How Does Alcohol Addiction Affect Women?

Women experience alcohol addiction differently than men! You might start drinking for different reasons, engage in different behaviors, and face different consequences. Rehabs that offer women-only treatment address those differences head-on. They put your addiction into the context of your life experience as a woman. These supportive communities provide a safe place for you to begin healing.

Understanding Alcohol Addiction in Women

Studies show that alcohol addiction among women is on the rise. ((Women and Alcohol | National Institute on Alcohol Abuse and Alcoholism (NIAAA). https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/women-and-alcohol. Accessed 21 Apr. 2023.)) While drinking can be a problem for people of every gender, it has pronounced risks for women. For example, women have higher rates than men of emergency room visits due to alcohol use. This could be because cis women tend to be more sensitive to the effects of alcohol.

Why Alcohol Affects Women Differently Than Men

While men are at a higher risk of alcohol addiction, women are more likely to face alcohol-related problems, even when they drink less than men.

This is partly because of differences in size and metabolism. On average, women are physically smaller and weigh less than men. If both a smaller and a bigger person drink the same amount of alcohol, the smaller person’s blood alcohol concentration will be higher. They’ll feel more drunk and be more likely to experience hangovers or blackouts.

Even for men and women of the same size, hormonal differences contribute to the increased effects of alcohol on women. ((Women and Alcohol | National Institute on Alcohol Abuse and Alcoholism (NIAAA). https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/women-and-alcohol. Accessed 21 Apr. 2023.)) Because sex hormones are part of brain chemistry, they can directly affect the way your body responds to alcohol.

Societal and Cultural Factors in Women’s Drinking Behaviors

As a legal substance, alcohol is often socially acceptable. But social pressures can change the way people—and especially women—choose to drink. For example, women are more likely than men to drink in secret, ((Blume SB. Alcoholism and women’s health. Public Health Rep. 1987 Jul-Aug;102(4 Suppl):38-42. PMID: 3120219; PMCID: PMC1478015.)) which can prolong their addiction.

Women are also more likely to experience traumatic events ((Minority Women and Alcohol Use. https://pubs.niaaa.nih.gov/publications/arh26-4/251-256.htm. Accessed 21 Apr. 2023.)) like physical or sexual assault. And it’s very common for survivors of sexual and physical violence to use alcohol ((Ullman SE, Lorenz K, Kirkner A, O’Callaghan E. Postassault Substance Use and Coping: A Qualitative Study of Sexual Assault Survivors and Informal Support Providers. Alcohol Treat Q. 2018;36(3):330-353. doi: 10.1080/07347324.2018.1465807. Epub 2018 Apr 25. PMID: 30555208; PMCID: PMC6290351.)) to cope with traumatic memories and distress.

While it’s socially acceptable for men to express negative feelings, women are expected to internalize stress, ((“Alcohol Use Among Girls and Young Women: A WORRYING TREND.” Substance Abuse and Mental Health Services Administration (SAMHSA). https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/PEP22-03-10-010.pdf)) depression, and anger. This makes women more likely to use drinking as a coping mechanism.

Alcohol’s Effect on Women’s Mental Health

Alcohol affects everyone’s mental health, but women with alcohol addiction face a higher risk of developing certain diagnoses: ((Beckman LJ. Treatment Needs for Women With Alcohol Problems. Alcohol Health Res World. 1994;18(3):206-211. PMID: 31798108; PMCID: PMC6876404.))

• Mood disorders like depression and bipolar disorder
• Anxiety disorders like panic disorder and social anxiety disorder
• Antisocial personality disorder (ASPD)

We need more data to understand whether alcohol addiction causes mental health problems, or vice versa. Either way, there’s a strong link between these issues.

The Impact of Alcohol Addiction on Women’s Physical and Reproductive Health

Women are more likely to develop physical health problems ((Women and Alcohol | National Institute on Alcohol Abuse and Alcoholism (NIAAA). https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/women-and-alcohol. Accessed 21 Apr. 2023.)) from alcohol addiction:

• Liver disease, including alcohol-related hepatitis. This can lead to permanent liver scarring (cirrhosis), a serious and life-threatening condition.
• Heart disease
• Brain damage, especially for women who began drinking heavily as teenagers.
• Memory loss, including blackouts while drinking and permanent memory loss
• Breast cancer

Alcohol addiction also affects women’s reproductive health. Studies show that heavy drinking may decrease your chances of getting pregnant. ((Van Heertum K, Rossi B. Alcohol and fertility: how much is too much? Fertil Res Pract. 2017 Jul 10;3:10. doi: 10.1186/s40738-017-0037-x. PMID: 28702207; PMCID: PMC5504800.)) Conversely, women who face infertility issues are more likely to drink heavily in response to unsuccessful attempts.

If you do get pregnant, alcohol is not safe in any amount during pregnancy. ((CDC. “Alcohol Use During Pregnancy.” Centers for Disease Control and Prevention, 4 Nov. 2022, https://www.cdc.gov/ncbddd/fasd/alcohol-use.html.
)) Drinking while breastfeeding can also pose a risk. ((CDC. “Alcohol and Breastfeeding.” Centers for Disease Control and Prevention, 4 Oct. 2022, https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/vaccinations-medications-drugs/alcohol.html.)) But studies show that while not drinking is the safest option, moderate drinking and waiting 2 hours before nursing can reduce harm to the baby. Heavily drinking and nursing right away can harm your baby’s development, growth, and sleep health. Plus, high alcohol consumption can decrease milk production and limit your ability to breastfeed.

Challenges of Alcohol Addiction as a Woman

In Western culture, women addicted to alcohol face certain unique challenges, which may impact the way you approach treatment. Each of these challenges can get more extreme due to the overwhelming social stigma against women with alcohol addiction.

Increased Risk of Violence and Sexual Assault

Drinking alcohol as a woman increases your risk of experiencing violence. ((Klein, Andrew. “Practical Implications of Domestic Violence Research.” US Department of Justice. https://www.ojp.gov/pdffiles1/nij/225722.pdf)) Data shows that for survivors of domestic violence, this is more related to your abuser’s drinking than your own. That’s because women with addiction are more likely to be in relationships with other people who also have addiction. Women with alcohol addiction face a lower risk of violence when they have partners without addiction.

Drinking is also risk factor for sexual assault. ((Maryland Collaborative to Reduce College Drinking and Related Problems. (2016). Sexual assault and alcohol: What the
research evidence tells us. College Park, MD: Center on Young Adult Health and Development.)) That’s true whether the perpetrator or the survivor has been drinking. Perpetrators purposely target women who are drinking heavily because they’re more vulnerable. This can also lead to and victim-blaming and stigma against survivors of sexual assault. It’s important to remember that regardless of your drinking, you are never responsible for someone else’s choice to commit violence.

This stigma against women who drink while pregnant is even stronger. One woman explained how social stigma contributed to her drinking while pregnant: ((“WHAT IS STIGMA?” Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/fasd/videos/fasd-primer/16-primer/video-16-trans-508.pdf)) “I am an alcoholic. I couldn’t stop and was shamed to look for treatment.” Another woman said that her fear prevented her from seeking treatment. “I was afraid to look for help,” she explained. “I was afraid I would be arrested, and I would lose my children.”

Barriers to Treatment for Women

Social stigma has very real consequences. Women are less likely to receive treatment ((Women and Alcohol | National Institute on Alcohol Abuse and Alcoholism (NIAAA). https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/women-and-alcohol. Accessed 21 Apr. 2023.
)) for alcohol addiction than men. In addition, women face many more barriers to alcohol addiction treatment: ((Beckman LJ. Treatment Needs for Women With Alcohol Problems. Alcohol Health Res World. 1994;18(3):206-211. PMID: 31798108; PMCID: PMC6876404.))

• • Fear of legal consequences
  • Concern about childcare and children, including worrying about losing them
  • Feelings of guilt, denial, and shame
  • Difficulty receiving referral from primary care physician
  • Lack of independent financial resources or insurance coverage to pay for treatment
  • Social acceptance of certain women’s drinking behaviors like #winemom culture

((Harding KD, Whittingham L, McGannon KR. #sendwine: An Analysis of Motherhood, Alcohol Use and #winemom Culture on Instagram. Subst Abuse. 2021 May 5;15:11782218211015195. doi: 10.1177/11782218211015195. PMID: 34017175; PMCID: PMC8114293.))

A lack of community support can make recovery that much harder. If you can’t get the help you need from your loved ones, you might have more success in residential rehab.