She was flushed in the face – and it wasn’t because she was excited or had been exercising. The annual Christmas function was underway and the waiters were pouring the wine. As the glass emptied, she had beads of sweat appearing on her brow and her face was red. I had so much sympathy for her. Because that used to happen to me too.
But nowadays I know better. I know how to manage my hot flushes when I attend parties or functions where alcohol is served. I had bought my own small bottle of organic wine and it was low in sugar and alcohol content.
The combination of my personal experience with alcohol and hot flushes as I moved into my post-menopause years, led me to put on my physiology hat and un-tangle the powerful connection between our hot flushes, liver levels of glucose and the end-of-year parties where alcohol consumption seems to always be the ‘main-event’.
When that sip of wine causes a sensation of heat to pass up your neck into your face and this is followed by a wave of sweat, you kinda notice. So do those around you. For women in post-menopause the effects can be immediate and severe. The more you drink, the more your beads of sweat become noticeable. It’s embarrassing and uncomfortable.
It’s hard to know exactly when it began to happen to me. When you’ve been enjoying that glass of beautiful New Zealand Pinot Noir for years without feeling the effects of hot flushes, then when it does happen, time after time, you know that ‘something’ is going on. But on reflection, it was when I moved from peri-menopause into post-menopause, so it wasn’t surprising when I saw that the research supports this effect on our hot flushes too. *
Peri-menopause begins around your mid-40’s. It’s the time of life when your reproductive hormones are starting to go into natural decline, but they haven’t fully declined yet. Whilst peri-menopause is when symptoms are usually at their worst, as we move into post-menopause, when our periods have stopped for a year or more, some of the symptoms can hang around – for women who drink alcohol, this might include their hot flushes.
The good news for those of you in peri-menopause, is that the effect of your biological ageing hasn’t hit your liver or blood vessels yet. You still have some way to go before structural changes begin to occur in your liver and for women in post-menopause, it’s these structural changes that help to explain why that glass of wine starts to make you feel hot and sweaty when it hasn’t had this effect on you before.
Peri-menopause is as different from post-menopause as chalk is to cheese. As you move through peri-menopause, you have higher levels of oestrogen than post-menopause women do. Therefore, it’s high levels of oestrogen in peri-menopause that are the cause of our symptom chaos and I often talk about this to women who join me on the MyMT programmes. You arrive in post-menopause when you haven’t had periods for a year or more. And when it comes to your alcohol tolerance and your hot flushes, whether you’re in peri-menopause or post-menopause matters.
Alcohol use has been associated with a higher risk of hot flushes when women are in post-menopause. It’s all to do with our post-menopause hormone, testosterone, which is made from another ‘master’ hormone called DHEA. Yes, even though we are females, our body still produces some testosterone, especially if women still have their ovaries as they move into post-menopause. Our ageing ovaries secrete some testosterone too. Add to this, our stressful lives, alcohol consumption and other lifestyle factors that cause us to produce more testosterone and the hot flushes get worse and so too does the post-menopause weight gain.
Numerous studies have shown that alcohol can mess up our hormones, especially testosterone and our blood sugar levels and our liver. This is especially so for women having more than 2-4 drinks a week – or having this many drinks all at once. One of the main hormones that gets messed up is our adrenal hormone called DHEA and another form of DHEA, which is the sulphated form. This is known as DHEA-S and is produced in our adrenal glands too.
Alcohol and DHEA-S don’t go well together and for women in post-menopause, the blood levels of DHEA-S are higher than the potent form of oestrogen, called oestradiol. Higher levels of this hormone increases the production of testosterone.
Testosterone is the hormone we can blame for our quick bursts of anger, frustration, weight-gain and even the growth of hairs on our chin as we move through menopause and into post-menopause. Too much testosterone production messes up our blood-sugar regulation hormone called insulin as well. It’s why women in post-menopause put on lots of body-fat and head down the slippery slope towards heart disease. Dianne in Brisbane was heading that way too.
So, for those of you who like a tipple or two, you need to manage your alcohol intake as you move into post-menopause. If you don’t, the belly fat goes on more rapidly, your fat cells becomes more inflamed and your hot flushes can increase too. This is all to do with our lovely liver as it changes with ageing.
Derived from cholesterol production in our liver, DHEA is produced by the adrenal glands, brain, ovaries and testes. This powerful hormone helps to make a number of the major sex steroids (oestrogen, progesterone, and testosterone). With production of all these hormones declining with ageing, it’s why DHEA is often touted by supplement companies as the “anti-aging hormone” or even the “fountain of youth”.
When women in post-menopause drink more than 2-3 glasses of alcohol at once, DHEA-S (the sulphated form) increases in the bloodstream. When levels of DHEA-S are higher than normal, this causes more hot flushes. The effect, according to researchers, is higher in post-menopausal women than peri-menopausal women. That’s why, if you are younger and only in peri-menopause, alcohol probably doesn’t come on your ‘hot-flush’ radar … yet.
However, higher production of DHEA-S and testosterone and how this affects hot flushes isn’t the only factor influencing hot flushes in women who are heading into post-menopause. There is something else going on as well … and it’s all to do with your liver as it loses oestrogen.
I always talk about the liver in my Masterclass on Menopause seminars (I’m coming your way in early February if you live in Oxford, Reading or Portsmouth – so excited to meet you if you can come – tickets are on my Event page!), because as we move into post-menopause, our liver is ageing and changing. Not only does it shrink in size, but it isn’t as efficient at storing glucose (sugar).
Alcohol consumption is well known to increase glucose levels in blood. So, it makes sense that women who have elevated glucose levels may already have reached the threshold of glucose that their ageing (and shrinking) liver can deal with clearing. If you’re on that high-fat Keto diet and you are in post-menopause, your liver is also working hard to clear saturated fats from animal sources of fat. This is why, in the MyMT™ programmes [choose between Circuit-Breaker or Transform Me depending on whether you need weight loss or not], I take you through an entire module called Liver-Lover and teach you how the liver changes as you go through menopause and why you need to focus on it, especially in order to lose weight if you have been putting on weight.
[Don’t forget that my January SALE has started now as well, so to access your NZ$50 savings and secure your place, please use the promo code JANUARY20 HERE]. Part payments of NZ$87/ month for 3 months are available too [AUS$80 or UK£45 a month for 3 months].
Alcohol is loved by your liver, because it supplies a ready and steady source of glucose (sugar) and glycogen (stored glucose) reserves.
At the same time however, whilst your liver is trying to take up the glucose from the alcohol, it is also trying to clear the toxins and preservatives in alcohol in order to protect your brain. The alcohol is therefore, preventing the liver from absorbing glucose and storing it, which is what the liver wants to do. Hence, many women have cravings for more and more alcohol as the need for glucose in the liver is so great.
For those of you doing lots of exercise as well, your cravings for more alcohol can increase too. When you are an avid exerciser, your muscles and your liver, are craving glucose to replace what you have used in your exercise session. The higher the intensity of your exercise, the more your body craves sugar. Just ask any sweet-toothed athlete. 🙂
For women in menopause, we may also feel stressed and/or we aren’t sleeping, so we also crave more sugar. This is because our brain demands it too. Hence, at stressful times of the year, such as Christmas and New Year, it’s easy to over-indulge in high-sugar alcohol, especially when someone else is paying.
For post-menopause women, the connection between the liver’s processing of alcohol and hot flushes is an important one.
In post-menopause, our liver is ageing. From a physiological perspective, the blood vessels are becoming ‘stiffer’ and the liver itself loses size and function. Therefore, this powerful organ has less cells to store glucose. This means that drinking lots of alcohol not only messes up our DHEA-S levels and testosterone production, but add to this, an ageing liver and it can’t handle a lot of glucose.
If we binge drink more than 2 glasses at a time, then that’s a lot of sugar and ethanol for your liver to process. But with stressful lives and a liver and brain that love the reward of sugar and the ‘normalisation’ of the production and ingestion of alcohol over our life-time, it’s easy to get into the habit of drinking a lot during the week and not just at the celebratory times of the year. Again, this is a lot of work for our ageing liver.
When our liver has so much sugar coming at it, and the liver cells are already fully saturated with glucose in storage cells, it spills over into the blood-stream because the liver and kidneys can’t keep up with clearing the excess. As such, our fat-cells are attracted to this excess glucose as well.
Fat cells store the excess sugar as well as the extra oestrogen, which is made from the ethyl-alcohol and testosterone too. This triple-whammy of sugar, alcohol and testosterone in fat-cells may also lead to weight gain in women, especially post-menopause women who don’t do a lot of exercise because they aren’t sleeping or their joints are sore, or they don’t have time or energy.
That’s why understanding HOW our body changes in menopause matters … as does knowing how to turn the health chaos around. This is what the MyMT programmes teach you to do.
Knowledge is power and positioning our menopause transition in ageing research, changed my life too. For example, understanding how our ageing liver doesn’t process glucose or alcohol very well is important. Especially at Christmas time. And no, I’m not entirely a ‘tea-totaller’ either. It’s not about going without for those of you who enjoy a drink, it’s about thinking through the total glucose and alcohol load on your liver as you enjoy your Christmas and New Year celebrations.
With this in mind, I have these things for you to try, so you reduce your hot flushes when you have alcohol:
- Buy an organic wine that is lower in sugar and alcohol content. Take this to the party if your host doesn’t usually have organic wine available. You don’t want the chemicals and excess of sugar nor do you need the high ethanol content which is all just ‘overload’ for your liver to process.
- Have some protein if you are drinking, rather than high sugar treats or carbohydrates. Protein will help to lower the effect of insulin production from your pancreas so your blood sugar doesn’t spike.
- Ask for sparkling water or bottled water as well. This way you have a balance of water and alcohol to slow down your drinking.
- Don’t eat a high fat meal before going out. Your liver will be too busy trying to process the fats and not the alcohol and excess glucose. It can’t do both.
I hope that you have a wonderful Christmas wherever you are and if your menopause symptoms or weight have been getting you down in 2019, then I invite you to join me on either of the MyMT™ programmes on my ANNUAL SALE. Women’ around the world call these programmes “life-changing”. I would love you to as well. I’ve made you a short video to explain the programmes to you. Please listen to it when you can or share it with someone you know who might be struggling.
Brady, C. (2015). Liver Disease in Menopause. World Journal of Gastroenterology, 21(25), 7613 – 7620.
Cogger, V., Hilmer, S. & Svistounov, D. (2011). Current Gerontology and Geriatrics Research, Article ID 150364, 1-3.
Hee Kim, Kisselina, T & Brenner, D. (2015). Aging and liver disease. Curr Opin Gastroenterol. 31(3): 184–191.
Roeca, C., Al-Safi, Z., & Santoro, N. (2018). The Post-Menopausal Women. https://www.ncbi.nlm.nih.gov/books/NBK279131/
* Schilling, C. et. al (2008). Current Alcohol Use, Hormone Levels, and Hot Flashes in Midlife Women. Fertil Steril., 87(6): 1483–1486. National Institute of Health.
Image Source: High Testosterone Levels – SheCares.