Question for Women: Is Alcohol Damaging Your Health?

A young woman in a bar waits for her Tinder date and asks for a beer to help calm her nerves—or soften a possible letdown. Longtime girlfriends gather for a getaway, raising their cocktail glasses high for an Instagram selfie. A mom finally gets a quiet moment at home, sinking into the couch with a glass of wine, which she jokingly calls her “mom juice.”

These moments may look carefree and fun. But beneath the surface, alcohol carries more risks than many women realize. A growing body of evidence shows that even moderate alcohol use—one drink or less per day for a woman—can be a significant health risk, raising the risk of chronic disease and even death, especially for women.

Some other numbers and trends are, well, sobering. A 2025 Gallup poll suggests the percentage of Americans who said they consume alcohol fell to 54%, the lowest point since Gallup started asking the question. However, the Centers for Disease Control and Prevention (CDC) notes that between 2016 and 2021, rates of alcohol-related deaths increased by 35% in women compared to 27% in men. For women, the majority of alcohol-related deaths are due to chronic health conditions, whereas for mn, most alcohol-related deaths are due to acute causes like accidents and driving fatalities.

“Honestly, we don't have the research to recommend exactly what number of drinks would be safe for women,” says Sherry McKee, PhD, a Yale School of Medicine researcher and director of the Yale SCORE Program for Sex Differences in Alcohol Use Disorder. “I'm not saying that there's not one, or that there is one. We just don't have evidence to show what a safe level of consumption is, or conversely, the evidence to document that no amount is safe.”

One reason for this, McKee says, is that research on alcohol consumption historically has focused on men, leaving a knowledge gap around alcohol and sex. That gap is something McKee and her colleagues are trying to close. Their goal is to understand more about the sex differences underlying alcohol use disorder (AUD), a condition characterized by an impaired ability to stop or control alcohol consumption. McKee is hoping to gather information that will help with providing better guidance and treatments for women with AUD.

For some physicians, though, the evidence is already strong enough to suggest caution. Yale Medicine hepatologist Bubu Banini, MD, PhD, regularly treats women who have developed serious liver disease associated with their alcohol consumption—including women in their 20s and 30s. She advises many women to stop drinking altogether. “When your liver is already in trouble, my recommendation is no alcohol use,” Dr. Banini says. “Less is better, and none is best.”

Women often drink for different reasons than men. While men are more likely to associate drinking with socializing, women are likelier than men to use alcohol to cope with stress, anxiety, or trauma, McKee says. For women, “there's quite a bit of literature showing that childhood trauma is an important pathway for developing an alcohol or other substance-use disorder,” she says.

On a biological level, alcohol behaves differently in a woman’s body. Because women generally have more body fat and less water weight than men, alcohol becomes more concentrated in their bloodstream. That means the same amount of alcohol will typically have a stronger effect on a woman’s body—and liver—than on a man’s.

A woman’s path to developing AUD may be different as well. People can move through first-time alcohol use to frequent, not-so-healthy alcohol use to AUD, Dr. Banini says. “That time frame seems to be accelerated for women compared to men.”

For McKee, that progression puts an important spotlight on women in their early 20s and even younger. While members of Gen Z (born 1997 to present) are reportedly drinking less, doctors say they are seeing more binge drinking in young women. Binge drinking for a woman is consuming four or more drinks in about two hours (compared to five or more drinks for a man). “College is a period of heavier drinking,” says McKee. “Patterns can be established, and those patterns can continue beyond the college years. We also know that women are delaying marriage and childbirth. So that just gives more space and time for those patterns to continue,” she says.

“Binge drinking is indeed a part of this trend,” says Dr. Banini. Data shows that among young women ages 18 to 25, binge drinking rates match or surpass those of men of the same age, she says. “Unfortunately, these trends start to develop early, with data showing that binge drinking among 12-to-17-year-old girls surpass rates in boys of the same age,” she adds.

Three medications are currently approved by the Food and Drug Administration (FDA) to treat alcohol use disorder—disulfiram, naltrexone, and acamprosate. But studies of potential medications for AUD have focused mostly on men, so these medications may not work as effectively for women.

Disulfiram was approved in 1949, largely based on its efficacy for men; only 1% of the research participants were women. In 1994, naltrexone became available for AUD (it was approved again in 2004 as an extended-release injectable). While the latter is effective for many women, its performance is inconsistent, and women are more likely to have side effects such as nausea and sleep disturbances, McKee says. Acamprosate was approved for AUD about a decade later. It hasn’t been shown to be less effective in women, although men still outnumbered women in studies of the drugs.

These medications work in different ways—for instance, disulfiram causes unpleasant physical reactions, notably nausea, if you drink alcohol. “From my perspective, medications haven't been developed that target the reasons why women are drinking,” McKee says. Her team is studying how stress and emotional processing in the brain influence drinking in women, with the hope of developing more tailored therapies in the future.

At the beginning of 2025, then U.S. Surgeon General Vivek Murthy, MD, issued an Alcohol and Cancer Risk advisory that highlighted the link between alcohol consumption—even moderate drinking—and at least seven types of cancer, with the overall risk higher for women than for men. He also called for stronger warning labels on alcoholic beverages, which currently only caution against drinking during pregnancy and while driving or operating machinery.

Doctors are also seeing differences in how alcohol-related diseases play out in women. Dr. Banini points out that deaths related to alcohol-associated liver inflammation (or alcoholic hepatitis) doubled in men and tripled in women between 1999 and 2020. She says patients with these conditions often describe episodic heavy alcohol use, such as weekend or social binge drinking, and are surprised when they learn how much damage has been done to their liver. Dr. Banini also notes that binge drinking accounts for a large share of preventable deaths from injuries and motor vehicle crashes.

“For young women, there are added concerns of breast cancer, in addition to other cancers that are increased by excess alcohol use (such as liver cancer, pancreatic cancer, colon cancer),” Dr. Banini says.

In addition, alcohol consumption has been linked to menstrual irregularities and a host of pregnancy- and perinatal-related consequences, says McKee. Fetal alcohol syndrome is still the number one cause of developmental disabilities in the United States, she adds.

Alcohol’s impact is also cumulative—the longer and more often a woman drinks, the higher her risk. Cutting back, or quitting altogether, can lower that risk, though the benefits depend on how much and how long a person has been drinking. “There is likely a cumulative effect with regards to a person’s drinking over the course of their lifetime,” McKee says.

According to the U.S. Dietary Guidelines for Americans, women should limit alcohol to no more than one drink a day. They also say women who are pregnant or might be pregnant should not drink at all. In the guidelines, a drink is defined as 5 ounces of wine, 12 ounces of regular beer, or 1.5 ounces of 80 proof distilled spirits (40% alcohol). It’s important to pay attention when you order a drink at a bar or in a restaurant, where you may get more than that in your glass—a 9-ounce glass, for instance, is almost the equivalent of two drinks, McKee says.

The next update to the dietary guidelines, covering 2025-2030, is expected later this year.

Sometimes it’s not easy to tell when drinking has crossed the line from casual to concerning. One sign, says McKee, is if alcohol is impacting your daily life—whether it’s disrupting sleep, lowering productivity at work, or straining relationships. Another red flag is tolerance. “Are you needing to drink more to have the same effect?” she asks, “Or are you drinking to manage negative stress or anxiety?”

The National Institute on Alcohol Abuse and Alcoholism provides online tools that can help people assess whether their alcohol use is becoming a problem. If you find yourself concerned, McKee recommends following up with a primary care physician or reaching out to a therapist for advice. They can help determine whether alcohol is harming your health and what kind of support you might need.

Dr. Banini emphasizes that alcohol use is one of the most important risk factors women can control when it comes to protecting their long-term health, and provides the following advice:

• Understand your biology: Women metabolize alcohol differently than men, which means the same amount of alcohol leads to higher blood alcohol levels and greater liver injury.
• Pay attention to your coping habits: If you’re drinking to manage anxiety, stress, or depression, it may be a sign to look for healthier ways to cope and seek support.
• Stick to low-risk limits: No more than one drink per day on average is recommended for women—and less is always better.
• Know what binge drinking means: For women, that’s four or more drinks in about 2 hours. Even occasional binges can cause cumulative liver damage.
• Consider screening if you’re concerned: Your doctor can order simple blood tests or noninvasive imaging to check for early signs of alcohol-related damage to the liver. It’s important to be aware that alcohol can affect other parts of the body as well, such as the heart, gastrointestinal tract, lungs, and even bone health.

Treatment and recovery from AUD look different for every woman. Some may benefit from support groups, online programs, or therapy. Others may need more structured help from a clinic or inpatient program. “There's still a lot of stigma around drinking,” McKee says. “But support is out there, and the first step is being open to change,” she says.

For many women, cutting back can start with small, mindful decisions. “It doesn’t always mean giving up alcohol completely,” McKee explains. “Sometimes it’s about asking yourself in the moment: Do I really want this drink right now? Every day we make so many decisions about our health. Just like we make daily choices about food or exercise, drinking is one more decision that can affect your health over time.”