Gender Issues and Alcoholism in Men & Women

In this article Addiction 411 explains the different issues related to alcoholism in men and women. Below are the contents of this page.

Alcohol is a destructive substance, and in larger amounts, it acts as a poison to the body. The body’s organs, tissues, cells, structure and function become severely impaired and damaged with chronic ingestion. Often the damage cannot be reversed.

There are many factors that determine a person’s response to alcohol and to its effects. Health issues related to alcoholism are all encompassing, but there are certain differences related to the impact of alcohol on women and men.

Men and Alcoholism

Genetic, biological, psychological, psychosocial and environmental factors all combine to determine whether a man becomes an alcoholic or not. That means that one man may drink less than another and still become an alcoholic. Despite these differences, statistics and case studies reveal a commonality about men who drink.

Men drink excessively more than women do. In addition, there is a link between alcohol and violence. Although alcohol does not cause violent behavior, it affects that part of the brain that inhibits violent behavior. Without that inhibition, an intoxicated, aggressive man may act impulsively upon his anger. (1)

  • Young adult men are more likely than other demographics groups to be involved in alcohol-related homicides and assaults.
  • Of all psychoactive substances, alcohol is the most common drug whose use has been most clearly shown to increase aggression.

Beyond an increase in anger and aggressive behavior, men may also have alcohol-related impulse control and the distorted perceptions that can then lead to inappropriate behavior. They engage in higher-risk behaviors as well, such as drinking and driving.

Injuries and Death as a Result of Alcohol Use in Men (2)

  • Men consistently have higher rates of alcohol-related deaths and hospitalizations than women.
  • Among drivers in fatal motor-vehicle traffic crashes, men are almost twice as likely as women to have been intoxicated (blood alcohol concentration of 0.08 or greater).
  • Excessive alcohol consumption increases aggression and can increase the risk of physically assaulting another person.
  • Men are more likely than women to commit suicide and more likely to have been drinking prior to committing suicide.

Alcohol-Related Liver Disease

About half of the people with liver disease have no symptoms or non-specific symptoms, such as excessive fatigue. By the time more specific symptoms appear, damage can be severe. Physiology separates men from women in their ability to absorb and handle different quantities of alcohol. Men have more of an enzyme that enables them to metabolize alcohol faster than women.

Alcohol-Related Sexual Dysfunction

Excessive and chronic alcohol use has a negative impact on the male reproductive system. Alcohol can interfere with testicular function and can disrupt hormone production. Because of this, the “reduction of male secondary sex characteristics such as facial and chest hair” occurs. (3)

Alcoholic men commonly experience impotency and infertility. Alcohol use also increases a man’s probability of engaging in unprotected sex and/or engaging in sexual assault. Alcohol distorts a person’s perceptions and lowers inhibitions, diminishing ability to interpret verbal and non-verbal clues.

Women and Alcoholism    

Women do not have to drink as long or as much as men to develop serious illnesses from alcohol. The female body is far more sensitive to alcohol than the male body because of differences in how women process alcohol. Women tend to develop alcoholism later in life than men. (4)

Intoxication

Alcohol affects women differently than men due to their body chemistry. A woman’s body has more fat and less water than a man’s. Women also have less of an enzyme that breaks down alcohol. When a woman drinks, the alcohol absorbed is less diluted and enters the bloodstream at higher concentrations. As a result, women become intoxicated more quickly. (5)

Brain damage from chronic or intense drinking can be profound. While both men and women experience a decrease in both white and grey brain matter due to alcohol consumption, women who are alcohol dependent “exhibit deterioration in planning, visuospatial ability, working memory, and psychomotor speed….Women [also] appear to be at greater risk than men for Alzheimer’s disease…” and are more vulnerable to alcohol related brain damage.
(6)

An estimated 4 million women consume large enough quantities of alcohol to threaten their health and safety. The following areas reflect some of physical and social consequences of excessive alcohol consumption for women.

Reproductive Health

  • In 2008, about 7.2 percent of pregnant women used alcohol. Drinking during pregnancy affects the development of the fetus and can lead to miscarriage, stillbirth and lifelong disorders known as fetal alcohol spectrum disorder. (FASD)
  • Excessive drinking may disrupt the menstrual cycle and increase the risk of infertility, miscarriage, stillbirth and premature delivery.
  • Women who binge drink are more likely to have unprotected sex and multiple sex partners. These activities increase the risks of unintended pregnancy and sexually transmitted diseases.(7)

Many healthy women experience fluctuations in hormone levels that contribute to premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). Alcohol can worsen these conditions because it disrupts the production of hormones. Some studies indicate that women of childbearing age who are heavy drinkers will have problems with infertility.

Heart Disease: Cardiomyopathy

Both men and women experience cardiac problems like atrial fibrillation, palpitations, stroke and hypertension. However, when alcohol consumption is considered, women with the same level of heart disease as men have consumed only 60 percent as much alcohol. And, women who drink excessively are at greater risk than men for heart damage.

Cancer

Alcohol places men and women at greater risk than the general public for several forms of cancer. Included within this group is breast cancer. According to the Centers for Disease Control and Prevention, the greater the intake of alcohol for women, the greater the risk of developing breast cancer.

Liver Disease

Gender is a key factor in liver disease (cirrhosis) Women are unable to metabolize alcohol as quickly as men because they lack specific liver enzymes. This is why women feel intoxicated so quickly and why they get sick faster.

Obesity, Depression, and Alcohol Abuse

While there may not be a direct link between alcohol abuse, depression and obesity, many alcoholic women do struggle with varying degrees from all three conditions.

  • Women with an alcohol disorder at age 24 were more than three times as likely to be obese when they were 27.
  • Women who were obese at 27 were more than twice as likely to be depressed when they were 30.
  • Women who were depressed at 27 were at increased risk for alcohol disorders at 30.

Other Alcohol Related Issues

Traffic Crashes. Although women are less likely than men to drive after drinking … and to be involved in fatal alcohol-related crashes … women have a higher relative risk of driver fatality than men at similar blood alcohol concentrations ... (9)

Victimization. Using data collected in a large general population survey, [researchers] found that women who reported being sexually abused in childhood were more likely than other women to have experienced alcohol-related problems and to have one or more symptoms of alcohol dependence. Another study found that women in alcoholism treatment were significantly more likely to report childhood sexual abuse and father-to-daughter verbal aggression or physical violence compared with women in the general population … (10)

According to the SAMHSA’s Pathway Course Online Fact Sheet on women, violence and alcohol, 85 percent of all “victims of intimate partner violence” are women. The issue of female substance abuse (alcohol and drugs) and partner violence is complicated. Prior physical and verbal abuse often leads to addiction for women, as does living with an active alcoholic or addict.

Overall Impact of Chronic Alcoholism for Women

  • 2.5 million American women meet the criteria for alcohol dependence.

“Chronic alcohol abuse exacts a greater physical toll on women than on men. Female alcoholics have death rates 50-100 percent higher than those of male alcoholics…”(11)

References:

  1. Center for Substance Abuse Prevention –SAMHSA, “Alcohol and Other Drugs,” http://preventionpathways.samhsa.gov/pdfs/fact_drugs.pdf
  2. CDC, Alcohol and Public Health, http://www.cdc.gov/alcohol/fact-sheets/mens-health.htm
  3. CDC, Alcohol and Public Health, http://www.cdc.gov/alcohol/fact-sheets/mens-health.htm
  4. Society for the Study of Addiction to Alcohol and Other Drugs, Laura C. Holdcraft et al, “Cohort effects on gender differences in alcohol dependence”, 2002, #97, p1026, http://www.psych.umn.edu/faculty/iacono/2002 cohort effects on gender differences in alcohol dependence.pdf
  5. Effects of Alcohol on Women, http://www.fasdcenter.samhsa.gov/documents/WYNK_Effects_Women.pdf
  6. NCBI, Physiological Effects of Alcohol, Drugs, and Tobacco on Women, Ch 3, http://www.ncbi.nlm.nih.gov/books/NBK25743
  7. http://www.cdc.gov/alcohol/fact-sheets/womens-health.htm
  8. Health Group, Inc., http://www.crchealth.com/articles/depression-obesity-alcohol-abuse-linked-in-young-women.php
  9. NIAAA, Publications, “Alcohol Alert”, Dec 1999, http://pubs.niaaa.nih.gov/publications/aa46.htm
  10. NIAA, Publications, “Alcohol Alert”, Dec 1999 http://pubs.niaaa.nih.gov/publications/aa46.htm
  11. National Institute on Alcohol Abuse and Alcoholism, Alcohol Alert, No. 10, 1990, http://pubs.niaaa.nih.gov/publications/aa10.htm
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