5 Ways Alcohol Affects Us More During Perimenopause

As a Grey Area Drinking Coach, I’ve supported thousands of women through changing their relationship with alcohol. Perimenopause, the transitional phase leading up to menopause Which can start 10 years before we go through menopause), often brings unique challenges for women, and alcohol amplifies them.

Many women start noticing how drinking affects them differently, and understanding why is the first step to making empowering changes. For me, I noticed a distinct difference in how alcohol impacted me after I turned 40 – it was one of the biggest reasons for me deciding to quit drinking in April 2019. Since then I’ve support thousands of women to change their relationship with alcohol.

Here are five ways alcohol impacts us more during perimenopause, along with some tips for navigating these changes. If you’d like additional support, I invite you to join my free community, The Women’s Wellbeing Collective on Facebook where we share tools and strategies for reducing or eliminating alcohol from your life.

1. Declining ALDH Enzyme Levels

As we age, our levels of ALDH (aldehyde dehydrogenase), the enzyme responsible for breaking down alcohol, naturally decline. This means alcohol isn’t metabolised as efficiently as it used to be, allowing more of it to enter the bloodstream.

What does this look like?

• Worse hangovers: Even small amounts of alcohol can leave us feeling foggy, nauseated, or fatigued the next day.

• Heightened negative effects: From irritability to poor digestion, the slower breakdown of alcohol can exacerbate these symptoms.

The stats: Research shows that alcohol stays in the system longer as we age, increasing its toxicity and effects on our organs. Women are particularly vulnerable because they naturally produce less ALDH than men, and this declines further as we age. It is also one of the main reasons women are more vulnerable to the physical health risks of alcohol than men.

2. Hormonal Fluctuations Intensify Alcohol’s Impact

During perimenopause, fluctuating hormones—especially estrogen—can make us more sensitive to alcohol. When estrogen levels spike (during the first 2 weeks of our cycle) , the same amount of alcohol that didn’t faze us before will impact us more – both at the time (showing up as getting drunk more quickly) and the next day (more anxiety and worse physical symptoms).

Why this happens:

• Estrogen affects how alcohol is absorbed and processed.

• Higher estrogen levels can increase the effects of alcohol, leaving us feeling more tipsy than usual on some days.

Real-life example:
Have you ever had a glass of wine one week and felt fine, only to drink the same amount the next week and feel completely wiped out? Hormonal swings are at play. It’s important we know where we are in our cycle. It’s also important our daughters know this so they are aware they will have different tolerances to alcohol at different times of the month.

3. Alcohol Disrupts Sleep

For many women in perimenopause, sleep becomes elusive - and alcohol only makes it worse. While it may seem like a glass of wine helps you fall asleep, it interferes with the architecture of your sleep.

The science behind it:

• Alcohol suppresses REM sleep, the restorative part of the sleep cycle.

• It causes you to wake up at 2–3 a.m., moving from deep sedation to fragmented sleep.

The next-day effect:
Many women attribute their fatigue to being “just tired,” not realizing that disrupted sleep due to alcohol is the root cause. This was my experience for years - I’d wake up feeling groggy and unrefreshed, even after what seemed like a full night’s sleep. Even 1 – 2 drinks will significantly impact the quality of your sleep. Poor sleep leads to sugar cravings, lower mood and negative thinking patterns.

4. Alcohol Increases Anxiety

Ever felt extra anxious the day after drinking? Alcohol can worsen anxiety, especially during perimenopause. When we drink, our bodies release cortisol, the stress hormone. Unfortunately, this hormone lingers long after the alcohol is gone, leading to heightened anxiety and overthinking.

The vicious cycle:

• Alcohol initially acts as a sedative, making us feel relaxed.

• But as it wears off, cortisol spikes, leaving us feeling more anxious than before.

The stats: Studies confirm that alcohol use is linked to increased anxiety and depressive symptoms in women, particularly those navigating hormonal changes.

5. Lower Progesterone and GABA Levels Trigger Cravings

One of the hallmarks of perimenopause is declining progesterone levels. Progesterone helps produce GABA, a neurotransmitter that promotes calmness and relaxation. When GABA levels drop, we often turn to alcohol as a quick fix to unwind.

Here’s the problem:

• While alcohol may temporarily mimic the effects of GABA, it ultimately depletes it further, leaving us more stressed and anxious.

• This creates a cycle: stress leads to drinking, which exacerbates stress.

My experience with clients:
Many of the women I work with have low GABA levels. By focusing on natural ways to boost GABA - such as mindfulness, exercise, and proper nutrition - we reduce cravings and break the cycle.

Breaking the Cycle

If you’ve noticed these changes and are struggling to cut back on alcohol, you’re not alone. Perimenopause is a challenging time, and alcohol often feels like a coping mechanism. But here’s the good news: making even small changes can lead to profound improvements in your mental, physical, and emotional well-being.

What you can do:

• Prioritise sleep: Establish a calming bedtime routine that doesn’t include alcohol. Eat your evening meal at least 2 hours before bed, no screen time for an hour before bed, lower lighting so your home is dark and calm for an hour before bed (supports melatonin production), take magnesium with glycine to support sleep and reduce caffeine.

• Manage stress naturally: Practices like yoga, meditation, and journaling can help lower cortisol and boost GABA.

• Join a supportive community: Connecting with like-minded women can provide accountability and encouragement.

If you’re looking for a place to start, my free community, The Women’s Wellbeing Collective, is a safe space to explore these topics. I also offer tools and resources tailored to women navigating perimenopause and alcohol.

To gain access to all the tools and strategies I have used as well as shared with my thousands of clients over the years, do grab a copy of my best selling book ‘Beyond Booze, How to Create a Life you Love Alcohol Free.’ This book has been described as ‘life changing’ by thousands of mid life women. Grab your copy HERE