Perimenopause and Drinking Alcohol

Alex Fulton

Written by Alex Fulton

Alex Fulton

Written by Alex Fulton

Do you look forward to unwinding with a glass of wine after a long day? Or maybe you enjoy celebrating the holidays with a cup or two of good cheer? You’re not the only one. Nearly half of all women in the United States report drinking alcohol in the last 30 days.1  

For perimenopausal women, alcohol may serve the added purpose of taking your mind off of your symptoms for a little while, the same can often ring true for women drinking alcohol during menopause. But is there a relationship between alcohol and perimenopause symptoms and if so, what is that relationship like? Could drinking do more harm than good if you’re in perimenopause? Is there a better way to destress and distract yourself from perimenopause symptoms? 

Does Alcohol Affect Women in Perimenopause Differently? 

Drinking alcohol impacts your hormone levels in different ways throughout your adult life, including during perimenopause. These effects can be positive or negative, depending on your age and how much you drink. Because alcohol can interfere with the body’s hormone system, it also has the potential to negatively impact other areas of the body, such as blood sugar levels, calcium metabolism and bone structure. When it comes to the impact of drinking alcohol specifically in perimenopausal women, there are direct correlations.

How Drinking Alcohol Affects Hormones During Perimenopause

During perimenopause, moderate alcohol consumption (one drink per day) can cause estrogen levels to rise and progesterone to drop. When consumed in moderation, alcohol’s positive effect on estrogen levels continues into perimenopause and beyond.  

An alcohol induced bump in estrogen may actually be a good thing, since decreased levels of the hormone are associated with common perimenopause symptoms like hot flashes and night sweats.2  

It is important, however, to remain aware of the amount of alcohol you consume, since drinking moderate amounts of alcohol during perimenopause can quickly turn into larger quantities. Heavy drinking, typically defined as 2-5 drinks per day, can have the opposite effect on a woman’s health during perimenopause, and it has the potential to make perimenopause symptoms worse. 

According to Bonafide Chief Medical Officer, Dr. Alyssa Dweck, “Not only are women typically smaller in size than men, but they also metabolize alcohol differently.  Women, by nature, have less alcohol dehydrogenase, an enzyme that helps metabolize alcohol in the body. This is especially true in perimenopausal women.” She continues, “Anecdotally, alcohol can be considered a trigger for hot flashes for some and is known to disrupt sleep in many. Cognition and memory might be affected with use as well. Alcohol is also calorie-dense, adding to the struggle with weight control during menopause.” 

Perimenopause and Alcohol Intolerance 

If it seems like you can’t drink as much as you used to without feeling it, you may be experiencing the natural lowering of your alcohol tolerance that comes along with aging, which can continue to evolve into an alcohol intolerance during perimenopause and beyond.  As you get older, it becomes harder for your body to metabolize alcohol. This means if you drink alcohol during perimenopause, it can potentially stay in your system longer, and you may feel its effects more strongly and for longer durations. An additional contributor to slower metabolization of alcohol is your cartilage and tendons, which slowly start to lose water as you age. Why does this matter? The less water present in your body, the less there is to dilute alcohol in your system and combat its negative side effects.

Does Drinking Alcohol Ever Make Perimenopause Symptoms Worse? 

Although drinking alcohol during perimenopause may provide a feeling of temporary relief for some women, it’s unfortunately not the case for everyone.  Again, this depends on how much you drink, and what you drink, with any potential benefits linked only to moderate consumption. According to the North American Menopause Society (NAMS), drinking outside of moderation can become problematic. NAMS goes on to cite The National Institute on Alcohol Abuse and Alcoholism, defining moderate drinking as no more than seven drinks a week, and no more than three drinks in any single day. Drinking more than the recommended amount of alcohol may negatively impact a number of perimenopause symptoms.

Alcohol and Hot Flashes During Perimenopause 

Some research has determined a link between alcohol and perimenopause hot flashes, as well as night sweats. In one study that included nearly 300 women aged 45 to 55, daily alcohol consumption significantly increased the risk of hot flashes and night sweats.3 This may be because drinking alcohol raises your internal body temperature, causing you to feel warmer. 

Alcohol and Mood During Perimenopause 

Changing hormone levels during perimenopause can wreak havoc on your mood, and alcohol may make your perimenopause symptoms and overall mental state, worse. Women often experience new or more severe symptoms of anxiety and depression during perimenopause, and drinking alcohol can intensify these symptoms. Alcohol is a depressant, so the lift you get from a glass of wine can ultimately cause you to feel even lower in the long run. 

Alcohol and Brain Fog During Perimenopause 

Many perimenopausal women may experience brain fog, that fuzzy-headed feeling that makes it hard to focus. Consuming alcohol could make things feel even foggier. If you’ve ever struggled to concentrate at work during perimenopause after one too many cocktails the night before, you know that alcohol can take a toll on your ability to think clearly. Even moderate drinking is linked to pathological changes in the brain, including impaired memory and decision-making.4   

Giving Up Alcohol in Perimenopause 

For some women, drinking alcohol during perimenopause may feel like more of a hindrance than a help.  If you fall into this camp, you may be wondering what you can you do instead of drinking alcohol during perimenopause, in order to manage your symptoms. Here are a few simple lifestyle tweaks that may help. 

Focus on Nutrition 

When considering how to support your body during perimenopause, start with what’s on your plate. Certain nutrients can be very helpful for relieving physical and emotional symptoms of perimenopause. A whole food diet, such as the Mediterranean Diet, that includes a variety of fresh veggies and fruit can provide your body with the fuel it needs to stay balanced. 

Even the healthiest of eaters can still struggle with nutritional gaps and may benefit from an extra nutritional boost during perimenopause. You could consider adding in dietary supplements as an alternative to alcohol for finding relief from some of your perimenopause symptoms.

Exercise Regularly 

Just 30 minutes of moderate physical activity has been shown to reduce anxiety and depression while boosting your mood and improving cognitive function.5 It can also help you manage perimenopausal weight gain. Try replacing your evening glass of red wine during perimenopause, with a brisk 10-minute walk at least three times a week, to start. 

Practice Good Sleep Hygiene 

If you rely on a drink before bed to help you sleep, try switching up your evening routine. Taking steps like keeping your bedroom cool and dark, going to bed at the same time every night and putting down your phone half an hour before bedtime can help you drift off to dreamland without alcohol. 



  1. Centers for Disease Control. Excessive Alcohol Use is a Risk to Women's Health. Accessed 11 Dec. 2020.
  2. Register TC, Cline JM, Shively CA. Health issues in postmenopausal women who drink. Alcohol Res Health. 2002;26(4):299-307.
  3. Sievert LL, Obermeyer CM, Price K. Determinants of hot flashes and night sweats. Ann Hum Biol. 2006;33(1):4-16. doi:10.1080/03014460500421338
  4. Welch KA. Alcohol consumption and brain health. BMJ. 2017;357:j2645. Published 2017 Jun 6. doi:10.1136/bmj.j2645
  5. Sharma A, Madaan V, Petty FD. Exercise for mental health. Prim Care Companion J Clin Psychiatry. 2006;8(2):106. doi:10.4088/pcc.v08n0208a


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