Women and Alcohol: Why the Effects of Drinking Hit Harder, Faster

Happy young adult dancing with her friends while at a nightclub party with confetti, holding a drink on her handI don’t like to admit it, but it’s true: generally speaking, women can’t handle their liquor as well as men. Although there are always exceptions, research indicates women are more sensitive to the effects of alcohol. More specifically, it hits them harder and faster.

One of the main differences between men and women related to drinking has to do with dehydrogenase, a metabolizing enzyme that helps the body get alcohol out of its system. This enzyme helps men process alcohol more efficiently, allowing them to drink more and not feel the effects as quickly. Women generally have less of the enzyme than men, so more of what women drink enters their bloodstream as pure alcohol.

Women tend to weigh less than men, and on average, women’s bodies contain less water and more fatty tissue than men’s. Because fat retains alcohol while water has a diluting effect, alcohol remains at higher concentrations for longer durations in a woman’s body, exposing her brain and other organs to more alcohol.

It would seem feeling the effects faster simply leads to not being able to drink as much as quickly. However, a dangerous biological factor comes into play for females.

Females are at greater risk than males for developing serious alcohol-related physical problems. Once a drink is consumed, it goes through the digestive tract where it is dispersed through water in the body. The more water that is available, the more diluted the alcohol gets. Again, on average, women weigh less than men. As a result, women’s bodies are more exposed to the toxic byproducts the body releases when it breaks down alcohol. Thus, a female is at significantly higher risk for developing organ damage such as alcoholic hepatitis and cirrhosis. Females are also more likely than males to die from these conditions.

But the potential damage does not stop at the liver. Because women’s bodies are more exposed to alcohol’s toxins, they are more likely to experience alcohol-related brain damage and loss of cognitive function. Women who drink heavily also have an increased risk of thinning bones, falls and hip fractures, infertility and miscarriage, premature menopause, high blood pressure, heart disease, and cancer, especially of the breast, head, and neck.

While men have higher rates of alcohol use disorder diagnoses, women experience the physical damage from drinking significantly more quickly than men do. Consider a man and a woman who both drink heavily. Over time, statistically, the woman will begin to have more severe health problems within five years, while it may take 20 years for the same health issues to show in a man.

Another biological factor that affects the sexes differently is hormones. The fluctuations in hormone levels during a woman’s menstrual cycle may affect how she metabolizes alcohol. The intoxicating effects of alcohol will set in faster when a female’s estrogen levels are higher. This typically occurs just before her period.

These biological factors explain why women may become intoxicated after drinking less and are more likely to suffer adverse consequences after drinking smaller quantities for fewer years than men.

Alcohol, in a cruel turn, increases estrogen levels. A woman taking estrogen-added birth control pills will become intoxicated faster and stay that way longer. The medication slows the rate at which the body eliminates alcohol. Her hangover may also be worse than a male counterpart’s. These biological factors explain why women may become intoxicated after drinking less and are more likely to suffer adverse consequences after drinking smaller quantities for fewer years than men.

As my previous article reported, while drinking, men tend to experience more impairment in judgment than women do. And as noted above, a woman is likely to feel alcohol’s effects more quickly and for a longer period. These two biological realities can lead to a dangerous outcome: sexual assault. Each year, one in 20 women is sexually assaulted. Research confirms there is an increased risk when both the attacker and the victim consume alcohol prior to the assault.

A final way in which alcohol affects the genders differently is in seeking help. While the stigma of women drinking may be decreasing, there still appears to be stigma around getting help. Women are more likely to attribute their problems to depression, anxiety, or family troubles rather than drinking. This creates a ticking time bomb of sorts. Behavioral health care providers must be trained to look beneath the presenting issue and help women see the first step may be to address the alcohol use. Once the drinking is under control, other issues may be more easily recognized and resolved.


Due to biological differences, women, on average, experience the effects of alcohol use in different ways than men. Weight, body fat, enzymes, and hormones are all factors that increase the likelihood a woman will experience physical problems related to drinking more quickly than a typical male.

By remaining aware of their respective risk factors, women and men alike may make more educated decisions regarding drinking and ward off potential consequences.


  1. B.R.A.D. (2013). Women and Alcohol. Retrieved from http://www.brad21.org
  2. Centers for Disease Control and Prevention. (2016). Fact Sheets – Excessive Alcohol Use and Risks to Women’s Health. Atlanta, GA: CDC.
  3. Connery, H. S. (2011). Alcohol Use and Abuse – Harvard Medical School Special Health Report.
  4. National Institutes of Health: The Office of Research on Women’s Health, Office of the Director, and the National Institute on Alcohol Abuse and Alcoholism. (2015). Alcohol: a Women’s Health Issue. NIH Publication No. 15–4956.

© Copyright 2017 GoodTherapy.org. All rights reserved. Permission to publish granted by Cyndi Turner, LCSW, LSATP, MAC, GoodTherapy.org Topic Expert


  • Leave a Comment
  • Claude

    April 18th, 2017 at 10:36 AM

    I know that this is scientifically proven, but wow, I knew some girls in school who could drink most of my frat brothers under the table. Either they hid it extremely well or the effects just didn’t hit them until later, but I am telling you, many times they would still be partying when the rest of the guys had already passed out. Now this could have been a good cover up, but I would have thought that we would have known if they were more inebriated than they really acted like they were.

  • Cyndi Turner

    April 25th, 2017 at 4:53 PM

    Claude- usually a woman’s tolerance to alcohol (or how much she can drink) is lower than her male counterparts. I wonder what the health of those ladies are today…

  • louisa

    April 20th, 2017 at 2:35 PM

    This information has been out there circulating for a very long time and yet still there are women who seem to insist on pitting themselves in unsafe situations by drinking too much and being around the wrong people. Now if something happens to them then of course they don’t deserve it, anyone should be able to let loose and have a good time, but not if you know that this is something that can seriously impair your judgement and could leave you in a vulnerable setting where you couldn’t take up for yourself if you needed to. I am not saying don’t drink, but do it responsibly and it would be a big help if you had someone with you who would let you know, hey, now would be a good time to stop.

  • Cyndi Turner

    April 25th, 2017 at 4:56 PM

    louisa- you bring up a good point: if you are planning to drink heavily, it is important to make sure you are part of a group who can help watch out for risky situations and get you home safely.

  • Frances

    April 24th, 2017 at 2:10 PM

    God, I hate it that we still play the blame the victim game over and over again.

  • Cyndi Turner

    April 25th, 2017 at 5:01 PM

    Frances- we can influence, not control, what happens to us. Sometimes we are in the wrong place at the wrong time but sometimes our decisions increase the likelihood of a bad outcome. Drinking in excess can increase the odds of being taken advantage of because we are not as aware of our surroundings.

  • Paige

    April 26th, 2017 at 7:38 AM

    After years of thinking that I just needed to like wine and keep up with other people in my life with the drinking I have recently made a decision that how crappy I feel afterwards is simply not worth it. Too many calories, too much money wasted to feel so bad the next day. I am done with drinking and already I notice that my skin looks better and overall I feel better.

  • Donnie

    April 26th, 2017 at 1:29 PM

    Why is that so many of us have a hard time with the key, which is moderation? I think that this is a thing that is relevant to most of us and yet many of us have such a hard time with the issue at all. I think that if we could all somehow have a better grasp of it then drinking would not naturally become such a downer for many who partake. It is something that should just be a fun every once in a while type of activity and instead it completely takes over many lives in a way that is dangerous.

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