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Rethink that drink: the true impact of alcohol on hormonal health

Ever wondered if your evening glass of wine might be affecting more than just your mood?

The idea that your casual drink could influence your body’s hormonal balance, leading to symptoms like premenstrual syndrome (PMS) or hot flushes, might initially seem far-fetched. Yet, this connection becomes clearer once you consider the central role of the liver. This vital organ not only helps detoxify alcohol but also plays a major role in sex hormone metabolism, including estrogen.

How much is too much?

With the myriad of health messages about alcohol we encounter, it’s understandable to feel uncertain about how much is too much. This query grows increasingly relevant in light of the World Health Organisation’s (WHO) recent revision of its guidelines, unequivocally stating that “no level of alcohol consumption is safe for our health“. This bold assertion underscores a stark reality: while pinpointing a universally ‘safe’ level of alcohol intake is elusive, the correlation between quantity consumed and risk is clear—the more you drink, the higher the risk, making moderation or abstinence the safer choices.

The WHO’s stance is rooted in a comprehensive review of the latest research, which highlights alcohol’s contribution to a range of health issues, from acute conditions to chronic diseases. The organisation’s revised guideline serves as a sobering reminder of alcohol’s far-reaching impact on health, extending beyond the liver to include increased risks of cardiovascular diseases, certain cancers and mental health disorders, among others.

This guidance, however, does not exist in a vacuum. It’s complicated by the fact that alcohol’s effects are not uniform across all individuals. Our unique biochemistry, genetics, and lifestyle choices – from our diets (how we eat) to our stress levels and physical activity – play significant roles in how our bodies process alcohol. What might be a relatively harmless amount for one person could be detrimental for another, making personal judgement and health advice crucial components of informed alcohol consumption.

The question of how much is too much, therefore, does not have a one-size-fits-all answer. It’s about making informed choices based on a comprehensive understanding of the risks, your personal health, and your lifestyle. When it comes to your hormones, it’s really the overall health of your liver that plays a key role in whether a glass or two of your preferred alcoholic beverage will cause hormonal chaos, or not.

How does alcohol affect your hormones?

Alcohol is a substance that is so harmful to our body that if it were to accumulate in your blood it would kill you. I don’t say that to scare you, it’s simply a fact – the human body cannot eliminate alcohol itself. Because of this, no matter what else the liver also has to detoxify and prepare for elimination, alcohol is the number one priority. It must convert the alcohol into acetaldehyde, which is then converted into carbon dioxide and water, the latter of which can be excreted. This is true for whatever form the alcohol comes in – beer, wine and spirits. A standard drink is considered to be anything containing 10 grams of alcohol. In New Zealand and Australia, examples of such include a 330ml bottle of 4% beer, one 30ml nip of spirits, 170ml of champagne, and a measly 100ml of wine, which is about four sips. In other words, it is so easy to knowingly or unknowingly overconsume alcohol.

The liver is also responsible for metabolising substances that the body makes which, once they’ve done their job, it no longer needs – including estrogen. Once a unit of estrogen has exerted its effects, it is transported to the liver where it has to be detoxified (changed) so that it can be excreted. There are two main phases to this detoxification process the liver is responsible for. Over time though, some of the liver detoxification pathways – particularly the phase two pathways – can become congested, just like traffic on a motorway. Where once substances flew through the liver at 100 kilometres per hour, they now crawl through at 20 kilometres per hour, for example.

When this process becomes terribly overloaded from years of too much chardonnay and biscuits, (or more precisely, from alcohol, trans fats, or the by-products of an unfavourable gut bacteria profile or bowel congestion (as can occur with frequent constipation), a useful way to imagine what happens is this: the estrogen will undergo its first stage of change (phase one), but there is no room on the second stage highway (phase two). As a result, this slightly changed form of estrogen has a tendency to be recycled back into the bloodstream. Recycling of estrogen (not what you want) can also occur when the gut microbiome contains too many species that make an enzyme called beta-glucuronidase. Eating more vegetables helps much of this.

When there is significant estrogen recycling occurring, your body is faced with both the new estrogen it continues to make from your ovaries (if you are still menstruating), your adrenal glands, body fat cells, as well as the recycled form. Plus testosterone (which men and women both make) can be easily converted into estrogen, more so when there is insulin resistance also present. This can lead to excess estrogen which can contribute to challenging symptoms like PMS/PMT, heavy, painful periods, pre-menstrual migraines and headaches, bloating and fluid retention, as well as a challenging perimenopausal transition.

So, what’s the answer?

You don’t need me to tell you whether you need to drink less alcohol – you know in your heart if this is true for you. So many people tell me they know they need to drink less alcohol, but they just can’t seem to do it. They say they lack the motivation or willpower. But it’s not willpower that is needed – it’s an understanding of why we do what we do, despite knowing what we know; an understanding of what is driving our behaviour. When we understand the interplay between our beliefs and values, our biochemistry and our nutritional status, we get an appreciation for the absolute miracle the human body is – who we are – and making choices that support our health can become effortless from this knowing. As can exploring the conscious and unconscious benefits we perceive we are getting from continuing to drink the way we currently do.

Be honest with yourself about how much you drink and whether your alcohol intake may be affecting your health – hormonal balance included. Start by aiming for more alcohol free days than you’re currently having and slowly increase these as you get used to consuming less. If reducing your alcohol intake or eliminating feels impossible, I encourage you to examine your relationship with it and reflect on what might be driving this.

Please note, support is always available: Counselling online in Australia or Alcohol Drug Helpline in New Zealand.

Debunking common nutrition myths

In the realm of food and nutrition, separating fact from fiction can sometimes feel like navigating through a maze. Let’s clear the air around some of the most persistent nutrition myths, offering insights that are both accessible and grounded in scientific understanding. Some of these will likely be stronger than others in your mind, and the nutrition messages of the time when you were growing up, can have lasting lousy effects. For example, I have had many, many patients over the years who remain fearful of eating dietary fat, having grown up during the low fat era.

Myth 1: Eating fat leads to weight gain

The fear of fat is a relic from the days when low-fat, high-carb diets were all the rage. Yet, the belief that dietary fat is a direct ticket to weight gain persists. It’s crucial to understand that not all calories are created equal, and nutritious fats are vital for our wellbeing. Foods rich in monounsaturated fats like avocados and olives, and those rich in omega 3 fatty acids including lamb brains and oily fish, are not just good for us—they’re essential. They support heart health, reduce inflammation, and help maintain healthy cognition. Incorporating nutritious fats into your diet isn’t a misstep; it’s a move towards optimal health.

Myth 2: Carbs are the devil

Carbohydrates have also been vilified, with diets promoting low-carb lifestyles gaining popularity. However, labelling all carbs as harmful oversimplifies the complexity of how our bodies use food for energy. All starches and sugary foods are broken down to glucose. That glucose then moves from your gut to your blood and insulin’s job is to move it out of there. The glucose fuels the activities of cells and leftovers are stored in your liver and muscles (as glycogen) as fuel for later and to help maintain blood levels overnight. Trouble is, when we eat junk which is knowingly or unknowingly very high in carbs that will illicit more glucose than you require or can store, insulin will pop those leftovers into your body fat. The carbs themselves are not the problem – the amount we’re consuming can be as can the source of them. A potato and a banana aren’t the problem – the junk is. It’s not about eliminating carbs but focusing on quality and working out the ratio that works best for your unique biochemistry.

Myth 3: Eggs are bad for your cholesterol

Eggs have been unfairly demonised for their cholesterol content, leading many to avoid them or worry about how many they eat. However, most of the cholesterol in our blood is produced by the liver, not derived from our diet. Cholesterol is also vital to our health – most of it is in our brain and is crucial for memory, nerve firing and cognition. It is also the building block of our steroid hormones that give us energy and vitality: estrogen, testosterone and progesterone, for example. Rather than banishing eggs, focus on a way of eating that is focussed on food (not junk), including plenty of green leafy vegetables, to provide your liver with some of the support it needs.

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