What Does the Surgeon General Cancer Warnings for Alcohol Mean for Menopausal Women?

You may have heard that even moderate alcohol consumption can increase your risk of breast cancer, but did you know that risk could be as high as 15%, according to one recent study?^1,2

The Office of the Surgeon General in the United States is part of the U.S. Department of Health and Human Services. It’s led by the Surgeon General, the nation’s leading voice on public health matters. The Surgeon General's primary role is to provide the public with scientific information and guidance on improving health and reducing the risk of disease.³

With the recent Surgeon General’s warning highlighting the connection between alcohol and cancer, it’s an important time for menopausal women to consider how drinking may affect their health.⁴

While consuming the occasional alcoholic beverage might seem harmless, the reality is that alcohol can have a more significant impact on your body during and after menopause. Hormonal changes, shifting metabolism, and age-related health concerns can make menopausal women more vulnerable to alcohol’s effects.  From bone loss and heart health to a higher risk of cancers, it’s important to understand the risks associated so you can make more conscious decisions for your health.⁵

In this article, we’ll break down what the new Surgeon General’s cancer warnings on alcohol mean for menopausal women. We’ll also talk through how alcohol can influence your overall health during this transitional phase, what the science says about its connection to certain types of cancers, and how to make mindful choices that support your overall well-being.

Why Menopausal Women Should Pay Attention: Hormonal Changes Amplify Alcohol’s Impact

During menopause, your body goes through a period of hormone volatility, which includes an eventual and significant drop in estrogen levels.⁶ This drop in estrogen not only contributes to hot flashes and mood swings, but it also impacts the way your body metabolizes alcohol. With less estrogen, your liver becomes less efficient at breaking down alcohol, which means it stays in your bloodstream longer. As a result, even small amounts of alcohol can have a stronger effect, making you feel intoxicated more quickly and intensifying its impact on your body.⁷

To make things even more challenging, alcohol can intensify common menopausal symptoms such as fatigue, brain fog, and hot flashes. Since alcohol consumption raises body temperature, it can trigger hot flashes by causing the blood vessels beneath the skin to expand to release heat.⁸ Additionally, alcohol is known to interfere with sleep quality,⁹ which is a significant concern for menopausal women who are already more susceptible to disruptive symptoms like night sweats and interrupted sleep. What may seem like an innocent evening drink could leave you restless and uncomfortable throughout the night.

We asked Dr. Alyssa Dweck, Chief Medical Officer at Bonafide, for her thoughts on alcohol consumption: “The American Cancer Society (ACS) suggests that there is no safe level of alcohol consumption for cancer prevention. The American Heart Association suggests that alcohol can be part of a healthy dietary pattern if consumed in moderation, defined as up to one drink per day for women with consideration towards individual medical and medication history. For women who do choose to drink, it’s recommended to limit alcohol intake to no more than one drink per day. The ACS also recommends alcohol screening and behavioral counseling to identify those at high health risk.” 

Alcohol’s Effect on Bone Health

Bone health becomes a greater concern during menopause, as declining estrogen levels contribute to bone density loss. This puts women at a higher risk for osteoporosis and fractures.¹⁰ The Endocrine Society states that “up to 20% of bone loss can happen during these stages and approximately 1 in 10 women over the age of 60 are affected by osteoporosis worldwide.”¹¹  Unfortunately, alcohol can increase these risks. Research shows that drinking regularly may interfere with your body’s ability to absorb calcium, which is essential for maintaining strong bones.¹²

Postmenopausal women who consume alcohol may also face an increased risk of fractures. Even moderate drinking can weaken bones over time, making falls or minor accidents more dangerous.¹³ For women navigating menopause, protecting bone health is key, and limiting alcohol intake is one simple way to do it.

What Science Says: Alcohol’s Role in Hormone-Related Cancers

Alcohol and Breast Cancer: A Clear Link

For menopausal women, there is a direct connection between alcohol consumption and breast cancer. A study published in the Journal of the American Medical Association found that consuming 5.0 to 9.9 grams of alcohol per day (approximately three to six drinks per week) was associated with a 15% increased risk of breast cancer compared to non-drinkers.¹⁴ This research demonstrates that even moderate drinking, around three to six drinks per week, could increase your risk of developing breast cancer.

The reason?

Alcohol raises estrogen levels in the body. Since many breast cancers are hormone-receptor-positive, higher estrogen levels can fuel the growth of cancer cells, making alcohol a significant risk factor.¹⁵

Menopausal women are already at a higher risk for breast cancer due to age and hormonal changes. As estrogen levels fluctuate, breast tissue becomes more sensitive, making the body more vulnerable to cell abnormalities.¹⁶ Adding alcohol to the mix further raises the risk. While an occasional drink may seem harmless, regular consumption could quietly increase your chances of developing breast cancer.

Other Hormone-Related Cancers

While breast cancer often dominates the conversation, alcohol is also linked to other hormone-related cancers, including ovarian and endometrial cancer. Some studies suggest that regular alcohol consumption may slightly increase the risk of these cancers, particularly in postmenopausal women.¹⁷

Part of the reason is alcohol’s inflammatory effect on the body. Drinking promotes oxidative stress, which can damage cells and make them more prone to mutations. Over time, this can lead to DNA damage, which is a known contributor to cancer development.¹⁸ Since menopausal women already face higher inflammation levels due to hormonal changes,¹⁹ alcohol’s pro-inflammatory effects may intensify their cancer risk.

“Alcohol consumption can increase the risk of multiple cancers, including breast, oropharyngeal, esophageal, stomach, liver, colon, and rectal,” cautions Dr. Dweck. “While this has long been known, a recent warning from the Surgeon General has recently highlighted this information” 

Minimizing alcohol intake may help to reduce cancer risk. While there is no completely “safe” level of alcohol when it comes to cancer, guidelines suggest limiting consumption to no more than one drink per day for women.²⁰ Even better, reducing alcohol intake to just a few drinks per week, or even eliminating it, can significantly lower your risk. Choosing alcohol-free alternatives or practicing mindful drinking habits are simple but effective ways to protect your long-term health.

Lifestyle Considerations for Menopausal Women

Maintaining a nutrient-rich diet is especially important during menopause, and it may help to counteract some of the inflammatory effects of alcohol. An anti-inflammatory diet, or one rich in antioxidants, fiber, and healthy fats such as the Mediterranean Diet, can support your overall health. Foods like leafy greens, berries, salmon, and nuts can help reduce oxidative stress, which may lower your cancer risk.²¹

Hydration is equally essential. Alcohol is dehydrating, which can worsen menopausal symptoms like dry skin, fatigue, and headaches. To offset this, try to make it a habit to drink water alongside alcoholic beverages. Aim for at least one glass of water per alcoholic drink to help your body stay hydrated and process alcohol more efficiently.²²

It’s no secret that menopause can be stressful. With fluctuating hormones, sleep disruptions, and mood changes, it’s tempting to reach for a glass of wine to unwind. However, there are healthier and more effective ways to manage stress. Relaxation techniques like yoga, meditation, and aromatherapy can help calm your nervous system and reduce tension.²³

Be Mindful of the Risks of Alcohol Consumption During Menopause

While enjoying the occasional drink may seem harmless, the reality is that alcohol can carry increased risks for menopausal women. With hormonal changes slowing alcohol metabolism, even small amounts can have a stronger impact. As mentioned, this could contribute to bone loss and raise the risk of heart disease. More concerningly, the science is clear and shows that regular alcohol consumption is linked to a higher risk of multiple cancers, especially breast cancer.

By being mindful of your alcohol intake, you can take meaningful steps to protect your health. Consider exploring healthier alternatives to alcohol or practicing moderation and adopting lifestyle changes that support your well-being. If you have any concerns, don’t hesitate to consult your healthcare provider about your personal risk factors.

By making informed choices and prioritizing your health, you can reduce your risk and feel empowered through menopause and beyond.

Resources:

1. https://jamanetwork.com/journals/jama/fullarticle/1104580
2. https://www.breastcancer.org/risk/risk-factors/drinking-alcohol
3. https://www.hhs.gov/surgeongeneral/priorities/index.html
4. https://www.hhs.gov/surgeongeneral/reports-and-publications/alcohol-cancer/index.htm
5. https://www.uhhospitals.org/blog/articles/2024/12/does-menopause-change-the-way-you-metabolize-alcohol
6. https://www.sciencedirect.com/science/article/abs/pii/S1521693422000426
7. https://womensinternational.com/blog/portfolio-items/liver/
8. https://www.uhhospitals.org/blog/articles/2024/12/does-menopause-change-the-way-you-metabolize-alcohol
9. https://www.ncoa.org/article/how-alcohol-affects-your-sleep/
10. https://pmc.ncbi.nlm.nih.gov/articles/PMC8836058/
11. https://www.endocrine.org/patient-engagement/endocrine-library/menopause-and-bone-loss
12. https://www.endocrine.org/patient-engagement/endocrine-library/menopause-and-bone-loss
13. https://www.endocrine.org/patient-engagement/endocrine-library/menopause-and-bone-loss
14. https://jamanetwork.com/journals/jama/fullarticle/1104580
15. https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet
16. https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet
17. https://www.nature.com/articles/s41598-024-53926-z
18. https://www.hhs.gov/surgeongeneral/reports-and-publications/alcohol-cancer/index.htm
19. https://www.health.harvard.edu/womens-health/beyond-hot-flashes
20. https://www.cancer.org/cancer/risk-prevention/diet-physical-activity/acs-guidelines-nutrition-physical-activity-cancer-prevention/guidelines.html
21. https://my.clevelandclinic.org/health/articles/oxidative-stress
22. https://www.eatingwell.com/does-water-help-for-hangovers-8418996
23. https://www.sciencedirect.com/science/article/abs/pii/S0965229916300395#:~:text=At%2012%20weeks%2C%20yoga%20practitioners,when%20compared%20to%20control%20group.