Perimenopause–or the time in a woman’s life right before she stops having periods–can be a very difficult time. Estrogen levels are fluctuating, causing all manner of physical and emotional symptoms, from hot flashes to mood swings to insomnia.
It may come as no surprise, then, that many women turn to drinking during perimenopause. In an effort to find temporary relief from symptoms–and often cheered on by a “mommy wine culture” that encourages cocktail or wine drinking during menopause–women in perimenopause are at high risk for developing or worsening alcohol addiction.
Though the link between perimenopause and alcohol addiction is strong, it is not unbreakable. Through hormone-aware therapies and trauma informed care, as well as sensitivity to dual diagnoses such as addiction to alcohol and anxiety, hope is possible.
What Is Alcohol Use Disorder?
Because drinking is such a big part of our culture, it can be difficult to tell when alcohol consumption has crossed a line from social activity to disorder.
The DSM-V, a diagnostic manual for mental health disorders, defines alcohol use disorder as a “problematic pattern of alcohol use leading to clinically significant impairment or distress in a 12-month period.” Key signs that alcohol use has crossed into disorder territory include:
- Feelings of guilt or shame after drinking
- Drinking more often
- Spending much of the day thinking about drinking
- Habitually drinking alone or in secret
- Unsuccessfully trying to cut back on drinking
- Drinking during inappropriate times, such as during caregiving or work
- Skipping commitments or social activities to drink or because of a hangover
- Blacking out or forgetting conversations because of drinking
- Engaging in risky behavior during drinking, such as driving
The effects of alcohol use disorder (AUD) on any person’s health is devastating, but particularly for women. The effects of alcohol abuse range from the physical–liver damage and even cancer–to the emotional. Especially during perimenopause, depression and drinking can go hand-in-hand.
This is further compounded by the many changes taking place in a woman’s body during menopause.
What Factors Link Perimenopause and Alcohol Addiction?
Biological Factors
A woman’s changing body during perimenopause can increase vulnerability to alcoholism. Fluctuating hormone levels affect neurotransmitters such as dopamine, serotonin, and GABA, which regulate mood, reward, and stress responses. These hormonal shifts can heighten anxiety, depression, sleep disturbance, and irritability, leading some individuals to self-medicate with alcohol.
Reduced estrogen can also contribute to perimenopause alcohol intolerance, and is associated with dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, increasing stress sensitivity and cortisol levels.
Psychological Factors
Mood instability, heightened anxiety, and depressive symptoms are just some of the psychological effects of hormone changes during perimenopause. Many women experience identity shifts related to aging, fertility changes, or career roles, which can lower self-esteem and increase feelings of loss or uncertainty.
Sleep disruption and chronic fatigue reduce coping capacity, making alcohol seem like a quick relief for stress or insomnia. Some complicating factors, such as prior trauma, can intensify this link between perimenopause and alcohol addiction.
Social Factors
An entire media ecosystem has built itself around the stereotypical “wine mom”: a funny character in movies and shows, the overworked perimenopausal woman drowns her sorrows in alcohol and is an innocuous punchline.
But the messaging received by some women is that drinking is an acceptable and common way to deal with the stresses of life, particularly during menopause. She and her girlfriends may almost subconsciously replicate what they see on TV.
Or, they may genuinely enjoy getting together with a glass of wine–but when social drinking crosses the line from occasional to frequent and intense, the consequences on health can be devastating, especially for menopausal women.
The Effect of Alcohol Use Disorder on Perimenopause Symptoms
Ironically, many women turn to alcohol to ease the symptoms of perimenopause, but it can actually make them worse.
Doctors advise, for example, that alcohol use can worsen sleep problems often caused by menopausal hormone fluctuations. Wine or cocktails might seem to cause sleepiness, but they can actually disrupt sleep cycles, leading to exacerbated insomnia.
Likewise, alcohol use has been shown to worsen night sweats or hot flashes, further interrupting the thermoregulatory zone of the body that is already thrown off by hormones.
Perhaps most serious of all is the likelihood that alcohol abuse during menopause can cause or worsen health conditions such as osteoporosis and heart disease. It has even been linked with a higher risk of breast and colorectal cancers. One study found that combining alcohol with the hormone replacement therapy many women take during and after menopause can increase breast cancer risk up to five times.
Recovery from AUD in Menopause Is Possible
Menopause and alcoholism can be a dangerous combination, but quitting alcohol during perimenopause is possible. Evidence-based treatment such as cognitive behavioral therapy or internal family systems can help rewire the brain so that it develops healthy coping skills for addiction and for perimenopausal symptoms.
Wellness and holistic rehab facilities combine these treatments with attention to the whole body, incorporating sensory elements such yoga, acupuncture, and even gardening into the recovery process.
Many women find that, alongside increased alcohol use, the hormonal fluctuations of perimenopause can worsen the effects of past trauma, re-triggering memories or causing PTSD symptoms to intensify. That is why a trauma-informed care approach is vital for women seeking holistic mental health treatment for perimenopause and alcohol addiction.
High-quality addiction or anxiety treatment centers will also offer specialized treatment approaches for women that address both hormonal health and alcoholism, not treat one to the neglect of the other. They will also be aware of and sensitive to the likelihood of dual diagnoses, such as anxiety, depression and addiction treatment.
Find Relief from Perimenopause and Alcohol Addiction at Sana at Stowe
Nestled in the beautiful natural setting of rural Vermont, Sana at Stowe is a residential treatment facility that combines evidence-based treatment, premium facilities, and holistic care.
For women in perimenopause, holistic recovery from addictions is possible with our trauma-informed, hormone-aware care. We explore the roots of addiction and potential dual diagnoses, offering combinations of treatments such as anxiety treatment through cognitive behavioral therapy combined with holistic somatic treatments that incorporate the body.
So if you or a loved one find themselves turning increasingly to alcohol to ease the symptoms of perimenopause, and if you feel it spiralling out of control, take heart: help is available, and a life of health and happiness is possible. Reach out to Sana at Stowe today at (802) 532-5277 or check out our resources online.
