Men and women are different—you probably knew that—and that’s true when it comes to wine and health. Alcohol impacts women differently than it does men, from first sip to metabolism to recovery. That means it’s important for women to understand how alcohol impacts their bodies.
Here, Wine Spectator explores the unique health benefits and risks for women drinking wine, including recent research and input from experts in the field.
Ladies, this one’s for you.
Women Process Alcohol Differently
Think you can go drink-for-drink with the man sitting next to you at the bar? Think again. There’s a reason why the U.S.D.A. Dietary Guidelines recommend up to two drinks a day for men and up to only one for women, and it’s not just because men are generally larger than women (though that helps).
In terms of body composition, women tend to have less body water than men, and because alcohol is highly water-soluble, that is one reason women have a higher blood-alcohol content (BAC) than men even after consuming the same amount.
When we consume alcohol, it’s broken down in the stomach by an enzyme called alcohol dehydrogenase (ADH). According to women’s health expert Dr. Jennifer Wider, women do not have as much ADH activity as men do, so they’re unable to process as much alcohol before it enters the bloodstream. This also leads to a higher BAC than men, which means women generally grow more intoxicated more quickly.
Wider says that estrogen, the primary female sex hormone, suppresses the process that leads to ADH production. Once women hit menopause and estrogen production declines, this suppression appears to go away. So as a woman ages, the way she metabolizes alcohol becomes more similar to the way men do.
It’s a fact that women face some different health concerns when it comes to alcohol. For many women, one of the most prominent areas of worry is an increased risk of developing cancer. In 2009, a large study published in the Journal of the National Cancer Institute examined the rates of cancer among more than 1.28 million women in the United Kingdom and compared these rates across weekly drinking habits. They found that any level of alcohol consumption is linked to a higher risk of certain cancers—those of the pharynx, esophagus, larynx, rectum, liver and breast—and that the risk increased for each drink per day.
However, several scientists spoke out about the wide range of limitations in the study—including a lack of diversity in methods for gathering data and the researchers’ failure to take drinking patterns, not just amount consumed, into consideration. Many called for further study on the topic.
Today, the most prevalent cancer concern for women who drink is breast cancer, the most common form of cancer for American women, according to the Center for Disease Control and Prevention (CDC). Though there is still a lot of confusion about how the relationship actually works, most experts agree that having more than one drink per day increases this risk. In addition to avoiding overconsumption, the American Cancer Society recommends women get regular exercise and maintain a healthy weight in order to mitigate this risk.
Colorectal cancer, the third most common cancer in women, has also been linked with alcohol—though multiple studies have also shown that moderate wine consumption may actually help combat it.
Another concern for women in regard to alcohol is how alcohol might affect their reproductive health. While the ongoing debate about alcohol and pregnancy tends to steal the spotlight, there are other aspects that also merit attention.
Few studies have looked at alcohol’s impact on fertility, and the findings of many of those that have were inconclusive or contradictory. One of the most recent studies, published in the BMJ in 2016, attempted to clear up the confusion, and found that having one to seven drinks per week had no effect on a woman’s ability to conceive. The researchers did, however, find that 14 servings or more decreased the likelihood of becoming pregnant by 18 percent compared to no alcohol consumption.
Of course, there are caveats. First, it’s important to also look at the drinking habits of the father—it does typically take two to make a baby, after all. While heavy drinking can negatively impact a man’s ability to conceive, moderate wine consumption may actually strengthen sperm.
Something else to keep in mind: To mitigate the risk of fetal alcohol syndrome, many doctors recommend that women who are trying to conceive avoid alcohol altogether, because women can be pregnant for weeks before they know it.
Another sex-specific health risk for women is an increased likelihood of developing liver inflammation. “We don’t 100 percent know the reason why,” Wider said, noting that while male-female differences are recorded in research, they aren’t often studied in depth. “It may be because the blood-alcohol level is higher [in women] as it’s going through the liver.” Considering the numerous studies linking moderate wine consumption with improved liver health, sex-specific studies on the topic would be beneficial.
According to Wider, none of these issues should cause wine-loving women to shelve their glasses for good, but rather they should get women thinking about wine’s role in their overall health. “The take-home message is that we need to be more cautious as a gender than men in terms of drinking the same amount of alcohol,” she said. “Moderation is key when it comes to all this.”
In contrast, numerous studies have shown that wine offers specific benefits for women too. For example, osteoporosis, a condition in which bones become weak and brittle, is more common in women, especially post-menopausal women, than in men. Fortunately, multiple studies have shown that moderate alcohol consumption increases bone density in women. According to Dr. Sherry Ross, women‘s health expert and author of the popular book She-ology, this could be because alcohol can increase estrogen levels, which is key to protection against bone loss.
For women with inflammatory conditions such as arthritis, moderate alcohol consumption has been shown to provide relief. In 2012, a Swedish study reported that women who drank more than three glasses of alcohol per week were 37 percent less likely to develop rheumatoid arthritis than women who don’t drink, while women who drank one or two glasses per week exhibited a 14 percent lower risk. Another study, published in 2010 from the University of Sheffield U.K., found that nondrinkers were four times more likely to develop arthritis than people who regularly drank alcohol; for those with the disease who drank, levels of inflammation were lower.
Though neither of these studies were alcohol-specific, it‘s believed that wine—red wine in particular—might offer the most anti-inflammatory benefits, thanks in large part to resveratrol and other antioxidants.
Resveratrol specifically has shown potential to help women with polycystic ovary syndrome (PCOS), which causes women to produce elevated levels of hormones such as testosterone, which can contribute to infertility, weight gain and menstrual irregularities. A 2016 study tested the effects of resveratrol supplements on women with PCOS and found that women who had taken the supplements showed lower testosterone levels than those who were given a placebo.
Heart health is another area in which wine shines, and now perhaps more than ever, women should be aware of the benefits: Once considered a “man’s disease,” heart disease is the leading cause of death for women in the U.S., according to the CDC. In 2015, a study from multiple institutions, including Indiana University and the Harvard School of Public Health, found that women who followed six healthy habits, one of which was moderate drinking, were significantly less likely to develop cardiovascular disease.
Another 2015 study found that, compared with abstainers, women who drank moderately had a reduced risk of heart failure, a chronic condition in which the heart cannot pump as much blood as the body needs. Further, a 2010 study published in the medical journal Heart Rhythm showed that women who drink moderately have a lower risk of sudden cardiac death.
Women who drink wine may also enjoy more protection against diabetes. In 2014, a study from the French Institute of Health and Medical Research found that women who started drinking wine at a young age had a lower chance of developing type 2 diabetes. It also showed that wine consumption helped prevent type 2 diabetes in overweight women.
Numerous sex-specific studies have also shown a positive correlation between moderate drinking and women’s brain health. A 2008 study published in the American Journal of Epidemiology followed 1,458 women in Sweden and found that those who were regular wine drinkers had a reduced risk of suffering from dementia. In 2005, two separate studies on cognition in elderly women found that light to moderate drinking may help maintain cognitive ability and lower the risk of brain deterioration.
There are plenty more women’s health issues in which wine may play a beneficial role, including ovarian cancer, sexual function and mental health, but further sex-specific study is needed.
For now, health experts such as Wider and Ross encourage women who drink wine to be aware of both the risks and the benefits of drinking wine, and to practice moderation when they do drink. “I think it’s important to prevent certain cancers and other medical conditions through our lifestyle,” Ross said. “It’s really [about] educating yourself … and knowing that mild drinking is not only socially enjoyable, but it also can have some health benefits that might improve your longevity.”