SPECIAL CONSIDERATIONS FOR WOMEN

SPECIAL CONSIDERATIONS FOR WOMEN

DIFFERENT SENSITIVITY

Alcohol does not treat all people equally, and there are some big differ­ences between the effects of alcohol on women and on men. As women have taken a more visible role in our society, they have found more free­dom (and perhaps more encouragement) to drink. Consequently, drink­ing is on the rise among women in general. Surveys indicate that the percentage of women who drink alcohol has increased from 45 to 66 per­cent over the past forty years and that as many as 5 percent of women are heavy drinkers.

Women's bodies differ from men's bodies in a number of ways that make them react differently to alcohol. For one, women are generally smaller than men, and their bodies have a larger percentage of fat, which causes them to develop higher blood alcohol concentrations than men after drinking similar amounts of alcohol. There is also a chemical called alcohol dehydrogenase (ADH) that breaks down some of the alcohol in the stomach before it gets absorbed into the blood. Women under 40 years of age appear to have less of this in their stomachs, so, compared to men, more of the alcohol they drink gets absorbed into the blood. In fact, after a given dose of alcohol, a woman may achieve a blood alcohol level 25 to 30 percent higher than a man. Women should know that they will likely be considerably more impaired than their male companions if they drink comparable amounts of alcohol.

HEALTH EFFECTS

Women who drink are at significantly greater risk for liver damage than men even if they drink less alcohol or drink for a shorter period of time. This increased risk has been reported for women who drink from one and a half to three drinks of alcohol per day and may be due to the differences in the way a woman's body eliminates alcohol.

The pancreas, too, is more likely to be damaged by alcohol in women. The cells of the pancreas make chemicals that are used for digestion. When alcohol damages the pancreas cells, the digestive chemicals begin to leak out and can actually begin to digest the pancreas itself. Although this hap­pens in both women and men, women tend to develop the disease sooner.

Women are also more likely than men to develop high blood pressure due to drinking alcohol. High blood pressure is one of the major causes of

heart attack and stroke. Women who have two to three alcoholic drinks per day have a 40 percent greater risk of developing high blood pressure. The good news is that this additional risk diminishes when the woman stops drinking. Still, for women who drink even moderate amounts of alcohol, the increased risk of high blood pressure is substantial.

The risk of breast cancer is also increased in women who drink. The minimum amount of drinking that it takes to increase breast cancer risk has not been established. However, there is solid evidence that even as few as one to two drinks per day can increase a woman's risk of breast cancer. And it does not take much more drinking to push the risk up consider­ably higher. For example, one analysis indicated that women who had two to four drinks per day increased their breast cancer risk by 41 percent while another showed that women who drank three or more drinks per day on average suffered a 69 percent higher risk of getting breast cancer.

Finally, women appear to be more sensitive to the effects of chronic alcohol drinking on brain function and seem to be more likely to show deficits in cognitive function.

SOCIAL AND PSYCHOLOGICAL ISSUES

Despite the increased acceptance of drinking by women during the past several decades, a number of studies have shown that women who drink a lot meet with more disapproval of their drinking than do men. In addi­tion, the divorce rate for alcoholic women is higher than for alcoholic men. This suggests that women are less likely to leave relationships with alcoholic men than the reverse.

It is also clear that women who drink heavily are at a much higher risk for domestic violence and sexual assault than other women. One particu­larly compelling study of more than 3,000 college women found that the more alcohol a woman consumed, the higher her chances were of being sexually victimized. This might occur because a woman impaired by alcohol may have more trouble accurately interpreting a man's behavior as threatening or resisting unwanted sexual advances.

ALCOHOL AND SEX

Anyone who has ever watched a commercial for beer can tell you that your sex life will improve considerably with drinking. The truth of the

matter is that most of the effects of alcohol on sexual functioning are bad. Of course, a person may feel more suave and sexy after drinking, and he may more easily convince himself that his sexual prowess is unparalleled. But all too often the mind makes a promise that the body cant keep after a night of heavy drinking. Men, in particular, should consider the mean­ing of the term "brewer's droop."

As many as 40 to 90 percent of chronic male drinkers (depending on the study) report reduced sex drive. Chronic drinkers show reduced capacity for penile erection, decreased semen production, and lower sperm counts. In fact, in alcoholic men the testes may actually shrink (a fact generally not presented in beer commercials). In extreme cases of chronic heavy alcohol abuse among men, a feminization syndrome can develop, which involves a loss of body hair and the development of breast tissue. Although these effects are most often seen in men who drink heav­ily over a prolonged period, some sexual and reproductive functions are impaired even by lesser intake. For example, evidence is accumulating that consuming two to three drinks per day may decrease sperm counts.