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Medical risks for women who drink alcohol

  • Clinical Reviews
  • Published:
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Abstract

OBJECTIVE: To summarize for clinicians recent epidemiologic evidence regarding medical risks of alcohol use for women.

METHODS: MEDLINE and PsychINFO, 1990 through 1996, were searched using key words “women” or “woman,” and “alcohol.” MEDLINE was also searched for other specific topics and authors from 1980 through 1996. Data were extracted and reviewed regarding levels of alcohol consumption associated with mortality, cardiovascular disease, alcohol-related liver disease, injury, osteoporosis, neurologic symptoms, psychiatric comorbidity, fetal alcohol syndrome, spontaneous abortion, infertility, menstrual symptoms, breast cancer, and gynecologic malignancies. Gender-specific data from cohort studies of general population or large clinical samples are primarily reviewed.

MAIN RESULTS: Women develop many alcohol-related medical problems at lower levels of consumption than men, probably reflecting women’s lower total body water, gender differences in alcohol metabolism, and effects of alcohol on postmenopausal estrogen levels. Mortality and breast cancer are increased in women who report drinking more than two drinks daily. Higher levels of alcohol consumption by women are associated with increased menstrual symptoms, hypertension, and stroke. Women who drink heavily also appear to have increased infertility and spontaneous abortion. Adverse fetal effects occur after variable amounts of alcohol consumption, making any alcohol use during pregnancy potentially harmful.

CONCLUSIONS: In general, advising nonpregnant women who drink alcohol to have fewer than two drinks daily is strongly supported by the epidemiologic literature, although specific recommendations for a particular woman should depend on her medical history and risk factors.

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Authors and Affiliations

  1. Center for Excellence for Substance Abuse Treatment and Education, VA Puget Sound Health Care System, Seattle Division, Seattle, Wash.

    Kristen Bush MPH

  2. Medicine Service, VA Puget Sound Health Care System, Seattle Division, Seattle, Wash.

    Katharine A. Bradley MD, MPH & Bradley Anawalt MD

  3. Department of Medicine, University of Washington, Seattle

    Katharine A. Bradley MD, MPH & Bradley Anawalt MD

  4. Department of Health Services, University of Washington, Seattle

    Katharine A. Bradley MD, MPH

  5. University of Pennsylvania, Philadelphia

    Seeta Badrinath BA

  6. Health Services Research and Development, VA Puget Sound Health Care System (Seattle Division), 1660 S. Columbian Way, Mailstop 152, 98108, Seattle, WA

    Katharine A. Bradley MD, MPH, Seeta Badrinath BA & Jodie Boyd-Wickizer BA

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  1. Katharine A. Bradley MD, MPH
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  2. Seeta Badrinath BA
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Dr. Bradley presented some of this review as part of a precourse on women’s health at the national meeting of the Society of General Internal Medicine, San Diego, Calif., 1995.

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Bradley, K.A., Badrinath, S., Bush, K. et al. Medical risks for women who drink alcohol. J GEN INTERN MED 13, 627–639 (1998). https://doi.org/10.1046/j.1525-1497.1998.cr187.x

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