Alcohol and Hormones: The Connection

1. Alcohol and Estrogen

How does alcohol affect hormones in females? The key player here is estrogen, which regulates the female reproductive cycle, bone density, and other important functions. And alcohol? It tends to ramp things up, boosting estrogen levels in the blood. The reason has to do with alcohol-related shifts in how the liver processes hormones, leading them to accumulate in the bloodstream. It also interferes with how this hormone functions in the body, leading to a cascade of detrimental effects.

According to “Alcohol’s Effects on Female Reproductive Function,” alcohol use can throw a wrench in the way estrogen performs its vital tasks at all stages of life. Here’s an overview.

• Alcohol disrupts menstrual cycling and impacts fertility. A PSA for anyone planning to start a family in the future (or just trying to keep a close eye on monthly cycle regularity): elevated estrogen from frequent drinking sessions can lead to irregular menstrual cycles and influence fertility. While chronic drinking is the most problematic, even occasional bouts of heavy drinking can disrupt ovulation or interfere with conception.
• Alcohol can damage bone health. You might be thinking, wait, if estrogen contributes to bone density, shouldn’t alcohol give our bones a boost rather than make them more brittle? Not so fast. While it’s true that alcohol increases estrogen levels, it also interferes with its function in other ways. So no, booze is not bone-friendly after all. 
• Alcohol-related estrogen disruptions can take a toll on our mood. Think that an evening glass of wine helps “take the edge off”? Think again. While many see booze as a quick way to relax, it can lead to mood swings. Elevated estrogen levels can cause mood swings and ramp up existing anxiety and depression symptoms. 
• These disruptions can also lead to weight gain. Even worse? The booze-related disruptions in estrogen levels can pack on the pounds even if we’re not eating more than usual by slowing down our metabolism.
• Alcohol use makes menopause more challenging. The bone density drops, mood swings, and weight gain related to estrogen fluctuations can be especially challenging during menopause. And who needs the extra hardships during an already difficult time?
• Alcohol misuse is linked to breast cancer. The stakes get higher with prolonged exposure. High estrogen levels are a known risk factor for certain types of cancer, including breast and ovarian cancers in women. Alcohol’s role in boosting estrogen places it as a significant player in this risk elevation.

Want more information? Take a look at “How Does Alcohol Affect Estrogen Levels?” and “Alcohol and Breast Cancer Risk: What's the Connection?”

2. Alcohol and Testosterone

Moving on to testosterone — the hormone of muscle building, male libido, but also so much more. To those who thought (or hoped) that the “alcohol testosterone myth” is, well, a myth — hate to break it to you, but there’s science behind it. Alcohol decreases testosterone levels in men, affecting muscle mass, mood, and sexual function. 

However, testosterone plays a role in women’s health as well! The dip — caused, once again, by the way the liver reacts in the presence of alcohol — affects both genders. Unlike estrogen, however, testosterone levels drop because the liver gets bogged down and can’t manage it effectively, failing to release adequate levels into the bloodstream. Let’s unpack the details of what happens to the body as a result.

• Alcohol-related testosterone dips cause a decrease in muscle mass. Did those laps around the track get longer? And did someone rig the weight machines to be heavier? Turns out it might just be the booze. Fitness enthusiasts take note: we need testosterone for muscle repair and growth, and with alcohol in the picture, we might see a dip in our workout performance.
• Libido and sexual health take a hit. Testosterone drives sexual desire and performance. Alcohol's depressive effects can dampen libido and, over time, lead to more significant sexual health issues like erectile dysfunction in men. For women, reduced testosterone can affect sexual desire and overall sexual satisfaction.
• Testosterone disruptions can lead to weight gain. Remember how alcohol raises estrogen levels, leading to weight gain? Well, testosterone and estrogen are a bit of a “yin and yang” pair of the hormone world: fluctuations in one affect the other. The imbalance of the two makes it harder to maintain a lean physique and could make our metabolism extra sluggish. 
• Our mental clarity and mood can tank as a result of testosterone dips. Testosterone plays a role in regulating mood and mental clarity. Lower levels can lead to fatigue, irritability, and a lack of focus. Regular alcohol consumption can exacerbate these symptoms, leading to decreased productivity and a general sense of unwellness.
• Our bones get even weaker. The disruption of the estrogen-testosterone harmony has yet another victim: our bones. While estrogen is a key player, testosterone plays a protective role in bone health, so dips in levels have a detrimental effect.

If you’re curious about the link between testosterone and alcohol and want to explore it further, check out “How Does Alcohol Affect Testosterone Levels in Men?” 

3. Alcohol and Cortisol

Next up is cortisol — the so-called “stress hormone,” which helps us deal with external and internal stressors and plays an important role in immune function and metabolism. Drinking amps up cortisol release, leading to a number of negative effects over time.

• Our sleep gets disrupted. Alcohol and sleep have a devious relationship. Sure, a few too many drinks can make us pass out on our friend’s couch. Ultimately, however, alcohol robs us of quality sleep — and cortisol is part of the reason why. Even though the depressant effects might help us doze off, the sleep that we end up getting isn’t as restorative due to high levels of the stress hormone buzzing in the background. We end up waking up more often and miss out on the most restorative REM phases of slumber.
• We get into a vicious cycle of drinking and stress. Cortisol can fuel a feedback loop: we drink to “relieve” stress but end up triggering more stress as a result. The physiological stress triggered by cortisol release is layered on top of the unease and rebound anxiety alcohol can cause through neurotransmitter imbalance, which sometimes shows up as next-day “hangxiety.”
• We become more susceptible to disease. Excessive cortisol release takes a toll on our immune system’s ability to fight off infections. Being in a state of high alert is taxing for the body — cortisol release is meant for truly stressful situations that require an immediate response. Overusing one of our natural defense mechanisms in this way makes us more vulnerable to external threats (including those from disease-causing pathogens) over time.
• We are more likely to gain weight. Situations that require us to be on high alert tend to make us hungry. (After all, we need energy to run away from that angry dog that’s chasing us!) However, when we’re drinking, our body doesn’t “know” that cortisol-induced hunger doesn’t signal a true need for food. And added on top of the empty calories that come with booze, those cravings for a midnight slice of pizza quickly add up to extra pounds. 

For a deeper dive into alcohol, cortisol, and stress, take a look at “Why Do I Have Alcohol Cravings When I'm Stressed?”

4. Alcohol and Insulin

As we can see, there’s a pattern developing here: alcohol’s effect on hormones often leads to weight gain. Nowhere is this more clear than in the case of insulin — a hormone that regulates our blood glucose levels. Initially, alcohol can cause our blood sugar levels to drop, as the liver focuses on getting alcohol out of our system instead of processing and releasing glucose into the blood. However, this pattern reverses over time, as frequent drinking lowers our insulin sensitivity and reduces our ability to metabolize sugar. Over time, this leads to increased blood sugar and can even trigger a prediabetic state.

Want to learn more? Check out “Alcohol and Insulin Resistance: What’s the Connection?”

5. Alcohol and Thyroid Hormones

Finally, thyroid hormones are crucial in maintaining our metabolism. Alcohol tends to suppress the function of the thyroid gland, decreasing its activity. Over time, we can end up with serious symptoms, such as weight gain, fatigue, and depression. According to NIH, alcohol affects the hypothalamic-pituitary-thyroid axis and changes the inner workings of the thyroid gland. It can suppress thyroid function directly through its toxic effect on the cells and can also have an indirect effect by hampering hormone response.

For more information, take a look at “How Does Alcohol Consumption Affect Thyroid Function?”