Medical Aspects

• Women have higher blood alcohol levels than men for given amount consumed per pound of body weight. The reason: extremely low gastric alcohol dehydrogenase (stomach) and less body water.
• Virtually all the alcohol that alcoholic women consume is absorbed directly into the bloodstream rather than metabolized.
• Woman react more intensely and rapidly to drinking. Effects are less predictable.
• Benzodiazepines and barbiturates have longer half-lives in women. The body fat/water ratio increases with age.
• The pathological physical effects of alcohol develop more rapidly even with lower intake. Alcoholic women start drinking and begin a pattern of abuse at later ages, but appear in treatment at the same time as males with the same severity of illness. This "telescoping" effect of the progression of the disease in women is particularly pronounced for women who are depressed before the onset of alcoholism. Alcoholic women develop liver cirrhosis at lower levels of intake and with shorter durations of drinking.
• Women have higher blood alcohol levels during their premenstrual phase. Increased drinking in the premenstrual period correlates with higher premenstrual dysphoria (PMS). Alcoholic and non-alcoholic women often increase alcohol consumption to relieve menstrual distress.
• Alcohol increases the risk for heart disease, stroke, hypertension, gastrointestinal hemorrhage, peptic ulcer, and colon cancer. If a woman regularly drinks one standard serving of an alcoholic beverage per day, she increases her lifetime breast cancer risk from 12 percent to 13 percent. If she drinks two to five drinks per day, her breast cancer risk increases to about 17 percent over the course of her lifetime. Alcohol increases the levels of circulating estrogen and insulin-like growth factors which, like estrogen, promote breast cell growth. Women who drank only one drink per day were twice as likely to fracture their hips as those who do not drink.
• Alcoholic women have increased infertility (inhibition of ovulation, decreased ovary size), gynecological disorders and sexual dysfunction (lack of interest, pain, no orgasm).
• Although women reported greater interest in sex while drinking, their physical responsiveness was significantly less. In fact, their physical responsiveness and ability to achieve orgasm are actually directly diminished in proportion to the amount of alcohol consumed. In non-alcoholic females, drinking is associated with initiating fewer sexual activities despite the beliefs that it enhances sexual desire and activity. Recovering women tend to avoid sex in early recovery.
• Physicians are more likely to recognize and treat the emotional and medical consequences of addiction rather than treat it as a primary disorder. Underdetection of addiction in women promotes psychiatric complications, birth defects, increased sedative prescription, development of later stage physical, mental, and social complications, and makes treatment more difficult and less successful.

Excerpted from Sheila Blume, MD "Women: Clinical Aspects," Substance Abuse: A Comprehensive Textbook, Third Edition, 1997, Editors: Joyce Lowinson, Pedro Ruiz, Robert Millman, John Langrod and summarized by Eileen Beyer, Psy. D., CAC Diplomate.