Women and alcohol: To your health?

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Publication Date: 
Wed, 2012-06-06

Most understand the major role that chronic alcohol abuse plays in family disruption, violence and injury, disability, illness and death. But women have many other physical vulnerabilities when it comes to drinking. “Hormonally, metabolically, men and women are different—and this has implications for tolerance and physical impacts over the long run,” says Dr. Joseph Lee, chief physician of Hazelden’s Center for Youth and Families in Plymouth, Minnesota.

Women’s vulnerabilities

Women’s vulnerabilities start with the simple fact that, on average, they have more body fat than men. Since body fat contains little water, there is less to dilute the alcohol consumed. As well, women have a lower level of a key metabolizing enzyme—alcohol dehydrogenase—which helps the body break down and eliminate alcohol. As a result, a larger proportion of what women drink enters the bloodstream. Furthermore, fluctuating hormone levels mean that the intoxicating effects of alcohol set in faster when estrogen levels are high.

The list goes on. Women’s chemistry means they become dependent on alcohol much faster than men. Other consequences—including cognitive deficits and liver disease—all occur earlier in women, with significantly shorter exposure to alcohol. Women who consume four or more alcoholic beverages a day quadruple their risk of dying from heart disease. Heavy drinkers of both genders run the risk of a fatal hemorraghic stroke, but the odds are five times higher for women.

Depending on a woman’s stage in life, there are specific considerations of which to be aware. If you’re female and adolescent, this is your brain on alcohol: consume four drinks, and you will leave yourself vulnerable to compromising your spatial working memory. Binge drinking in adolescence can interrupt normal brain cell growth, particularly in the frontal brain regions critical to logical thinking and reasoning. In short, it damages cognitive abilities—especially in female teens. Says researcher Lindsay Squeglia, lead author of a new study in Alcoholism: Clinical & Experimental Research: “Throughout adolescence, the brain is becoming more efficient, pruning. In female drinkers, we found that the pre-frontal cortex was not thinning properly. This affects executive functioning.”

“Are the girls trying to keep up with the boys?” asks Edith Sullivan, a researcher at Stanford’s School of Medicine. “Quantity and frequency can be a killer for novice drinkers. Adding alcohol to the mix of the developing brain will likely complicate the normal developmental trajectory. Long after a young person recovers from a hangover, risk to cognitive and brain functions endures.”

Trauma

Sullivan, who has done a lot of work with the brain structure of alcoholics, is certain that what is known as “telescoping” is real: “As they develop alcoholism, women seem to develop dependence sooner than men. Drink for drink, it is worse for females.”

Gender is a strong predictor of alcohol use. So too is trauma. One groundbreaking project is GENACIS—Gender, Alcohol and Culture: An International Study. With 40 participating countries, including Canada, this project offers an extraordinary opportunity to improve our understanding of how gender and culture combine to affect how women and men drink. Sharon Wilsnack, who oversees the GENACIS project, is also the lead author of the world’s longest-running study of women and drinking, the National Study of Life and Health Experiences of Women. Between 1981 and 2001, she and her team interviewed the same women every five years. One of their findings: the strongest predictor of late onset drinking is childhood sexual abuse. Says Wilsnack, “It has an increasingly adverse pattern over the course of women’s lives.”

“The central question isn't, ‘What's wrong with this woman? It's, ‘What happened to this woman?'” This is the voice of Nancy Poole, director of research and knowledge translation at the British Columbia Centre of Excellence for Women's Health. With more than 30 years' experience in the field of addictions, Poole is a dynamo with her finger in dozens of projects, including a new book on trauma. She is talking about the importance of what is known in the field as trauma-informed care, which gives credence to the woman's past or present, and the role it plays in her addiction. “We miss the biggest part of the story,” says Poole, “if we don't link the addiction to the rest of the woman's life.”

If you head to the most renowned of all treatment centres, Hazelden outside Minneapolis, you will hear a similar story. Brenda Servais is a counsellor for 16- to 21-year-olds, and she is blunt: “Trauma? Not 100 per cent, but a very high number. There's a lot of sexual trauma, whether it happened when they were sober or under the influence. A lot of rape. Certainly PTSD. And we can see a rise in their substance use right after the event.”

“Pinking” the market

One thing is undeniable: women have become a significant target market for the alcohol industry. Just consider the names: Mike’s Hard Pink Lemonade. Smirnoff Ice Light. Wines like MommyJuice and Stepping Up to the Plate (with a label sporting a very high heel). Berry-flavoured vodkas. Vex Strawberry Smoothies. Coolers in flavours like kiwi mango, green apple, wild grape.

Women’s buying power has been growing for decades, and their decision-making authority has grown as well. What these labels are battling for is women’s downtime—and their brand loyalty.

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