Women are catching up to men when it comes to alcohol consumption –and according to most experts, this isn't a gender gap we want to close.

For women in particular, the line between healthful and harmful drinking is easy to cross. Because of body composition and other factors, women achieve a higher blood level of alcohol for each drink compared to men. This means women can become intoxicated faster and maintain blood alcohol levels longer, all which can lead to an increased risk for developing long-term health problems.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines low-risk drinking for women as no more than seven drinks a week and no more than three on any given day. However, there are also individual differences that affect the amount a woman can safely drink, including weight and health, genetics and family history, and age.

To better understand why women are more vulnerable to the risks of alcohol we spoke to Kathleen Grant, Ph.D., a senior scientist and head of the Division of Neuroscience at the Oregon National Primate Research Center. Dr. Grant has spent over thirty years researching the risks and benefits of alcohol consumption.

The Hormone Connection 
Dr. Grant is taking a closer look at the role female reproductive hormones (specifically, progesterone) play in alcohol consumption and alcohol sensitivity. Her research suggests that women's menstrual cycles (and fluctuating hormones) may have a lot to do with when we choose to drink and how much we drink.

"Progesterone has metabolites (products of progesterone metabolism) that interact with brain circuitry the same way alcohol does," she says. "Our research suggests these metabolites lower stress and anxiety. Progesterone peaks and then rapidly declines about 1 week prior to menstruation. Some women may experience higher levels of anxiety as progesterone declines during this premenstrual phase of the cycle. This may make them more likely to drink alcohol at that time to help alleviate perceived stress."  She says more research is necessary to see how other factors, such as age-induced hormonal changes, impact alcohol consumption.

Risks vs. Benefits 
Women who drink heavily (five or more drinks on the same occasion on five or more days per month) are more likely than men to develop liver disease (including hepatitis and cirrhosis) and to suffer from alcohol-induced brain damage. And when compared to women who either don't drink or drink in moderation, women who drink heavily are also at increased risk of developing breast cancer, osteoporosis, heart disease and reproductive issues, including infertility. Yet as much as we hear about the risks of alcohol, it also seems there are a growing number of studies highlighting the benefits of that glass of red wine. Dr. Grant says, "Yes, for some people, low doses of alcohol can increase attentiveness and activity and may reduce the risk of developing heart disease. "But, that doesn't mean these health benefits outweigh the risk of developing an alcohol use disorder if someone engages regularly in heavy drinking, particularly in younger adults."

"Because establishing a pattern of drinking to intoxication as a young adult (18-21) is associated with a greater risk of acquiring alcohol dependence, and this is usually a period of life when people are generally very healthy, we don't advocate that young people start drinking for the health benefits, they simply don't outweigh the risks," she adds. 

Monitoring Risk 
Currently, healthcare providers rely on self-reporting to assess a person's risk for alcohol abuse, a process that Dr. Grant says is subjective. "People are highly inaccurate in self-reporting," she says. "The reality is that alcohol impairs memory, that many people don't understand what defines a standard drink or they don't want to disclose what they drink" she adds.

She sees a future where evaluating a person's risk for alcohol-related diseases can be tailored to him or her as an individual. "Think of a test that's as simple as a pregnancy test, but instead of only measuring acute alcohol content (like the current blood alcohol tests) it can reflect a person's long-term alcohol intake," says Dr. Grant. Even more, that test could help providers and consumers understand if their alcohol intake, whatever that may be, is placing them at a risk for specific diseases (such as liver or heart disease). She adds that more research is necessary to make these tests more accurate and widely available.

When it comes to alcohol, as is the case with many things in life, practicing moderation is key. The NIAAA's Rethinking Drinking hub offers great resources for questions about drinking patterns, how much is too much, and how to recognize signs of a drinking problem.