The festive season has officially begun and you might have already found yourself drinking more than you usually do. From work drinks to Christmas parties to family reunions, during this time we see so many of our patients asking our clinical team about the impact that drinking has on menopause symptoms.

Generally speaking, alcohol intake in moderation is safe and there is no need to go alcohol free just because you're menopausal or peri-menopausal. For most people, it’s fine to drink moderately during menopause, but because alcohol can have an impact on the symptoms of menopause, there are some important considerations to be aware of.

In this article, Dr Gidon Lieberman (our Medical Director) will explain the impact alcohol can have on menopause and how to mange drinking during the festive season.

Alcohol can exacerbate menopause symptoms

There are lots of symptoms that are common to both the effects of drinking and menopause. These symptoms are:

• Hot flushes
• Next day anxiety
• Sleep disorders
• Mood swings
• Bladder problems
• Relationship problems
• Weight gain

Drinking alcohol during menopause can mean that some of the most common symptoms such as mood swings, hot flushes and sleep problems feel exacerbated and slightly worse. Whilst some evidence around this has been found it be inconclusive (and a lot is anecdotal), it has been proven that alcohol can trigger hot flushes. How? Because alcohol causes a dilation of blood vessels, which can then cause a hot flush to come on.

Alcohol also raises your body temperature, making the chance of experiencing night sweats greater. If you've found that your menopause symptoms have become any worse, try to see whether this happens when you've been drinking slightly more that usual.

As we get older, our bones slowly get thinner too, particularly after menopause. Drinking a lot of alcohol can make this worse, increasing your risk of osteoporosis. Osteoporosis is a condition that affects the bones, causing them to become weak and fragile and more likely to break.  

Drinking can cause weight gain during menopause

Alcohol consumption affects how your body metabolises or processes carbohydrates and this can have a knock-on effect on your weight. During menopause, your metabolism will slow down anyway and drinking a lot can slow it down even more, causing weight gain (especially around your stomach area).

Weight gain from alcohol can have a longer term impact on your body too and can cause conditions like diabetes and heart disease. If you're struggling to control your weight during menopause, we always advise our patients to cut back on alcohol as well as other lifestyle changes like regular exercise and maintaining a healthy, balanced diet.

It can make HRT treatment for menopause less effective

HRT (Hormone Replacement Therapy) can be used to combat the symptoms of menopause but drinking can weaken the impact HRT has on your body, making it less effective in doing what it's meant to be doing (helping with menopause symptoms).

This happens because when you drink, your liver will break down (or metabolise) alcohol using enzymes. The more you drink, the more enzymes your liver will need to create to do this. Your liver will also metabolise tablet forms of HRT (the most common form) and so drinking can weaken the impact HRT has on easing menopause symptoms. HRT that's taken in the form of patches, sprays, gels and coils are not processed by the liver, and so if you're drinking it may be worth switching to this form of medication.

The risks of taking HRT vs. the risks of drinking alcohol

The combination of progesterone and estrogen post-menopausal therapy is associated with an increased risk of breast cancer. This is still a major factor in why it's not used by lots of people who experience menopause symptoms. However, drinking alcohol over the recommended unit limit has the same risk of developing breast cancer.

For every 1000 women aged 50-59, there will be between 8 and 10 additional women who will develop breast cancer with the use of combined HRT (estrogen and progesterone).

For every 1000 women aged 50-59, there will be between 8 and 10 additional women who will develop breast cancer if they drink 4-6 units of wine per day.

Managing your drinking during menopause

If you are looking to control, change or simply be more aware of your alcohol intake during the menopause, there are lots of great online resources available:

• NHS Alcohol Support
• Drinkaware
• Age UK

For anyone looking to enjoy the festive season with less alcohol, here is a lovely recipe for an alcohol-free festive 'Orange and Rosemary Fizz' mocktail:

Ingredients (serves 2):

Orange – 1, cut into 4 large wedges

Rosemary – 2 sprigs

Soda Water – 100 ml

Cinnamon stick – 2, to garnish

Pomegranate seeds – a handful to garnish

Steps:

Place 2 orange slices in each glass with half a sprig of rosemary. Muddle well then fill with ice. Top each glass with 50ml of soda water, stir to mix, then garnish with pomegranate seeds, a cinnamon stick and the remaining rosemary.

If you're a patient of Fertifa and you're looking to speak to someone in our clinical team about how to manage menopause and alcohol, get in touch via the app to book an appointment. Don't forget, we're here to help 💜