Some women may be able to hold their liquor as well as men do, but there's no equality when it comes to whose health suffers more for it. Excessive alcohol use takes a higher toll on women's bodies, with a greater risk of liver, brain or heart damage, among other devastating conditions.
"We are very concerned about the fact that more young women are starting to drink in harmful ways, including binge drinking," said Dr. Deidra Roach of the National Institute on Alcohol Abuse and Alcoholism.
A decades-long study of data on more than 500,000 people nationwide indicated women ages 21 to 23 were the only group whose binge drinking has increased. The research, reported in the July 2009 issue of the Journal of the American Academy of Child and Adolescent Psychiatry, showed a 30 percent jump between 1979 and 2006 in women who binge drink (that is, who down at least four alcoholic drinks in rapid succession).
The physical differences between the sexes play a significant role in how their bodies metabolize alcohol. Women have more body fat and less water in their systems than men do, as well as lower levels of an enzyme important in the breakdown of alcohol, according to the NIAAA. This means they experience the effects of drinking more quickly and for a longer time than men.
Of the estimated 17.6 million Americans who abuse alcohol, 5.3 million of them are female, according to the National Institutes of Health.
"Because women are smaller than men . . . the same amount of alcohol will be more concentrated in a woman's body than a man's body," said Roach, a health scientist administrator in the NIAAA's Division of Treatment and Recovery Research. "This means when a man and a woman drink the same amount of alcohol, in general, the woman's internal organs will be exposed to more alcohol than the man's."
A bevy of health problems
For women, the consequences of drinking include damage to organs and increased rates of chronic diseases.
- Liver damage: Women develop alcohol-induced liver disease — including hepatitis and cirrhosis — over a shorter period of time and after consuming less alcohol than men, according to the NIAAA. It may be the female hormone estrogen that increases these risks.
- Brain damage: MRI scans have shown that certain brain regions are smaller in women alcoholics than in other women and in men who are alcoholics, even after measurements are adjusted for head size, according to the NIAAA.
- Heart disease: Many studies have shown a drink or two per day is heart-healthy. However, other research shows similar rates of severe damage to the heart muscle among women and men who are alcoholics, despite the fact that women who are alcoholics consume 60 percent less on average over their lifetimes, according to the NIAAA.
- Breast cancer: The risks of developing breast cancer go up dramatically for heavy female drinkers. According to Loyola Marymount University, a large analysis showed the risk of developing the disease jumped 9 percent for each 10-gram increase (0.35 ounces) in daily alcohol consumption, up to 60 grams (2 ounces).
- Violent injury: Not only are women put at greater risk of being assaulted, sexually or otherwise physically, by heavy drinking, according to the NIAAA, there has been an increase over the past decade in the proportion of women drivers to men drivers involved in fatal car crashes.
Unhealthy drinking habits place women at greater risk for a variety of adverse health and social consequences, including becoming infected with the AIDS virus, Roach said.
"We are seeing a growing body of evidence that binge drinking is a major risk factor for acquiring HIV among some groups of women," she said.
A disease that 'sneaks up' on you
Even less serious conditions, such as sinus or bladder infections, can be brought on by alcohol abuse.
Joyce Rebeta-Burditt of Los Angeles said she had chronic sinus infections when she drank excessively 40 years ago. Rebeta-Burditt has since become a UCLA-certified alcohol recovery expert and the author of two books about recovering alcoholic women.
"Alcoholism is very dehydrating," she said. "I didn't appreciate how sick I was physically. I got IBS [irritable bowel syndrome] from alcohol irritation, and I still have bouts."
Rebeta-Burditt compared alcoholism to diseases such as diabetes that "sneak up on people," making it difficult to know when the line has been crossed.
"The difference is, most people know diabetes is an illness and don't know that alcoholism is, too," she said.
Roach said the NIAAA encourages health care professionals to screen women of all ages for problem drinking, because symptoms are so easily overlooked. For example, in older women alcohol may be a "hidden culprit" contributing to depression, frequent falling or heart failure, she said.
"Neither health professionals nor patients should ever simply assume that alcohol could not be a problem," Roach said.