Biological Differences Leave Women at Higher Risk of Alcohol Misuse

Though men are more likely to drink alcohol and consume larger amounts than women, it’s women who find themselves at a higher risk of alcohol misuse, revealing that biological factors play an important role in alcohol misuse, more than we may have realized.

For women, biological differences in body structure and body chemistry cause women to absorb more alcohol and take longer to metabolize it. But, that’s not all, as there are key structural and biochemical differences that make alcohol more problematic for women including:

• Women weigh less and their bodies contain less water and more fat than men’s bodies. Alcohol resides predominantly in body water and pound-for-pound, women have less water in their bodies than men. And, fat doesn’t absorb alcohol, so women absorb more alcohol, pound for pound, than men. In fact, a woman’s body absorbs 30 percent more alcohol after drinking the same amount as a man, according to the Office of Alcohol and Drug Education at the University of Notre Dame. Women also end up with a higher blood alcohol concentration as well.

• Women’s bodies take longer to metabolize alcohol, the result of gender differences in gastric acid activity and reduced levels of dehydrogenase, a digestive enzyme that helps break down alcohol. This is also why women become more intoxicated more quickly after drinking the same amount as men.

• Hormonal factors may make women more susceptible to the effects of alcohol. For example, using birth control pills, as well as menstruation or ovulation, can all slow a woman’s alcohol metabolism and lead to higher blood alcohol concentrations.

• Psychological factors can also be an issue in how women’s bodies react to alcohol. Women are twice as likely as men to have anxiety disorder, which is partially responsible for the high rates of alcohol misuse among females. Women are more likely to describe their motivation for alcohol use as a means of “taking the edge off.” And, women experience unique, gender based societal pressures that contribute to feelings of anxiety. The same connection can be found between alcohol use and depression, with women at heightened risk for self-medicating negative moods such as depression with alcohol.

• Women are more likely to endure chronic pain than men, which could cause them to self-medicate with alcohol.

• While men typically drink alcohol to enhance positive feelings, women more frequently drink in response to negative emotions, anxiety or stress. In addition, trauma, abuse, social isolation, prolonged stress, and “negative affect” (a state of emotional stress characterized by “bad” feelings such as anxiety, fear, anger, irritability and sadness) are all predictive of alcohol misuse and associated with rising rates of AUD in women.

• Stress may play a significant role in initiating and maintaining alcohol use in women. In one study, women who had two or more past year stressful life events were four times more likely to have a new onset AUD than men.

• How early in life a person starts drinking can also predict future alcohol use. In this case, gender differences have shifted significantly. Male drinking used to far surpass female drinking at all levels from eight to 12th grades. Over the past 20 years though, females in their teens and early twenties reported drinking and getting drunk at higher rates than their male peers – in some cases, for the first time since researchers began measuring such behavior.

• Victimization, a term used to describe the presence of abuse in a woman’s life, appears to be a significant risk factor for AUD in women.

• Alcohol (and other substance use) in women tends to develop into an addiction more quickly than in men.

With nearly four million American women suffering from alcohol misuse and dependence, it’s hard not to take a further look at the structural disparities and their correlation to alcohol misuse. The impact alcohol misuse has on women can have a lasting impact on others around them, and to their own health and wellbeing.

And, with the odds seemingly stacked against women from the start, it’s important to recognize and understand the reasons why women are at higher risk and how to help combat alcohol misuse.

You can play a key role in helping stem the tide of female alcohol misuse, contact Pelago to learn how.