It’s Friday. The end of a stressful week. You’ve been looking forward to unwinding with friends at your local watering hole. And your doctor has also told you that glass of red wine you plan to have can help guard against heart disease.

But, what if you find yourself anticipating and reaching for that glass of wine more often. Say, on a nightly basis? Researchers warn that, especially for women, it’s wise to monitor drinking habits, lest they evolve into problem drinking. “[Women] need to monitor how much they’re drinking and how often because what happens is that the amount and frequency tend to creep up over time,” cautions Elizabeth E. Epstein, PhD, a professor at Rutgers University’s Center of Alcohol Studies. “Before you know it, you’ve got a problem and you don’t really realize it.”


Last year, Melanie Crawford, who had just retired at 52 from her job as a bank officer in Dayton, OH, began a nightly tradition with her husband of enjoying a bottle of wine. Before too long, that one bottle progressed to two—almost every night of the week. When her friends expressed concern, she recalls, “I was shocked because I’d always been able to handle alcohol before.”

This is what Dr. Epstein describes as a “telescoping effect.” In women, she explains, alcohol problems tend to develop more quickly. “They’re likely, over time, to have less and less positive feelings in reaction to the alcohol and to develop tolerance,” she explains. “So they’ll end up drinking more and more to get that same feeling—and that’s how alcohol problems can start.”

Surveys conducted by the CDC have shown that men tend to be heavier drinkers at all ages than women. Yet women are more at risk for developing physical problems from alcohol consumption than men. Our bodies have less water content to dilute the alcohol. We also produce fewer enzymes in our stomachs to help break down the alcohol molecule. So alcohol is more likely to be absorbed by fatty tissues (in our breasts) and organs (our livers and brains). Add in other factors, such as genetic predisposition, an addictive type personality, environmental concerns, or co-occurring conditions such as depression, trauma or the losses associated with aging, and you’ve got “the perfect storm” for progression to alcohol dependence, says Brenda Iliff, MA, LADC [Licensed Alcohol and Drug Counselor]. Iliff is the Clinical Director of Hazelden Foundation’s Women’s Recovery Center in Center City, MN, and author of A Woman’s Guide to Recovery.

Recent research suggests that as women grow older, there may be special cautions against regular drinking. Women in mid to late middle age are more likely to take medications, for instance, and alcohol can produce adverse interactions with many over the counter, prescription and even herbal preparations.

So what constitutes a safe or moderate level of drinking? Alcohol and substance abuse researchers recommend a common-sense approach, such as that taken by Jane Lenthall. An insurance broker in Huntington Beach, CA, Lenthall is divorced and works from home. “I don’t normally drink at home by myself,” she says. “If I’ve had a really stressful day, I might have a glass of red wine at night time as a stress reducer—rather than eating a box of chocolates. But it isn’t on a regular basis.” She’s equally mindful of her alcohol intake when she meets friends for dinner, especially if she’s driving home afterward.

“Our society, at times, encourages people towards excess or over imbibing, whether it’s with food, alcohol, work or gambling,” Iliff says. “Our friends may say, ‘have just one,’ or ‘just try a little bit.’ For a lot of people, a little bit is fine, but for other people, it’s not.” For instance, some women should not drink at all, such as women who are pregnant or may become pregnant, anyone taking drugs that can interact with alcohol and those recovering from alcoholism.

It’s important to track how often and how much you drink. Compare your amounts with the safe drinking guidelines (see When Is “A Drink” Not Just One?) Are you going over the limits? If you are, you may consider drinking more slowly, having food along with your wine or having drinks with less alcohol in them (such as a wine spritzer). Tune up your “refusal skills:” Simply say “Not today,” “I’ve had enough” or “No, thank you.” You don’t need to explain why you’re not drinking.

If you have trouble adhering to the safe drinking guidelines and these coping strategies do not work, that could be a red flag. Consider asking those close to you whether they have concerns about your drinking, Iliff advises. It’s not always about the amount of alcohol you consume; other signs that you may be having a problem with alcohol are showing up late for work, drinking 5 or more drinks at one sitting, anticipating drinking, frequent hangovers and a feeling of shame or embarrassment about your inability to control your drinking. It’s because of shame and stigma that women are often afraid to admit they have a problem with alcohol, Iliff says.


While there is a lot of help for women who are alcoholics, researchers still are learning what works best in treating the female alcoholic population. “Most of what we know about alcohol comes from male samples,” Dr. Epstein says. Historically, only about 8% of all alcohol and substance abuse research has been conducted in women, Iliff says.

In long term follow up of men and women who enter treatment, Dr. Moos and colleagues have found that women tend to remain in treatment and maintain abstinence once they get into treatment—whether it’s at an alcohol center, through Alcoholics Anonymous, or both. Studies by Derek Satre, PhD, a professor in the Department of Psychiatry at UCSF and a researcher with Kaiser Permanente Division of Research, have revealed similar, hopeful results. “Even though older women come in [to treatment] with drinking severity equal to older men, they seem to stay in treatment longer,” Dr. Satre says. “That better treatment retention translates into better abstinence outcomes.”

At Rutgers, Dr. Epstein is working on developing treatments specifically for women. Her research focuses on addressing issues that may have led women to using alcohol as a coping strategy in the first place. This type of treatment emphasizes learning to care for yourself, being more autonomous and less emotionally reactive to people around you. Dr. Epstein says that at critical junctures in our lives, such as during retirement, it’s important to take care of ourselves: Reduce anxiety by exercising rather than drinking and seek healthy interpersonal ways to feel connected instead of becoming lonely and isolated.

Dietary Guidelines for Americans, as well as the National Institute on Alcohol Abuse and Alcoholism (NIAAA), recommend no more than one drink per day for women, and a maximum of 7 drinks per week. Although definitions vary, binge drinking usually corresponds to 4 or more drinks at a sitting for women (generally within about 2 hours).

According to NIAAA guidelines, a standard drink equals the following:

• 1 12-ounce bottle of beer
• 1 5-ounce glass of wine
• 1.5 ounces of 80-proof distilled spirits
• A Long Island Iced Tea, typically made with equal parts tequila, vodka, rum and triple sec could really be equivalent to 2 to 4 (or more) drinks in one glass, depending on the bartender’s measure

About the Author: Gretchen Henkel is a freelance writer based in CA.