at lower levels.”

Why alcohol affects women more than men

Humphreys explains that, while the precise physiology is not well understood, one of the reasons why alcohol has a more profound effect on women is because, on average, they weigh less than men. According to the NIAAA: “Alcohol resides predominantly in body water, and pound for pound, women have less water in their bodies than men. This means that after a woman and a man of the same weight drink the same amount of alcohol, the woman’s blood alcohol concentration… will tend to be higher, putting her at greater risk for harm.”

But it’s not just about size. Research shows that women also have fewer alcohol dehydrogenase (ADH) enzymes, which help the body metabolize alcohol.

The health consequences of drinking also develop more rapidly in women than in men. Humphreys says it’s called “telescoping” — “a term used to describe an accelerated progression from the initiation of substance use to the onset of dependence and first admission to treatment,” according to one study. “You’ll commonly see a woman who hasn’t been [drinking alcohol] as long as men and the physical punishment comes faster,” says Humphreys.

As Harvard University’s Celeste Robb-Nicholson, MD, puts it: “At every age, women are quicker to become alcohol-dependent and suffer the consequences.”

The U.S. Dietary Guidelines for Americans has recommendations aimed at reducing the risk of alcohol-related health issues, noting that if alcohol is consumed, it should be done in moderation: up to 1 drink per day for women and 2 drinks per day for men of legal drinking age.

“Next time you go to a bar or a liquor store, keep the risks of alcohol in mind,” noted the National Center for Health Research. “All women — regardless of size — need to remember that less alcohol could affect you more severely than it would a man.”

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