It’s hard to know exactly when I made the connection between alcohol and my night sweats and insomnia during menopause. All I knew, was that the beatuiful New Zealand wines that I had enjoyed with dinner for years, were keeping me awake and making me sweat. Moving from from peri-menopause into post-menopause was the most noticeable. In setting up the MyMT™ programmes, I wasn’t surprised when research consistently reported on the effect of alcohol on hot flushes and night sweats in menopause.
Did you know that as we move into and through menopause, our lovely liver doesn’t quite do the job that it used to do?
Declining oestrogen levels during menopause affect your liver enzymes – in particular, the enzymes that help to break down alcohol compounds and metabolise them in the body. These enzymes are called ADH and ALDH and if you don’t have enough of them, you cannot convert all that alcohol through the usual pathways in the liver.
Your enzymes are crucial to converting the alcohol you drink into the energy your liver uses to maintain the metabolism of alcohol.
The more you drink, the harder your liver is working.
What I didn’t know at the time, was that the combination of menopause weight gain and drinking alcohol, meant that all the exercise I was doing wasn’t helping either – you see, instead of burning up fat stored in fat cells when you exercise, your liver is converting the sugars from alcohol to burn for energy instead. That’s why excess alcohol consumption over many years, can contribute to a fatty liver. When alcohol energy is always available, fat starts to accumulate in the liver cells, resulting in fatty liver, with or without the weight gain.
Even for those of you who are thinner and leaner and aren’t overweight, this fatty liver can still occur. Some of you may have found that your liver function tests reveal quite a different picture of your health. So, if you want to get levels of these enzymes tested sometime, then ask your Doctor to test them the next time you visit.
Australian, Sarah Rusbatch, knows this only too well.
“Behind closed doors, drinking was taking from me so much more than it was giving. I was suffering terrible insomnia, developing a severe hormone imbalance which affected my weight and my motivation and drive to be the mum, wife and friend I knew I wanted to be.”
I love how Sarah turned adversity into her new career and is now an accredited Grey Area Drinking Coach. I’m so pleased that she connected with me, because if you are struggling to get off the booze, then she shares great tips for you in her Guide to Sobriety which you can access HERE – you might also like to check out her website for her upcoming July Alcohol-Free Challenge too.
But back to your night sweats and hot flushes and the connection with alcohol.
The problem is, that much of the calorie energy in alcohol can’t be stored in the body. So, when we have a tipple, the alcohol (ethanol) is burned off in your liver as heat … and then dissipated through your skin. If you’ve had a few drinks in the evening, then this can happen overnight, especially between 2am and 4am, when your liver is busy trying to remove and metabolise toxins.
Skin is your largest organ, so no surprises for those of you, who also experience a red, flushed face when having an alcoholic drink. A red flushing face when you have alcohol means that your body isn’t very tolerant of alcohol. And although you have an initial burst of energy, your blood sugar levels can crash afterwards leaving you exhausted. I wish I knew this sequence of events as I went into my menopause transition and pleased that women on my 12 week menopause symptom reduction programmes understand how alcohol affects them too.
When we have a drink, alcohol (in the form of ethanol) distributes from the blood into all tissues and fluids in proportion to their relative content of water. So, if you also think about the fact that our muscles lose density as we get older, then we don’t have the same propensity to store water in muscle tissue that we used to when we were younger. This affects our ability to metabolise alcohol and yes, we differ from men. Hence, if the men in your life keep topping up your glass, you might want to slow them down a bit and tell them to grab you a water instead.
Your tolerance to alcohol is lower due to menopause. Even more-so if you are in post-menopause.
For those of you in peri-menopause (the start of menopause), you might be fine with alcohol if you like a wee drink. The effect of your natural biological ageing which is what menopause is signalling, hasn’t quite produced changes to your liver enzymes, gut enzymes, muscles or blood vessels yet. You still have some way to go before structural changes begin in your liver and you lose your alcohol-converting enzymes.
For those of you in post-menopause (when your periods have stopped for a year or more), it’s these structural changes to our liver and the bio-chemical changes to our liver and gut enzymes, 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.
This is why alcohol is associated with a higher risk of hot flushes when women are in post-menopause (and a higher risk of breast cancer, but that’s another story).
But there’s another issue too. And this is to do with our post-menopause hormone, testosterone. 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.
When women in post-menopause drink more than 2-4 glasses of alcohol a week or at once, a hormone that is related to testosterone, increases in the bloodstream. This hormone is DHEA-S and it is a male sex hormone that is also produced in women.
Alcohol and DHEA-S production don’t go well together. This is why, for women in post-menopause, the blood levels of DHEA-S are higher than the potent form of oestrogen, called oestradiol. Higher levels of DHEA-S increases the production of testosterone which upsets the balance of oestrogen in the body.
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 as causing excess oestrogen to be stored in fat cells as blood sugar levels increase. It’s why women in post-menopause may put on lots of body-fat and head down the slippery slope towards heart disease.
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.
I know that getting through the past year has been a major accomplishment for all of us, so yes, if women don’t have addiction problems with alcohol, then the odd glass of wine is fine on the MyMT™ programmes. However, as a women’s health educator, I always advocate that ‘knowledge is power’ so, in order to keep loving your liver, I have some suggestions for you, specific to alcohol consumption and menopause:
- 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 high salt 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. 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.
If you haven’t watched my Masterclass on Menopause yet, then please make time to do this sometime. There is only a small admin charge of NZ$15/ £10 as I host you in my member area. I tell you about it in the brief video below. You can also read about how to purchase it HERE.
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.