What Is the Link Between Alcohol and Perimenopause? 7 Things to Know

Last updated 12.19.2023 | by Sabrina Johnson | 10 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.

Alcohol use disorder affects around 28 million adults across the USA; that’s about 20% of the entire population. And a significant number of those adults are women going through menopause.

I’ve been contacted by several readers seeking help for alcohol use disorder during their menopausal transition.

Many say they’re using alcohol as a way to escape the pressures of their day-to-day lives, pressures which become worse by the symptoms of perimenopause.

I’m here to raise awareness of the dangers of drinking and help women out there struggling with this issue, particularly perimenopausal women.

Perimenopause (the build-up to menopause) is a challenging time for many of us.

Physical symptoms, such as hot flashes, weight gain, and vaginal dryness, plus hormone-driven emotional changes, impacts self-confidence and interpersonal relationships and also cause depression and anxiety in the majority of women.

But consumption of alcohol has a huge detrimental effect on your physical and mental health. And during perimenopause, the damage can be even more profound.

So, if you’re struggling with alcohol use disorder, it’s essential to understand the risks and seek help as soon as possible.

Thousands of perimenopausal women go through the same struggles, but with the right information and support, each of you can overcome the challenges and lead a healthy life.

In this post, I’ll share 7 things you should know about perimenopause and alcohol consumption, including the dangers of drinking and how to seek help.

7 Things to Know About Perimenopause and Alcohol Use Disorder

Let’s know how excess alcohol can worsen the situation for women in the perimenopause stage.

1. Excess Alcohol Increases the Risk of Depression

Alcohol is a depressant, and even if you feel happier while you’re having a drink, the effect is only temporary. Once alcohol’s mood-boosting effect has worn off, you’re likely to feel sad, low, and depressed.

Perimenopause and menopause already raise a woman’s risk of developing depression, and adding alcohol into the mix only increases this risk further.

Plus, alcohol use disorder also leads to increased feelings of anxiety, another preexisting risk factor for perimenopausal women.

2. Alcohol Increases Hot Flashes and Night Sweats

Vasomotor symptoms (VMS) such as hot flashes and night sweats are two of the most significant issues women face during perimenopause. Around 80% of women will experience VMS throughout their menopausal journey, and I know firsthand how disruptive these symptoms can be.

I began suffering from frequent hot flashes and night sweats during the early stages of perimenopause, and I noticed that even a moderate amount of alcohol with dinner would make these symptoms worse.

Scientific research confirmed my observations, and I discovered that alcohol is one of the leading triggers of VMS[1].

So, I totally stopped my intake of alcohol, and I’m so glad I did. Hot flashes became less frequent, and my night sweats reduced in severity. I also lost a little weight, which helped to increase my energy levels and boost my overall health.

3. Alcohol Reduces Sleep Quality

One of the most frequently reported symptoms of perimenopause is sleep disturbances and insomnia. Drinking alcohol before you go to bed is likely to exacerbate these symptoms.

While alcohol has a sedative effect that can make you feel drowsy and sleepy, studies show it reduces the quality of sleep and disrupts our natural sleep cycles.

Regular alcohol consumption and alcohol use disorder can also trigger insomnia and make other sleep disorders, such as snoring and sleep apnea, much worse.

Even moderate alcohol intake (1-2 servings per day) has been shown to reduce women’s sleep quality by almost a quarter, and heavier use reduces sleep quality by a staggering 40%.

All regular, moderate, to heavy drinkers must understand that alcohol’s sleep-disturbing properties can impact every area of life. A chronic lack of sleep increases inflammation and raises the risks of a variety of chronic diseases. Plus, it can lead to mental health issues such as anxiety and depression.

4. Perimenopause Lowers your Tolerance to Alcohol

During perimenopause, many women notice that their tolerance of alcohol diminishes. This was certainly the case for me. In the past, I would enjoy a couple of glasses of wine with friends with no ill effects.

However, once I entered perimenopause, suddenly, one glass of wine felt like 3, and I’d wake up the following morning with a pounding headache.

This sudden change took me by surprise. Despite my extensive research into menopause, I wasn’t aware that hormonal shifts could have such an effect.

But as I dug deeper into the science, I discovered that both aging and perimenopause reduce our ability to metabolize alcohol. As a result, alcohol stays in the system longer and has a more potent effect.

This is particularly important to be aware of if you are struggling with alcohol dependency or use disorder. Regular or heavy drinking is detrimental and dangerous at any stage of life, but during perimenopause, the physical and psychological risks increase even further.

5. Alcohol Addiction Increases the Risk of Chronic Disease

Shifting hormones during perimenopause increases the likelihood of developing certain chronic diseases, for example, osteoporosis and heart disease.

However, adding alcohol into the mix during this transitional time increases these risks exponentially.

Osteoporosis is a common condition in menopausal women. A drop in estrogen during perimenopause contributes to a decline in bone density. Moderate to heavy alcohol use further weakens the bones, making them brittle and increasing the likelihood of fractures.

Excess alcohol consumption is also linked to an increase in heart disease, high blood pressure, and stroke, as well as liver disease and certain types of cancer.

6. Drinking in Moderation May be Beneficial for Some

Considering the points above, you may be wondering if there’s any way at all to incorporate alcohol into a healthy lifestyle.

A small amount of alcohol can also cause a subtle rise in estrogen, which may be beneficial for perimenopausal women. After all, the most bothersome symptoms of perimenopause (e.g., hot flashes, mood swings, and low libido) are all caused by declining estrogen levels.

So, a moderate increase in this all-important hormone can help to reduce the frequency and severity of these symptoms.

According to a study from South Korea, light drinking is also associated with an increase in bone density, thus reducing the chances of developing osteoporosis[3].

But before you pour yourself a second glass of wine, it’s important to understand that this is where the benefits of alcohol end. Any more than a single drink per day can have negative consequences on the body’s delicate hormonal balance and will make the symptoms of perimenopause worse.

7. Perimenopause is the Perfect Time to Change your Relationship with Alcohol

So, we know that anything more than a moderate intake of alcohol during perimenopause is detrimental. But for many women, giving up drinking can feel like an unwinnable battle, especially where alcohol use disorder is concerned.

However, perimenopause can be the perfect catalyst to change your relationship with alcohol. Instead of surrendering to the bottle, you can choose to put your mind and body first and look after your health during this transitional time.

There are plenty of fantastic resources and support networks out there that can help, but the first step to overcoming alcohol use disorder is to recognize that you have a problem.

Then, it’s time to reach out to your GP, a therapist, or a local or online support group who can help you on your journey to recovery. Alcoholics Anonymous is a great place to start[4].

They offer both online and face-to-face meetings, and they’ve successfully helped millions of women around the world to break the cycle of addiction.

But what if you’re not facing alcohol use disorder and simply want to cut down on your intake to stay healthy during perimenopause?

There are plenty of things you can do to cultivate healthier drinking habits, including:

Track your Intake

According to the U.S. Department of Health and Human Services dietary guidelines, women should limit their alcohol intake to a maximum of 1 drink per day.

Switch to Alcohol-Free

If you’re craving a beer or a glass of wine, opt for alcohol-free choices. There are numerous great tasting alternatives on the market these days that mimic the look and flavor of an alcoholic beverage without the negative health effects.

Plan Alcohol-Free Social Activities

If you and your friends often get together at a bar or gather around a bottle (or two) of wine, why not opt for some alcohol-free social activities instead?

Chances are, you’re not the only person in your friendship group who wants to cut down on their drinking. So next time you make plans, suggest sober activities like a stroll in nature, a trip to the movies, or a coffee shop date instead.

Have Alcohol-Free Evenings at Home

Even low to moderate drinkers can benefit from some alcohol-free days each week. So, set aside certain nights of the week when you skip that glass of wine. As an extra incentive, why not reward yourself with a deliciously soothing cup of hot cocoa before bed?

Pair Alcohol with Meals

If you do choose to drink, try to enjoy beverages alongside a meal. This will slow the absorption of alcohol into your bloodstream and minimize any detrimental effects.


What are the signs and symptoms of alcohol use disorder during perimenopause?

The signs of alcohol use disorder during perimenopause are the same as those during any phase of adult life.
Physical symptoms include slurred speech, hand tremors, and impaired cognition and coordination. A person may spend more time drinking alone. They might also attempt to hide the extent of their drinking by concealing bottles and withdrawing from social situations.

How can I best support a loved one with alcohol use disorder during perimenopause?

If you suspect your partner, family member, or friend is struggling with alcohol, it’s important to take a delicate approach. Understand that perimenopause can be a challenging time in a woman’s life, and hormonal shifts can have a huge impact on her physical and mental health.
Encourage open, honest, and non-judgmental conversation where your loved one feels at ease and supported to share their struggles. If necessary, encourage them to seek professional help from their doctor, a therapist, or a support group such as Alcoholics Anonymous.

How common is alcohol use disorder during perimenopause?

While there are no official statistics surrounding alcohol use disorder during perimenopause, we know that 12.4 million women over the age of 18 have an Alcohol Use Disorder (AUD) in the USA. A significant proportion of these women are perimenopausal or menopausal.


Alcohol use disorder is a serious health issue at any stage of life. However, the challenges presented during perimenopause can push some women to drink more than usual, and this can have serious implications on their overall health.

Remember, if you’re struggling with an alcohol dependency or use disorder, you don’t have to suffer alone.

If you think you have a problem, reach out to your healthcare provider or therapist or contact a support group such as Alcoholics Anonymous. Help is out there, and with the right support, you can change your relationship with alcohol and regain your physical and emotional health.


  • Sabrina Johnson

    Meet Sabrina Johnson, a compassionate author and a seasoned expert in Obstetrics and Gynecology. She is a driving force behind Simply Menopause, where her extensive medical knowledge and empathetic nature come together to empower women in their menopausal journey. Sabrina offers culturally sensitive guidance and support through her approachable writing, making her a trusted friend on the path to menopause wellness.