Medical Risks for Women Who Drink Alcohol

Authors

  • Katharine A. Bradley MD, MPH,

    1. Health Services Research and Development, VA Puget Sound Health Care System, Seattle Division, Seattle, Wash.
    2. Medicine Service, VA Puget Sound Health Care System, Seattle Division, Seattle, Wash.
    3. Departments of Medicine, University of Washington, Seattle
    4. Health Services, University of Washington, Seattle
    Search for more papers by this author
  • Seeta Badrinath BA,

    1. Health Services Research and Development, VA Puget Sound Health Care System, Seattle Division, Seattle, Wash.
    2. University of Pennsylvania, Philadelphia
    Search for more papers by this author
  • Kristen Bush MPH,

    1. Center for Excellence for Substance Abuse Treatment and Education, VA Puget Sound Health Care System, Seattle Division, Seattle, Wash.
    Search for more papers by this author
  • Jodie Boyd-Wickizer BA,

    1. Health Services Research and Development, VA Puget Sound Health Care System, Seattle Division, Seattle, Wash.
    Search for more papers by this author
  • Bradley Anawalt MD

    1. Medicine Service, VA Puget Sound Health Care System, Seattle Division, Seattle, Wash.
    2. Departments of Medicine, University of Washington, Seattle
    Search for more papers by this author

Dr. Bradley: Health Services Research and Development, Mailstop 152, VA Puget Sound Health Care System (Seattle Division), 1660 S. Columbian Way, Seattle, WA 98108.

Abstract

OBJECTIVE:

To summarize for clinicians recent epidemiologic evidence regarding medical risks of alcohol use for women.

METHODS:

MEDLINE and PsychINFO, 1990 through 1996, were searched using key words “women” or “woman,” and “alcohol.” MEDLINE was also searched for other specific topics and authors from 1980 through 1996. Data were extracted and reviewed regarding levels of alcohol consumption associated with mortality, cardiovascular disease, alcohol-related liver disease, injury, osteoporosis, neurologic symptoms, psychiatric comorbidity, fetal alcohol syndrome, spontaneous abortion, infertility, menstrual symptoms, breast cancer, and gynecologic malignancies. Gender-specific data from cohort studies of general population or large clinical samples are primarily reviewed.

MAIN RESULTS:

Women develop many alcohol-related medical problems at lower levels of consumption than men, probably reflecting women’s lower total body water, gender differences in alcohol metabolism, and effects of alcohol on postmenopausal estrogen levels. Mortality and breast cancer are increased in women who report drinking more than two drinks daily. Higher levels of alcohol consumption by women are associated with increased menstrual symptoms, hypertension, and stroke. Women who drink heavily also appear to have increased infertility and spontaneous abortion. Adverse fetal effects occur after variable amounts of alcohol consumption, making any alcohol use during pregnancy potentially harmful.

CONCLUSIONS:

In general, advising nonpregnant women who drink alcohol to have fewer than two drinks daily is strongly supported by the epidemiologic literature, although specific recommendations for a particular woman should depend on her medical history and risk factors.

Ancillary