Alcohol and PCOS: Should You Avoid It?
Do you enjoy drinking a tall glass of wine after a long day’s work? Well, you are not alone. Alcoholic beverages like wine are consumed on a regular basis worldwide. But can alcohol be making your PCOS worse?
Alcohol is often integral in any social gathering whether it’s a family dinner, a wedding or a birthday party. But many women with PCOS want to know if avoiding alcohol is necessary to help them reverse their PCOS.
In today’s post, you will find out if you should avoid alcohol for your PCOS. We will look at the benefits and drawbacks of alcohol for PCOS and if alcohol is safe to drink with PCOS.
So, if you want to know if you can continue enjoying your favorite tipple guilt free, read on!
What is Alcohol?
The ‘alcohol’ found in alcoholic beverages is a chemical compound known as ethanol.
Alcohol is made by fermenting fruits, vegetables and grains. Fermentation is the process in which yeast breaks down sugar found in food and converts it to ethanol and carbon dioxide.
So, as I mentioned, many women are curious to know about alcohol and PCOS.
Here's the thing.
To some people, alcohol is a harmless addition to their lifestyle, while to others it is seen as a poison. So let’s take a look at what the research says and weigh up the benefits and drawbacks of drinking alcohol for PCOS.
The Benefits of Alcohol for PCOS
Several studies over the years have found that drinking alcohol in moderation can be beneficial for PCOS. Here’s how
Insulin resistance is the most common root cause of PCOS, with about 70% of PCOS women suffering from this. This is a condition where the cells in the body have become unresponsive to the effects of insulin. As a result, there is a build-up of sugar in the bloodstream.
To reduce blood sugar levels the pancreas starts producing even more insulin. High levels of insulin in the body then has the unwanted side effect of telling the ovaries to produce more androgens. Which then causes the PCOS symptoms women experience.
Insulin resistance that is not managed increases the risk of Type 2 Diabetes. But a study found that moderate alcohol consumption, 6-48g/ day, reduced the risk of diabetes by ~30%. So for perspective 48g equals 6 units of alcohol which is about 2 large glasses of 250 ml (12% ABV) red wine or 3 medium 175 ml glasses. The researchers, however, found drinking ≥48 g/day did not reduce the risk.
But, further research is needed to test the effect of alcohol consumption on Type 2 Diabetes.
Decreases the Risk of Heart Disease
Research shows 70% of women with PCOS have high levels of LDL cholesterol, 'bad cholesterol', and low levels of HDL cholesterol, 'good cholesterol'. This combination puts women with PCOS at greater risk of heart disease.
A study found drinking alcohol in moderation has been shown to reduce the risk of heart disease. This may be because of it can increase HDL cholesterol levels and lower blood pressure.
Despite the evidence, there is still controversy because it is not clear whether the relationship is truly causal. Meaning we cannot say with certainty whether alcohol prevents heart disease. Or if there are other dietary or lifestyle factors that are reducing the risk. It may be that drinking alcohol in addition to another diet or lifestyle choice can reduce the risk of heart disease. There is a need for further research to identify if alcohol really helps here or not.
So although the results sound great, this isn’t a reason to drink more often.
Women with PCOS are at a higher risk of suffering from depression. Yet, research suggests that alcohol, wine in particular, reduces the risk of depression.
A study found the group who drank two to seven small glasses of wine per week had the lowest rate of depression. Results remained significant even when the individuals were adjusted for factors, such as diet and smoking. Experts suggest compounds found in wine, such as resveratrol (an antioxidant) may have protective effects on the brain.
Improves Gut Health
Living inside the human gut are many different types of bacteria. Researchers have found that women with PCOS have less variety of bacteria in their gut. Now, this is a problem because the diversity of our gut bacteria can affect our immune system, mood and digestion.
But a study found that people who consumed a monthly average of 2 units of red wine (one medium 175ml glass) had an increased gut microbiota diversity compared to non-red wine drinkers.
The researchers believe it's because red wine contains polyphenols. Polyphenols are naturally found in plants and contain many antioxidants, vitamins and minerals.
They found drinking red wine once every two weeks, is enough to improve the diversity of gut bacteria.
All of the above benefits are incredible. The results show drinking alcohol in moderation reduced the risk of diabetes, heart disease, depression and improved gut health. Such results are highly encouraging for women with PCOS.
Drawbacks of Alcohol for PCOS
Whilst there are some benefits of drinking alcohol for PCOS. There are some drawbacks you must know if you are trying to balance your hormones and reverse PCOS.
As well as high male hormones, women with PCOS may have high estrogen levels. Researchers have found that alcohol can increase estrogen levels.
Alcoholic beverages not only contain ethanol (alcohol) but also a substance called congeners. Researchers say congeners are phytoestrogens that have an estrogen-like effect on the body. This is because their chemical structure is similar to the bodies real estrogen.
A study was carried out on post-menopausal women, who cannot produce estrogen themselves, to test if consuming alcohol would produce the hormone. Results were positive showing that the congeners in alcohol increased estrogen levels. So given that post-menopausal women, who suffer from low estrogen levels, experienced an increase, we can infer that women with PCOS may also see a further rise in estrogen.
Drinks high in congeners include cognac, tequila and whiskey. While drinks like gin, rum and vodka have low levels of congeners.
However, recent research suggests that while phytoestrogens can imitate estrogen in the body, they show weak estrogen activity. This is because they do not bind to estrogen receptors in the body as firmly as the body's real estrogen.
Alcohol Impacts Gut Health
You might remember earlier in the post I said that drinking red wine once every two weeks can improve gut health. However, contrary research suggests alcohol can disrupt the balance of gut bacteria. Experts indicate the change in gut bacteria leads to an increase in the release of endotoxins that promote inflammation.
Inflammation is a response the immune system takes to protect us from viruses and bacteria.
Researchers have found that PCOS women suffer from chronic inflammation. This inflammation occurs when the immune system believes it is always under threat.
A study found inflammation directly stimulates the ovary to produce male hormones. And as a result PCOS symptoms.
Increases the Risk of Depression
Above in the benefits section, I mentioned that drinking alcohol can lower the risk of depression. But this only applies to moderate alcohol consumption. Researchers say that overconsuming or abusing alcohol can increase the risk of depression. Experts suggest this is because alcohol changes the chemistry of the brain. So it is crucial that you keep track of your alcohol intake.
Interferes with Metformin
As discussed, insulin resistance is a root cause for around 70% of women with PCOS. Doctors often give Metformin for insulin resistance because it helps the body's insulin work better. But, it is advised not to drink alcohol while taking metformin because it may increase the risk of lactic acidosis.
Lactic acid is a by-product made when there are low levels of oxygen during the breakdown of carbohydrates into energy. Signs of lactic acidosis include sleepiness, abdominal pain, muscle cramps and headaches. All of which are often easily mistaken for signs of alcohol consumption.
Interferes with Sleep
Sleep plays a key role in balancing hormones. However, women with PCOS report difficulty falling asleep. With research showing sleep disturbances were twice as common in women with PCOS compared with those without. Studies reveal alcohol can affect sleep.
Now, you may be thinking more time in deep sleep is what you want, but this is not the case. During a normal night, we progress through various stages of sleep. Changes to the natural process of sleep can affect your health and wellbeing.
REM sleep typically accounts for 20 to 25% of an adult’s sleep cycle. It is an important part of the sleep cycle because it can influence memory and help with repairing the body and brain. Conversely, a lack of REM sleep can impact memory, concentration and cause migraines.
So as women with PCOS already suffer from sleep disturbances, avoiding alcohol may help achieve good quality sleep. Which will in the long term help with hormonal balance.
High in Calories Leading to Weight Gain
I hate to break it to you but alcoholic beverages can contain lots of calories. Just for reference, there are 7 calories per gram of alcohol. So using our example of wine, a medium glass contains around 148 calories.
Now, this is not to say that you will gain weight by knocking back a few shots or drinking one glass of wine. There are more factors to take into consideration like your overall diet and lifestyle. However, it is important to know and keep track of how much alcohol you drink because the calories do add up. But also certain drinks contain extra sugar from mixers etc and this increases the calories.
You can check out this list to find out the number of calories in various alcoholic beverages.
Women have Low Levels of Alcohol Dehydrogenase (ADH) Enzyme
Now, this important to know for all women in general. Research shows women younger than the age of 50 have less of the alcohol dehydrogenase (ADH) enzyme that breaks down alcohol before it enters the bloodstream. Because of this nearly 30% more alcohol is absorbed into a woman’s bloodstream.
Best Alcoholic Drink for PCOS?
So here’s the thing.
While research has shown alcohol does offer some benefits for PCOS, it is difficult to say which is best. The effects of certain substances, found in alcohol, have only been investigated separately. Scientists have yet to determine how all the substances found in alcoholic beverages interact and their role in the body.
But, with that said, below is a list of alcoholic beverages that may be PCOS friendly.
Red wine has been the most widely studied because the skin of grapes used to make red wine contains resveratrol. Resveratrol is an antioxidant that can protect your body from damage which puts you at a greater risk of chronic illnesses.
Now, while red wine is a great source of resveratrol it is not a justification for drinking it. This is because you would need to consume a significant amount to reap the benefits.
As well as containing a powerful antioxidant compound, red wine is also low in sugar. You see, although originating from grapes, the sugar is converted to alcohol during the fermentation process. So with less sugar, wine is a much better choice.
Gin and Rum
Both these spirits contain no additives or sugar. As a result, they also contain the least amount of calories.
But if you don't drink gin neat or on the rocks, swap the tonic for soda. This is because tonic surprisingly has almost as much sugar and calories as coke or sprite. Soda water, on the other hand, is just carbonated water, so it's got no sugar or calories.
In recent years, this traditional Irish drink has gained a reputation as the healthiest beer. Researchers found Guinness contains the same antioxidants found in red wine (which are not found in other beers). As well as folate (a B vitamin) and soluble fibre. Guinness also has fewer calories and a lower alcohol content (ranging from 4.1% to 4.3% ABV) compared to other beers.
Support your Liver
So here’s the deal.
If you don’t drink, I wouldn’t recommend starting because of all these potential benefits. However, if you enjoy drinking alcohol in moderation, evidence suggests it may be safe to continue including it in your PCOS diet. But here are some things you can do to support your liver and the detoxication process.
N-acetyl Cysteine (NAC)
N-acetyl Cysteine (NAC) comes from the amino acid L-cysteine. In the body NAC turns into glutathione a powerful antioxidant. Researchers found because of its antioxidant benefits, NAC promotes detoxification. As a result, supporting and protecting the liver from damage.
Curcumin is the active ingredient found in turmeric (the curcuma longa plant). Turmeric is a flowering plant from the ginger family. It is native to India but also now grown in other parts of Asia.
Research shows curcumin can boost the production of glutathione and support the liver.
Dandelion is a flowering plant that grows in many parts of the world.
The liver's role is to produce bile, a fluid, that helps breakdown fats into fatty acids and detoxify the blood. In Chinese Medicine, dandelion root is known as a ‘liver tonic’ because of increases the flow of bile and helps the liver remove toxins.
Eat Plenty of Cruciferous vegetables
Cruciferous vegetables like broccoli, cauliflower, Brussel sprouts and bok choy, have glucosinolates (natural compounds found in plants) that help detoxify the liver.
The truth is, there is no clear yes or no answer. There is evidence to suggest alcohol can be a part of your PCOS friendly diet. The benefits of moderate alcohol consumption for PCOS include reduced risk of diabetes and heart disease.
However, the jury is still out on whether alcohol is safe for women with PCOS. Firstly because there is no research looking at the impact of alcohol on PCOS. Secondly, there are tons of conflicting results and information among researchers. Studies are not concurrent on whether alcohol improves or affects gut health.
Moderation is Key
As I mentioned, if you are going to drink alcohol whether you are at a social event or you fancy a drink at home, red wine, gin, rum or a Guinness beer may be best. But as discussed, women have less of the enzyme that breaks down alcohol. So just like with most things, it is all about moderation.
Lastly, if you do drink make sure you support your liver. Include NAC, dandelion root, cruciferous vegetables and curcumin in your diet to help with the breakdown and removal of alcohol from the body.
Hey there! I am Despina Pavlou, founder of PCOS Oracle, certified personal trainer and corrective exercise specialist. I want to share with you the diet and lifestyle changes I made to naturally reverse my PCOS and achieve hormonal balance. I believe using my holistic approach you too can take back control from PCOS.