These days, it isn’t unusual to see Kerry Washington sip wine in Scandal or watch Amy Schumer swig from a bottle in Trainwreck — western women are now active participants in drinking culture. But this is a relatively new trend. A hundred years ago, women were rarely seen drinking in public, and on average drank half as much as men.

“Researchers point to a rather dramatic shift in the culture around women’s drinking,” says Dr. Deidra Roach with NIAAA’s Division of Treatment and Recovery. “Lots of things influence culture. When I was growing up it was very stigmatized for a woman to drink to intoxication in public. But now it is a much more acceptable part of the culture.”

However, as more women head off to party in college, and enter the happy-hour-centric workforce, they are drinking more than ever before. According to the research, 51% of women drink once a month. The rates of binge drinking have also increased: 32% of women between the ages of 15 and 44 binge drink at least once a month, and over the last three decades, there was a 26% increase in binge drinking among women ages 18 to 23.

With these new trends come new risks for women. Doctors warn that women are putting themselves at even greater risk of developing alcohol-related diseases than their male peers. Data shows such diseases have skyrocketed among females. Although men are twice as high to die from cirrhosis than women, from 1983 to 2013 the number of cirrhosis deaths among women due to cirrhosis increased by 64%. Meanwhile, from 1999 to 2014, alcohol-related liver disease deaths increased 53% for men and 89% for women during that time period.

Below, Dr. Roach explains how alcohol affects women’s bodies differently, and why this puts them at greater risk for alcohol-related diseases than men.

Physically, why do women’s bodies respond differently to alcohol than men’s bodies?
The average adult male is made up of 60% water, and the average adult female is made up of 50%. This means that if men and women were to drink the same amount of alcohol, the alcohol would be more concentrated in a woman’s body, so she would have a higher blood alcohol content. This also helps explain why people who weigh less tend to get intoxicated more quickly — when you weigh less, you have less water in your body, and so, when you drink, your blood alcohol content is higher. Women’s stomachs also contain less gastric alcohol dehydrogenase, an enzyme that processes alcohol that is found in the average male’s stomach.

Why does this put women at greater risk for alcohol related diseases than men?
Simply, because alcohol is more potent in a woman’s body than in a man’s body, and as a result, women have to drink less alcohol to experience alcohol-related problems. “A woman’s vital organs will be exposed to a higher concentration, for a longer period of time than a man, and that places them at a higher risk for organ injury,” Roach explains.

What alcohol related risks do women specifically face?
Alcohol-related health risks can include liver damage, heart disease, breast cancer, compromised bone quality, and brain diseases. Women who have one drink a day have a 10% higher chance of developing breast cancer than women who don’t drink. And that risk increases 10% for every additional drink they have daily.

How much is safe for women to drink?
Currently, the NIHAA advises women to have no more than seven drinks per week and no more than three drinks in a given sitting. Researchers don’t make a major distinction between what women are drinking. One drink is considered to be five ounces of wine,12 ounces of beer, or 1 ½ ounce of spirits. Very moderate alcohol consumption has been shown to reduce the risk of diabetes and improve cardiovascular health. “There is evidence that moderate drinking can be protective of the heart, and it is aroun
d 1.5 to 2 drinks per day we start to see that reverse,” Roach says. “After about 1.5 per day we start to see harmful effects on the heart.”

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