• Ruth Dewar

The Menopause and Alcohol...

So, here – as promised – is my guide to alcohol and its effects on peri-menopausal and menopausal women.

Tragically, research in this area is critically underfunded and whilst many papers have been widely published on this subject, there is little information on suitable treatment and help in this area.

The increase in prevalence rates of alcohol use disorders in younger versus older cohorts of female drinkers is many times higher than the corresponding increase in prevalence rates for male drinkers. Thus, the number and impact of older female drinkers is expected to increase over the next twenty years as the disparity between men's and women's drinking rates decrease. Due to differences in the metabolism of alcohol, women of all ages compared to men are at higher risk for negative physical, medical, social, and psychological consequences associated with "at-risk" and higher levels of alcohol consumption.

Low-level drinking actually equates to ONE DRINK PER DAY... (not one bottle!) but as we know, for most of us, our alcohol intake is much much higher. Any alcohol consumption increases the risk for breast cancer in older women. The possible beneficial effects of alcohol must be weighed with the fact that the research does not typically establish causality, that low-risk drinking equates to one standard drink per day, that there is a risk of progression towards alcohol dependence, and that there are alternate methods to gain the same benefits without the associated risks.

Ageing women face new sets of antecedents related to challenges in the middle and older adult phases of life, such as menopause, retirement, "empty nest," limited mobility, and illness. As women age, they are subject to an even greater physiological susceptibility to alcohol's effects, as well as to a risk of synergistic effects of alcohol in combination with prescription drugs.

Older women also experience unique barriers to detection of and treatment for alcohol problems. Current treatment options specifically for older women are limited, though researchers are beginning to address differential treatment responses of older women, as well as the development of elder women-specific treatment approaches. Treatment options include self-help/mutual peer support, which provides ancillary advantages, brief interventions in primary care settings, which have been demonstrated to be effective in reducing drinking levels, and cognitive-behavioural techniques, which have been demonstrated to be useful; but more studies and larger samples are needed and this type of intervention is old school and not for everyone! Elder-specific treatments need to be appropriate in terms of content, to address the challenges associated with life stage, such as the loss of the parental role and the onset of menopause, and in terms of process, such as delivery in a respectful therapeutic style and at a slower pace. Future directions in research should address the lack of assessment instruments, the risks of simultaneous use of alcohol and prescription medications, and the under-representation of older women in randomized trials of alcohol treatments.

Alcohol intake affects the female body differently than it affects the male body. This is caused by females' lower levels of dehydrogenase enzymes, the enzyme that breaks down alcohol, coupled with the higher fat/water ratio of the female body. Both these factors cause alcohol levels to rise more quickly after ingestion in women than in men. This makes females more vulnerable to alcohol's harmful effects, and consequently, women tend to develop alcohol-related diseases earlier in life than do men.

As women age and go through menopause, they experience changes in body composition and life changes like those listed above. The disparity between men's and women's rates of alcohol consumption decreases, especially in the last two decades.

Stress and depression related to menopause may trigger the onset of alcohol abuse or worsen established alcohol misuse. Alcohol abuse decreases quality of life and any potential positive effects of moderate alcohol intake are minuscule in comparison to the adverse effects caused by alcohol abuse. Further, due to social stigmas, women tend to have more difficulty gaining access to treatment and recovering from alcohol dependence than do men. Current research on interventions and treatments that aim to reduce alcohol use disorder (AUD) or to prevent its occurrence in middle-aged and elderly women is limited.

Adversely affecting and risky factors for women who overdrink include the following.

  • Mixing alcohol with prescription drugs – we are more susceptible to being prescribed medication as we age for general health problems and this is risky

  • Serious dependency but being in denial

  • Weight gain

  • Heart disease

  • Breast cancer!

  • Dysfunctional relationships with family and peers

  • Mental health problems, especially depression

  • Severe ageing in the skin

  • Inability to function socially – drinking at home alone

So what can we do? How do we access help?

Combatting excessive drinking is a tough mountain to climb. Every social situation entices us to drink...when we're happy...we drink; when we're sad...we drink; the kids have left home...we drink; it's a birthday...we drink; hey, the sun is out...let's go for a drink. I'M MENOPAUSAL AND ALL OVER THE PLACE...let's have a drink?

It's everywhere...and it's hard to escape, especially if we are worried about our consumption and are unsure how to tackle the problem head-on.

Hitting peri-menopause, I decided it was finally time to quit drinking. I will wholeheartedly admit that...with ageing, a couple of shitty relationships, my son getting older, and feeling lonely (the list goes on), my alcohol intake was becoming an issue.

I was full of self-loathing and feeling distressed about it all. It was affecting me physically and, most importantly, mentally too. I knew I had to make radical changes to achieve my life goals...but the thought of doing it without my good old friend Gin-ny and her sister the wine witch – well, it felt impossible.

I started to seriously look at my options...and to be honest, at first, there weren't that many.

The first step was to be honest with myself. Was this how I wanted to enter my next most fabulous phase in life? NO!!!

I opened up to a few close friends as to how I was feeling and was surprised to find that there seems to be a kind of underground movement of alcohol-free friendships. A few of my friends admitted that they too had been in the same situation and had decided to QUIT. It was such a relief. By being honest with myself...and with them; it allowed them to be honest back. So, I took my inspiration from there.

Then I got serious about how my life would be without drinking and I found a whole world opening up before me...The Sober Club, The Sober Heroes, and holistic style approaches were all there for the taking. If only I had known this sooner! Dry bars, online sober groups...for the first time in a long time, I had found MY TRIBE!

The most useful resources I have come across are:

  • online AA groups – IF YOU CAN'T OPEN UP TO A FRIEND

  • one year no beer – Facebook – PAID FOR CHALLENGE

  • The Sober Club – www.thesoberclub.com (I LOVE THIS – funny, real, helpful WOMEN-FOCUSED SOBER GROUP)

  • the easy way for women to stop drinking – Alan Carr, Challenging your perception of alcohol – THIS IS A MUST (Thank you, Mum x)

  • signposts of the spiritual journey – John Siddiqui, Helping you get to grips with your true self

So whilst the above is not for everyone, there are other options. The non-alcoholic beverage industry is slowly catching on:

  • McGuigan non alcoholic sparkling wine - lovely

  • The McGuigan non alcoholic chardonnay and merlot - almost tastes like the real thing

  • 0% Tanqueray and Fever Tree tonic - Just like the real thing but without the hangover!

  • CBD based drinks - to help you unwind (not for me personally)

It took a lot of time and consideration as to how I was going to write this menopause article, and whether I was ready to be wholly honest about the effects alcohol was having as I was thrust into peri-menopause, but I hope that by being honest and sharing how I have started to transform this chapter...if you are struggling, you can do the same too.

Don't be afraid to reach out. If any of you are struggling, you can drop me an email and I will do my best to point you in the right direction. I am by no means an expert...just another menopausal woman, trying to find her way. x

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