Medical risks for women who drink alcohol

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, alcoholrelated 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. L ess than three quarters of women in the UnitedStates drink alcohol, and those who do drink consume fewer drinks and less absolute alcohol than men. 1 However, at similar levels of self-reported alcohol consumption, the risk of psychosocial problems or dependence is greater for women than men (for definitions, see Appendix A). [2][3][4][5][6] Women also appear to develop alcohol abuse and dependence after fewer years of drinking than men. 7 Although only 4% to 5% of women in the U.S. general population meet criteria for past-year alcohol abuse or dependence, 8,9 9% of female primary care patients in some studies have reported recent heavy drinking or alcohol-related problems. 10,11 Many heavy drinkers decrease consumption following brief interventions that include explicit advice about safe drinking limits. [12][13][14] In addition, offering feedback about specific risks or consequences of their drinking to patients who drink heavily can help motivate them to decrease alcohol consumption or seek treatment. 15,16 Physicians report they would be more likely to advise patients about safe drinking practices if they were more confident of their knowledge about safe levels of alcohol consumption. 17 Women who drink more than two drinks daily on average, or who frequently drink five or more d...

Alcohol Screening Scores and the Risk of New-Onset Gastrointestinal Illness or Related Hospitalization

“…20 This may be especially true for women, who are more vulnerable to the toxic effects of alcohol. 21,22 Indeed our data show that women in the AUDIT-C 0 group (abstainers) were at increased risk for new-onset liver disease. With the exception of abstainers (AUDIT-C 0), women's risk for adverse gastrointestinal outcomes increased only in women in the AUDIT-C 9-12 group.…”

“…This is unexpected given that men had increased risk at lower scores (≥ 5), and women are more vulnerable than men, especially to the hepatotoxic effects of alcohol. 21,22 Several factors may be biasing the results for women in the AUDIT-C 5-8 group to the null. First, even with a sample of over 9,000 women, we had low power to detect rare events (see Table 2).…”

A Randomized Controlled Trial of IVR-Based Alcohol Brief Intervention to Promote Patient–Provider Communication in Primary Care

“…Further education of the medical community and the general public is warranted regarding the effects on medical conditions and disease management, not just AUD, that can result from exceeding the NIAAA threshold for low-risk alcohol consumption. [31][32][33] Limitations Data on what transpired during the clinic visit was based solely on patient self-report, and thus was subject to recall and impression management biases. Existing evidence for the validity of proxy measures for clinician behavior is limited; however, a review study concluded that patient report is more accurate than provider report or records review.…”

Alcohol consumption and ovarian cancer risk in a population‐based case–control study

“…44 Other studies have suggested that moderate to high alcohol intake causes menstrual irregularities. [45][46][47] In rats, chronic alcohol consumption can lead to ovarian failure. 48 If suppression of ovulation and gonadotropin levels are protective against ovarian cancer as has been hypothesized, 25,26 and if alcohol disrupts these processes, then high levels of alcohol consumption may be protective against ovarian cancer.…”