Recent reports have shown that women are drinking more than ever, be that as it may due to stress, at social events, or just to have a good time. In the United States, a study released in July found that an increasing number of women are drinking themselves to death. While alcohol-related deaths remain higher among men, “the gender gap is narrowing”, as per the report.
India, too, is witnessing a rise in drinking among women. “Alcohol use has definitely increased across the population with women and younger people using it more than ever,” says Dr Jyoti Kapoor, founder-director and senior psychiatrist at Manasthali. A similar trend was seen in last year’s study by The Lancet. In another survey, 37% of women in Delhi said they felt their alcohol consumption has increased since the Covid pandemic. Over 45% of women in the national capital attributed their increased drinking to stress.
Fair play
“Women tend to be more sensitive to alcohol than men,” says Dr Shambhavi Jaiman, consultant psychiatrist at Fortis Memorial Research Institute, Gurugram. “It is because women generally have a higher percentage of body fat and a lower percentage of water than men, which can lead to higher blood alcohol concentrations after consuming the same amount of alcohol,” she explains. This is because fat retains liquor while water dilutes it. Women also produce smaller quantities of an enzyme called alcohol dehydrogenase (ADH), which is produced in the liver and breaks down alcohol, research shows. Hence, it appears that physiology makes the ill effects of alcohol more pronounced among women compared to their male counterparts. “They may also be likely to experience unpleasant acute effects, such as hangover symptoms,” says Dr Ajay Agarwal, director and HOD, internal medicine, Fortis Hospital, Noida.
Not only hangovers, “the risk of cirrhosis and other alcohol-related liver diseases is higher for women than for men”, says Dr Rajinder Kumar Singal, principal director and HOD, internal medicine, BLK-Max Super Speciality Hospital. The same holds true for alcohol-related cognitive decline and shrinkage of the brain. Notably, “women who drink excessively are at increased risk for damage to the heart muscle at lower levels of consumption and over fewer years of drinking than men,” the doctor says. “Also, in women, drinking is also associated with breast cancer, even at low levels of consumption,” he adds.
Alcohol is a diuretic, which means it increases urine production and makes you lose water. “Heavy drinking can also worsen menstrual cramps by thickening menstrual fluids and blood. It can also make the periods heavier,” says Dr Singal. Regular heavy booze sessions can also cause irregular or even skipped periods. “It is because alcohol can temporarily increase estrogen and testosterone levels, disrupting typical hormonal fluctuations that happen during ovulation,” explains Dr Agarwal.
These are in addition to the already-known impacts when a woman drinks during pregnancy, which can increase the risk of having a baby with foetal alcohol spectrum disorders (FASD). In extreme cases, it can even result in foetal alcohol syndrome, which is associated with intellectual disabilities and birth defects.
“Excessive drinking also raises the risk of miscarriage, stillbirth, premature delivery and Sudden Infant Death Syndrome (SIDS),” comments Dr Agarwal.
With such an impact on physical health, that on mental and brain health is also evident. “The short-term effects include impaired judgment and mood alterations. Long-term effects may lead to structural changes in the brain, mental health disorders, addiction (AUD), worsening of existing conditions, and increased risk of neurological disorders,” says Dr Jaiman. “Moderate drinking may have limited health benefits, but excessive or heavy drinking poses significant risks,” she adds.
Problem area
Despite such pronounced harms, an increasing number of women are not only drinking more but are also struggling with alcohol-related issues.
“With widespread acceptance of social drinking comes the risk of alcohol use disorders. So we see quite a few women with alcohol use disorder (AUD) in the OPD. The incidence of alcohol addiction, acute and chronic liver disease and emotional dysregulation with alcohol intoxication is also on the rise,” says Dr Kapoor.
Here, it needs to be factored in that the motivations for drinking differ among men and women, which are influenced by a complex interplay of personal, cultural and social factors. For example, women might resort to drinking in a bid to cope with stress and social pressures, weight and body image concerns, as well as escaping trauma and abuse, says Dr Jaiman. “However, individual motivations can vary widely, and not all women or men will have the same reasons for drinking. Additionally, problematic drinking patterns can develop for various reasons and are influenced by a combination of biological, psychological and environmental factors,” she highlights.
If experiencing dependency, one can watch out for the following signs to stay cautious:
Preoccupation with alcohol
Craving
Inability to limit the amount of alcohol consumed
Tolerance
Withdrawal symptoms when drinking is reduced or stopped
Repeated unsuccessful efforts to quit or control alcohol use
Neglecting responsibilities
Engaging in risky behaviours while under the influence, such as driving while intoxicated
Social isolation
Continued use despite consequences. Naturally, addiction can have a detrimental impact on health and the quality of life in general. However, there is treatment available, which includes:
Cognitive-behavioural therapy or CBT, where the focus is on identifying and changing thought patterns and behaviours related to alcohol use
Motivational enhancement therapy or MET, which is a counselling approach where the aim is to increase motivation for change and build a commitment to treatment
Contingency management or CM, where tangible rewards are provided for positive behaviours, such as staying away from alcohol
12-step programmes, which include participation in support groups, can play a crucial role in the recovery, among others.
Also, there are coping mechanisms that can help in managing alcohol use. These include developing healthy habits, practising mindfulness, adopting relaxation techniques, seeking support from friends and family, engaging in hobbies, avoiding triggers and, most importantly, setting realistic goals, says Dr Jaiman. There is help available, and it is always ideal to consult a professional if you feel your alcohol pattern has become problematic.