Yes, Hangovers Get Worse as We Age. Here’s Why

Do hangovers get worse as we age? Yes! The days of bouncing back after a night out are replaced by prolonged headaches, nausea, and fatigue. Several factors are at play here, including changes in our liver function, enzyme activity, cumulative effects of long-term drinking, and hormonal shifts in women. Alcohol exacerbates the symptoms of menopause, making it almost impossible to drink even the smallest amount and not feel the effects.

The Role of Alcohol Dehydrogenase (ALDH)

Hangovers intensify with age because of changes in the activity of alcohol dehydrogenase (ALDH), an enzyme crucial for alcohol metabolism. When we drink, it is first converted into acetaldehyde, a toxic compound. ALDH then breaks down acetaldehyde into acetate, a less harmful substance that the body can eliminate. As we age, the efficiency of ALDH decreases. This reduction means that acetaldehyde stays in the system for longer, leading to more severe hangovers. Women produce less ALDH than men so more alcohol enters a woman’s bloodstream. Women and men are both vulnerable to alcohol-related stroke but for women it occurs four times faster. Women and men are both vulnerable to heart disease from alcohol, but it happens quicker in women. Women also became addicted to alcohol faster. This is all because women have less ALDH, and especially as we age.

Ageing and the Liver

The liver plays a vital role in processing alcohol, but its ability to do its work diminishes as we age. With age, the liver gradually shrinks and loses some of its functional cells. The liver can shrink up to 40% in women. This reduction in liver size impairs its ability to metabolize alcohol efficiently, resulting in prolonged hangover symptoms. Ageing also reduces blood flow to the liver, which impacts its ability to process alcohol and remove toxins from the bloodstream.

Accumulated Damage

Years of drinking can lead to cumulative liver damage, such as fatty liver, fibrosis, or even cirrhosis. These conditions reduce the liver’s overall capacity to process alcohol and contribute to more severe hangovers as we age. Another factor is the cumulative effect of years of drinking. The body’s ability to recover from alcohol intake diminishes over time, simply due to sustained exposure. While heavy drinkers might build up a tolerance to alcohol, meaning they need more to achieve the same effects, this also means more stress on the body and organs over time. Light-to-moderate drinkers might find that their tolerance decreases with age, making them more sensitive to alcohol’s effects and resulting in worse hangovers.

Hormonal Changes and Menopause

For women, hormonal changes during menopause, can significantly affect how the body processes alcohol, making hangovers worse.  Menopause brings about significant hormonal changes, particularly in oestrogen and progesterone levels. These fluctuations can affect how women metabolise alcohol, often leading to increased sensitivity and more severe hangovers. Menopausal symptoms like night sweats and insomnia can exacerbate hangover symptoms, as poor sleep quality can make recovery from alcohol even more difficult.

Oestrogen and Alcohol Metabolism:

During menopause, oestrogen levels can fluctuate dramatically. Oestrogen influences how the body metabolizes alcohol. Higher oestrogen levels can slow down the breakdown of alcohol, leading to prolonged exposure to its toxic by-products, such as acetaldehyde. This can result in more severe hangover symptoms.

Progesterone and the Central Nervous System:

Progesterone has a calming effect on the central nervous system. During menopause, levels of progesterone decrease, which can make the central nervous system more sensitive to the stimulating effects of alcohol. This heightened sensitivity can contribute to more intense hangover symptoms such as anxiety, irritability, and disrupted sleep.

Drinking can alter sleep architecture, reducing the time spent in deep, restorative sleep stages and increasing the number of awakenings during the night. For menopausal women already experiencing sleep disruptions, this can lead to compounded fatigue and more severe hangovers.

Research shows alcohol consumption before bedtime can reduce REM sleep by up to 20%. This effect is more pronounced in women going through menopause, who may already struggle with sleep.

“If you’ve ever found yourself saying “I’m not hungover, I’m just tired” now you know why – you simply aren’t getting deep, restorative sleep when you drink, even if it’s only one or two glasses.”

-Beyond Booze, How to Create A Life You Love Alcohol-Free

If you’re ready to change your relationship with alcohol, check out my programs here. You find a copy of my book Beyond Booze, How to Create A Life You Love Alcohol-Free here.