As evidenced by these articles, the National Institute on Alcohol Abuse and Alcoholism has successfully targeted many of these areas for support in recent years, yet much remains to be learned as we confront the rapidly changing characteristics of women’s alcohol misuse and harms. Three decades of magnetic resonance imaging (MRI) studies describe patterns of brain structural abnormalities characteristic of chronic, heavy drinking.81,82 Despite the rich literature on neuroimaging in AUD, the mainstay of studies does not address sex differences. The focus of this section is on the research in women with AUD and starts with studies using conventional structural MRI to quantify regional brain volumes; also summarized are studies using magnetic resonance diffusion tensor imaging to assess the microstructural integrity of white matter fibers and finally functional MRI done in the task activation state.
The hidden risks of drinking
- It is widely acknowledged that excessive alcohol consumption has negative effects not only on life expectancy but also on sexual health and relationships.
- Sex differences outside of AUD typically note better performance in women than men in decoding emotional facial expression and in performing tasks of social cognition such as the Reading the Mind in the Eyes Test or the Faux Pas Recognition Test.59-63 Taken together, these findings suggest a potential resilience to social cognition disorders in women.
- The death rate from that latter cause accelerated for both men and women during the pandemic, another study confirmed.
Studies of acute alcohol effects on cognition indicate that women typically perform worse than men on tasks requiring divided attention, memory, and decision-making. Beneficial effects of moderate alcohol consumption on cognition have been reported; however, a number of studies have cautioned that other factors may be driving that association. Although chronic heavy drinking affects working memory, visuospatial abilities, balance, emotional processing, and social cognition in women and men, sex differences mark the severity and specific profile of functional deficits. The accelerated or compressed progression of alcohol-related problems and their consequences observed in women relative to men, referred to as “telescoping,” highlights sex differences in the pharmacokinetics, pharmacodynamics, cognitive, and psychological consequences of alcohol.
Links to NCBI Databases
The US remains an outlier among prosperous and developed nations in our lack of a national health insurance scheme and its failure to properly prioritize primary care prevention, which leaves millions of Americans without access to decent health care. Without good care, many Americans are simply not getting sustained and accurate messages about what it actually means to make healthy choices, from the medical care we seek to the food we eat to what and how much we drink. Our culture treats alcohol-saturated fraternities as a normal part of the college experience, black-out drinking as entertaining comedy fodder and now, for women, getting white-wine wasted as a way to cope with the stress of raising children. Millions of readers rely on HelpGuide.org for free, evidence-based resources to understand and navigate mental health challenges.
Guiding Principles for Women’s AUD Treatment
Three studies used the standard FSFI questionnaire 15, 17, 18, while two studies used the self-administered questionnaire 19, 20. One study relied on the ASEX standard 21, two studies used the FSDS-R standard, and another used the GRISS tool 22. Furthermore, one study utilized the HSDD tool 18, and another used the SADD tool 21 to define the presence of sexual dysfunction.
Treatment Implications and Conclusion
A woman charged with hitting and killing a WSSC Water employee while he was working in Montgomery County, Maryland, had a blood alcohol content more than twice the legal limit and officers found a half-empty bottle of alcohol in her front passenger seat, police say. News reports and testimonies suggest the tourists may have consumed alcohol laced with methanol – a deadly substance often found in bootleg alcohol. It also urges people to be wary of homemade brews, and free drinks or drinks priced far below normal.
Studies show that women start to have alcohol-related problems sooner and at lower drinking amounts than men and for multiple reasons.3 On average, women weigh less than men. Also, alcohol resides predominantly in body water, and pound for pound, women have less water in their bodies than men. This means that after a woman and a man of the same weight drink the same amount of alcohol, the woman’s blood alcohol concentration (the amount of alcohol in the blood) will tend to be higher, putting her at greater risk for harm. For example, research suggests that women are more likely than men to experience hangovers and alcohol-induced blackouts at comparable doses of alcohol.5,6 Other biological differences may contribute as well.
- While alcohol misuse by anyone presents serious public health concerns, women who drink have a higher risk of certain alcohol-related problems compared to men.
- In addition, Black women in this study experienced greater sedating effects from alcohol than White women.
Booze and the female liver
Yet when it comes to prevention and treatment of alcohol-related health issues, “that message is not really Women and Alcoholism getting out there,” Sugarman says. “We have a real concern that while there might be fewer people drinking, many of those who are drinking might be doing so specifically to try to cope,” White says. “That’s when I got scared, when I tried to not drink and only made it two days,” says Cooper, now 30.
It’s easy to cross the line into risky drinking
A pandemic sent many of us home for week or months at a time, severing the low-stakes interactions and connections with acquaintances, colleagues and even strangers that are all a key part of human socialization. When it comes to alcohol, many conservative churches discourage its use, many states and localities retain vice laws that limit its sale and we allow young people to enroll in the military before they can legally get a drink at a bar, while we also glorify dangerous binge drinking as almost a rite of passage. Any kind of alcohol in any amount can harm a developing fetus, especially during the first and second trimester. Physicians and public health officials recommend that women avoid drinking any alcohol during pregnancy. Because women become addicted to alcohol more easily than men, drinking even moderately can be a slippery slope. Trends suggest that white, employed women are drinking greater amounts of alcohol and with greater frequency.
Other Social and Biological Factors
A systematic review of transgender individuals (including gender minority women) by Gilbert and colleagues found estimates of binge drinking among transgender individuals ranging from 7% to 65%, with estimates of lifetime and past-year DSM-IV AUD prevalence at 26% and 11%, respectively.29 More research is needed on these groups. As noted by Gilbert and colleagues, to facilitate research on alcohol use disparities among gender minority women and transgender individuals, new methods will be needed, as many of the current alcohol use measures to assess unsafe drinking rely on physiological sex-specific cut points. A 2017 study by Bn et al. found that female patients seeking treatment for alcohol dependence syndrome (ADS) often reported low libido (55%), difficulty reaching orgasm (52.5%), and, if they did reach orgasm, it was often unsatisfactory (50%). Compared to healthy women, women with alcohol dependency reported lower scores in all sexual domains 7. These results are similar to Amidu et al.’s findings and suggest that alcohol consumption significantly impacts sexual dysfunction in women. In 2011, Lianjun et al. reported that alcohol consumption was one of the independent risk factors for decreased sexual performance in women 17.
- Reflecting core concepts of life-course developmental theory,46 both the age at which heavy drinking occurs and the duration of heavy drinking across the life course are relevant to disparities in alcohol-related problems.
- Surprisingly, change in depression was linked to better drinking outcomes for women in gender-neutral CBT.
- Three decades of magnetic resonance imaging (MRI) studies describe patterns of brain structural abnormalities characteristic of chronic, heavy drinking.81,82 Despite the rich literature on neuroimaging in AUD, the mainstay of studies does not address sex differences.
- Taken together, these studies demonstrate the relation between chronic heavy drinking and structural and functional brain abnormalities in men and women; however, due to their cross-sectional nature, these studies cannot determine whether AUD-related brain dysmorphology was caused by drinking, was pre-existing, or both.
General differences in how people’s bodies handle alcohol
For instance, it is possible that among women who have a history of trauma or abuse from men, single-gender treatment might be preferable because of the possibility that participation in a mixed-gender program could trigger trauma-related symptoms. In addition, given the broader literature on the relative interactional dominance of men in mixed-gender groups, women may have more opportunities to participate when in women-only groups.38 However, research on women’s treatment preferences yields a more nuanced picture. Women are the fastest-growing segment of alcohol consumers in the United States, increasing the potential number of women who across their life span could develop negative health consequences related to alcohol consumption.