Why You Shouldn’t Mix Menopause With Alcohol

It’s an unhealthy combination for mood and memory

Joelle Klein

Updated October 06, 2025

A woman sitting at a table with one hand on her chin and the other holding a glass of wine

Peter Dazeley/Getty Images

It’s a cruel twist of fate. As menopause symptoms such as stress, anxiety, mood swings and depression kick in, you may find yourself reaching for a glass of wine or a cocktail for relief. Unfortunately, just as you’re going through menopausal changes, your tolerance for alcohol is also shifting, which may not mix with your mixed drink.

Learning about the effects of alcohol on your body and brain during menopause is more important than ever, because women are drinking more than ever. One study revealed that, over the last decade, rates of excessive drinking among women have risen 84 percent as compared to a 35 percent rise among men.

Why are more women reaching for the bottle? For women age 50 and over, there are a whole lot of changes going on, which may include children leaving the house, parents needing care, more responsibility at work — and menopausal symptoms. And women are generally more likely than men to turn to alcohol to deal with stress and feeling overwhelmed, says MacKenzie Peltier, an assistant professor of psychiatry at Yale School of Medicine.

There’s this reduced stigma and normalization of drinking to relieve stress and low moods, Peltier says. “It was a bit more taboo [in the past] than it is now.”

Aging and alcohol

Even before the countdown to their last period, women have about 40 percent fewer dehydrogenase enzymes, the enzyme that breaks down alcohol, than men. As women get older, their bodies make even less of this enzyme, which means alcohol stays longer and accumulates more in their bodies.

On top of that, the imbalance between levels of body fat and levels of water in women’s bodies also accelerates as they age — body fat increases while water levels decrease, Peltier explains. Why is that a problem? Fat retains alcohol, and water disperses it.

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These biological changes mean that women feel the effects of alcohol more quickly and more strongly around middle age than they did when they were younger, even when they drink the same amount.

“It also means that, as we age, we’re more sensitive to some of the effects of alcohol, such as its impact on coordination, balance, attention and memory,” she adds.

Plus, hangovers the next day can be worse than ever.

Alcohol can worsen menopause symptoms

All this means that, instead of providing respite from bothersome menopause symptoms, alcohol can exacerbate them.

Sleep, for example, or lack of it, is a common issue for menopausal women, with about 40 to 60 percent reporting sleep disturbances. Many people reach for a nightcap to relax before bed. However, while alcohol is a sedative and can help you fall asleep initially, it’s also a sleep disruptor, so the sleep you do get is less likely to be restorative, Peltier says.

Hot flashes and night sweats — which affect up to 80 percent of menopausal women — are the result of fluctuating hormones that can lead to temperature deregulation, hence the sudden overheating. Certain foods or beverages can trigger hot flashes, and alcohol is one of them.

Additionally, alcohol can exacerbate anxiety and depression in complex ways, says Sara Shihab, M.D., women’s health internist and senior associate consultant at the Women’s Health Internal Medicine division at the Mayo Clinic in Phoenix. When women are feeling more mood symptoms or not sleeping or have other distressing things going on in their life around the time of menopause, she says, “they’re reaching for alcohol, which can lead to more mood-related symptoms. It’s almost like a vicious cycle, and sometimes it’s difficult to tell what caused what.”

Alcohol, menopause and heart and brain health

Another unfortunate combination: Due to lower estrogen levels, postmenopausal women may be at higher risk for conditions such as heart disease, osteoporosis and stroke. Drinking alcohol may increase those risks even more.

For starters, drinking too much alcohol can cause weight gain. Weight gain due to alcohol coupled with weight gain due to menopause can increase the risk of high blood pressure and high cholesterol — two risk factors for heart disease and dementia. Further, long-term and excessive alcohol use (8 or more drinks per week for women) is a risk itself for those conditions, as well as certain cancers.

The combination of drinking more alcohol and women’s reduced ability to metabolize it can affect cognition and memory, too. With alcohol accumulating and lasting longer in the body, all our organs — including our brains — are exposed to more alcohol for longer periods of time.

How to drink to your health and not against it

While previous studies pointed to health benefits from light to moderate drinking, more recent studies report that no alcohol is better than some alcohol. However, if abstinence is not for you, pay attention to the amount you’re drinking.

“If you absolutely want to drink, don’t drink more than one drink a day or seven drinks a week,” Shihab recommends, adding that it’s better to “have as many alcohol-free days as possible.” Furthermore, know that a standard drink is 5 ounces of wine, 12 ounces of beer or 1.5 ounces of distilled spirits. So that means, one martini counts as two drinks, as does an 8-ounce goblet of wine.

Lastly, Shihab advises, try to find other ways to manage stress and anxiety. Effective strategies include regular physical exercise and a healthy diet. Get together with friends over an activity or mocktails. Also, if you’re having mood issues or bothersome menopausal symptoms, talk to your doctor rather than reaching for a cocktail.