Harvard Women's Health Watch

Ask the doctor: Why does alcohol affect women differently?

Q. Is it true that women are more susceptible than men to the effects of alcohol, and if so, why is this?

A. Yes. There are several reasons for this. Our bodies contain proportionately less water and more fat than men's bodies. Water dilutes alcohol and fat retains it, so our organs are exposed to higher concentrations of alcohol for longer periods of time. Also, women have less alcohol dehydrogenase, an enzyme that breaks down alcohol before it reaches the bloodstream. At any given dose, our blood levels of alcohol will be higher than a man's, even taking into account differences in body weight. As a result, one drink for a woman is roughly equivalent to two drinks for a man.

As we age, our bodies contain even less water and more fat, so blood alcohol levels rise even faster. And we are also likely to metabolize alcohol less effectively as we get older. At every age, women are quicker to become alcohol-dependent and suffer the consequences, which may include psychiatric problems, damage to the brain and other organs, and fatal accidents. What is moderate drinking for a man (two drinks per day) is nearing heavy drinking for a woman. As a result, the recommended alcohol intake for women is no more than one drink per day, on average.

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