Gender and Alcoholism

Alcohol is a destructive substance; and in larger amounts, it acts as a poison to the body. Regardless of whether a person is male or female, 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 deleterious effects. Health issues related to alcoholism are all encompassing, but there are certain scientifically established differences related to the impact of alcohol on women and men.

A few of the most common gender-related topics are discussed below.

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 male may drink less than another and still become an alcoholic. Despite these differences, statistics and case studies reveal a commonality about men who drink alcoholically.

Men drink more excessively than women. There is a link between alcohol and violence. Though alcohol does not cause violent behavior, it reduces that part of the brain that inhibits violent behavior. Without that inhibition, an intoxicated, aggressive male may act impulsively upon his anger.

  • Young adult males 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.
  • According to the National Victimization Survey (NCVS), in 1999, based on victims perceptions, 1.2 million violent crimes occurred each year in which victims were certain that the offender had been drinking.
    (source: Center for Substance Abuse Prevention –SAMHSA, “Alcohol and Other Drugs”, http://preventionpathways.samhsa.gov/pdfs/fact_drugs.pdf)

Beyond an increase in anger and aggressive behavior, men suffer from alcohol-related impulse control and the distorted perceptions which 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

  • 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 (i.e., a blood alcohol concentration of 0.08% or greater).
  • Excessive alcohol consumption increases aggression and, as a result, 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.
    (source: CDC, Alcohol and Public Health, http://www.cdc.gov/alcohol/fact-sheets/mens-health.htm)

Alcohol-Related Liver Disease

According to the University of Iowa Hospitals & Clinics website, 50 percent of people with liver disease have no symptoms or non-specific symptoms, such as fatigue or excessive tiredness. Physiology separates men from women in their ability to absorb and handle different quantities of alcohol; men metabolize alcohol faster than women. Because men metabolize alcohol faster than women, they are able to drink greater quantities.

Alcohol-Related Sexual Dysfunction

Excessive and chronic alcohol use has a negative impact upon the male reproductive system. Alcohol can interfere with testicular function and, like the female body, it can disrupt the production of necessary hormones typically found in the healthy male body. Because of this, the “reduction of male secondary sex characteristics such as facial and chest hair” occurs.
(source, CDC, Alcohol and Public Health, http://www.cdc.gov/alcohol/fact-sheets/mens-health.htm)

It is common among alcoholic men to experience impotency and infertility as well.

Furthermore, alcohol use increases a male’s probability of engaging in unprotected sex and/or engaging in sexual assault on others. Alcohol distorts a person’s perceptions diminishing his or her ability to properly interpret verbal and non-verbal clues and to make appropriate choices.

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. Women tend to develop alcoholism later in life than men. It may be because societal expectations about women and behavior are harsher than those for men. Studies have found that women suffer more drinking-related familial consequences while men suffer from more from occupational, legal and violence related consequences.
(source: 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)

Intoxication

Alcohol affects women differently than men due to their body makeup and chemistry. A woman’s body has more fat and less water than a man’s. When a woman drinks, the alcohol absorbed is less diluted. Therefore it enters the blood stream at higher concentrations. As a result, women become intoxicated more quickly.
(source: Effects of Alcohol on Women, http://www.fasdcenter.samhsa.gov/documents/WYNK_Effects_Women.pdf)

Brain damage from chronic or intense drinking can be profound. And while both men and women will 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.
(source: NCBI, Physiological Effects of Alcohol, Drugs, and Tobacco on Women, Ch 3, http://www.ncbi.nlm.nih.gov/books/NBK25743)

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% of pregnant women used alcohol. Drinking during pregnancy often distorts the development of the fetus leading to miscarriage, stillbirth, and other lifelong disorders known as fetal alcohol spectrum disorder. (FASD)
  • Excessive drinking may disrupt menstrual cycling 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.
    (http://www.cdc.gov/alcohol/fact-sheets/womens-health.htm)

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

Heart Disease: Cardiomyopathy

There are many heart conditions that both men and women share. Generally, men and women will suffer equally from these conditions: atrial fibrillation, flutter, stroke, hypertension etc. The difference is that women consume only 60% of what men consume over a life time but suffer the same from heart disease. 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 Center for Disease Control, 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. Women are more likely to develop Stage 2 liver disease than men, but they can also develop cirrhosis of the liver faster.

Obesity, depression, and Alcohol Abuse

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

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 ... Laboratory studies of the effects of alcohol on responding to visual cues and other tasks suggest that there may be gender differences in how alcohol affects the performance of driving tasks ... 
(source: NIAAA, Publications, “Alcohol Alert”, Dec 99, http://pubs.niaaa.nih.gov/publications/aa46.htm)

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 (e.g., family discord or household accidents) 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 … (source: NIAA, Publications, “Alcohol Alert”, Dec 99 http://pubs.niaaa.nih.gov/publications/aa46.htm)

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 well 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 alcohols have death rates 50-100 percent higher than those of male alcoholics…”
(source: National Institute on Alcohol Abuse and Alcoholism, Alcohol Alert, No. 10, 1990, http://pubs.niaaa.nih.gov/publications/aa10.htm)

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