This January, many women are embracing “Dry January” to reset after indulging throughout the holidays, but new findings suggest there’s a compelling reason to go beyond a single month of sobriety.
Earlier this month, U.S. Surgeon General Dr. Vivek Murthy released a groundbreaking advisory on alcohol and cancer risk, highlighting an overlooked but critical truth: alcohol is a direct contributor to cancer, and women are particularly at risk.
According to the advisory, alcohol ranks as the third leading preventable cause of cancer in the United States, following tobacco and obesity. The statistics are sobering: alcohol consumption is linked to approximately 100,000 cancer cases and 20,000 cancer-related deaths annually. Yet, despite decades of evidence, fewer than half of Americans recognize alcohol as a cancer risk factor—a knowledge gap that may be putting women’s health in jeopardy.
Why Women Face Unique Risks
While alcohol poses risks for everyone, women are more vulnerable to its harmful effects due to biological differences in body composition, hormones and metabolism.
“Women tend to feel the effects of alcohol more strongly than men,” Dr. John Whyte, chief medical officer of WebMD, tells Flow Space. “These factors may make women more vulnerable to the short- and long-term effects of alcohol, even at lower amounts.”
With less water and more body fat than men, Whyte explains that alcohol becomes more concentrated in a woman’s system, leading to faster intoxication and prolonged exposure to its effects. Furthermore, women metabolize alcohol slower than men which extends the duration of its impact on women’s bodies. Whyte also explains how hormones during one’s menstrual cycle or menopause can affect how alcohol is processed.
“For example, alcohol may have a stronger effect just before menstruation or during ovulation,” Whyte explains. “Birth control and hormone therapy can also slow alcohol metabolism as well as other prescription medications.”
The Cancer Connection
Murthy’s advisory outlines the well-established link between alcohol and at least seven types of cancer, including cancers of the breast, liver, colon, esophagus and throat. For women, breast cancer is a particularly significant concern. The International Agency for Research on Cancer estimates that alcohol consumption is responsible for 4% to 10% of breast cancer cases in the United States, contributing to 9,000 to 23,000 new invasive breast cancer diagnoses annually.
“Even small amounts of alcohol can increase the risk of breast cancer,” Whyte notes. “It also increases oxidative stress, which can cause problems in cell division. It may also decrease immunity.”
Dr. Bubu Banini, a gastroenterologist and researcher at the Yale Cancer Center, as well as associate director of the Clinical and Translational Core at the Yale Liver Center, explains that the risk of alcohol-related harm increases progressively with the amount consumed.
“The most commonly studied pathways relate to alcohol’s role as a carcinogen and in altering estrogen levels,” Banini tells Flow Space. “Alcohol is converted into acetaldehyde, which is highly toxic and can bind DNA and proteins, interfering with DNA synthesis and repair.”
Banini explains that excessive alcohol consumption can elevate estrogen levels while potentially reducing the activity of the tumor suppressor gene BRCA1. This combination may promote increased cell proliferation and raise the likelihood of genetic mutations that predispose individuals to cancer.
Dr. Anne Peled, a breast cancer surgeon and survivor based in San Francisco, notes that while the Surgeon General’s advisory has sparked significant attention and is supported by robust data, the information itself isn’t new. She emphasizes the importance of understanding the context behind the findings.
“When you look at the data, the increased risk of breast cancer really starts at one drink per day, which is still only a 10% increased relative risk compared to non-drinkers,” Peled says. “So while even a very minimal increased risk for some women might feel like something they would rather avoid, from a medical standpoint, the increased risk of breast cancer with minimal alcohol consumption such as two or three drinks per week is very small and would be considered safe by most people.”
Alcohol’s Impact Beyond Cancer
While moderate drinking has been suggested to have some heart benefits, excessive alcohol consumption is a major risk factor for heart disease, which is the leading cause of death for women in the U.S. Heavy drinking increases the risk of hypertension (high blood pressure), stroke and cardiomyopathy (weakened heart muscle).
According to a recent study from the American College of Cardiology, women without a history of binge drinking who reported high alcohol consumption faced a 45% higher risk of heart disease compared to those with moderate intake. Even moderate drinkers had a 29% higher risk of heart disease compared to women with low alcohol consumption.
Additionally, women are more susceptible than men to alcohol-related liver disease, including alcoholic hepatitis and cirrhosis. Women develop liver disease with lower amounts of alcohol and over shorter periods of time compared to men. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) states that women account for nearly 40% of deaths from cirrhosis in the U.S., even though they consume less alcohol on average than men.
Plus, research from the Alzheimer’s Association indicates that excessive alcohol consumption significantly raises the risk of dementia, particularly among women, who account for two-thirds of Alzheimer’s patients in the U.S. However, moderate alcohol consumption has not been conclusively linked to an increased risk of dementia.
A Wake-Up Call for Women’s Health
The Surgeon General’s advisory is more than just a presentation of statistics—it’s a call to action for greater public awareness about the health risks associated with alcohol. While the numbers may seem alarming, it’s important to maintain perspective. For many people, drinking small amounts of alcohol is generally considered safe, though its effects depend on factors like overall health, age, sex and personal or family history of certain conditions.
Interestingly, some research suggests that moderate alcohol consumption, particularly red wine, may offer cardiovascular benefits. These benefits are often attributed to resveratrol, a natural compound found in the skin of grapes, as well as in blueberries, raspberries and mulberries. However, such potential benefits should be weighed against the risks, especially for women, who face unique vulnerabilities to alcohol’s effects.
If you choose to drink, it’s essential to follow the recommended guidelines. The Centers for Disease Control and Prevention (CDC) advises that women limit alcohol intake to one drink or less per day, while men should stick to two drinks or less per day. For middle-aged and older adults, moderate consumption may help lower the risk of certain heart conditions.
However, it’s equally important to consider your personal risk factors, such as a family history of cancer or heart disease, when deciding how much, if any, alcohol to consume. If you’re concerned about the long-term health effects, explore alternatives like mocktails or alcohol-free beverages to enjoy during social occasions without the risks.