When you’re uncorking a bottle of zesty Pinot Grigio or cracking open a frothy brewski, there’s usually a reason. Your fermented beverage might be accenting a bowl of cacio e pepe or helping you unwind after a brutal day of work. While there’s no shortage of studies warning us of the dangers of overdrinking and hazardous drinking, there’s one influence many of us might be unaware of: the menstrual cycle.
In a study published in January in the journal Alcoholism: Clinical & Experimental Research, researchers at the University of Illinois Chicago found that among people with psychiatric vulnerabilities, who were initially being studied to see how the menstrual cycle affects suicide risk, they were more likely to drink heavily around the time of ovulation (when a mature egg is released from the ovary), especially on the weekends. They were also more likely to drink heavily on the days between menstrual cycles, called the perimenstrual phase, to cope with the mood changes, irritability, and other premenstrual symptoms that surface during that time.
“This study… [is] really considering the interaction of both biological and psychological factors [when] looking at drinking motives,” Barbara McCrady, professor emerita of psychology at the University of New Mexico, who was not involved in the study, tells Inverse. “Heavy drinking, extreme binge drinking, and alcohol use disorder are all increasing in women. It’s really concerning, and research that’s focusing on trying to better understand why women drink [and] what motives there are should lead to innovations in treatment… it’s important work.”
A connection not fully understood
For scientists investigating factors contributing to or influencing alcohol use and abuse disorders, the impact of hormones associated with the menstrual cycle is old news but one mired in uncertainty. Animal studies have found that the flux of estrogen and progesterone, particularly triggered by luteinizing hormone, which switches on ovulation, seems to drive a thirst for alcohol.
“We [have] kind of a cultural [understanding] that drinking is risky or that people are sad around their menses, and those are just huge overgeneralizations,” Jordan Barone, a doctoral candidate at the University of Illinois Chicago and first author of the paper, tells Inverse. “Then there is mixed literature out there that maybe people are drinking more, maybe they’re drinking less in relation to different hormonal states. There’s a decent body of literature in both humans and in preclinical animals, but… no one really knows.”
Tory Eisenlohr-Moul, an associate professor of psychiatry at the University of Illinois Chicago who led the new study, tells Inverse that the mixed findings in humans have been due to issues like small sample sizes, involving healthy volunteers, or inconsistent measuring of when ovulation occurs (which is often assumed to be the same time for all menstruating individuals at around two weeks after the period).
“It’s been easier to pinpoint when menstruation happens because it’s an obvious bleeding event,” Eisenlohr-Moul tells Inverse. “It’s harder to know when ovulation is happening, and that’s where all the error has been historically.”
What we do know, though, is that while males experience higher rates of drinking and a condition called alcohol use disorder, which affects 14.5 million Americans ages 12 years and older, individuals who menstruate are more likely to “telescope”. This means they start with imbibing lower levels or amounts of alcohol (or other substances) but quickly escalate to greater amounts or frequencies indicative of addiction and dependence. Studies have also found that women and girls with co-existing mood or anxiety disorders are more likely to misuse alcohol to help cope with negative emotions.
Does your menstrual cycle influence your inclination to drink?
Barone, Eisenlohr-Moul, and their colleagues at the University of Illinois Chicago were originally conducting clinical trials looking at how the menstrual cycle impacted suicide risk. But as sort of a side project, they decided to also see how one’s motives for drinking alcohol varied as well.
To do that, they took survey data from 94 participants ages 18 to 45 involved in their menstrual cycle-suicide risk trials, which ran from 2017 to 2022. The surveys had participants filing away daily reports through their phones, which amounted to over 3,700, tracking their menstrual cycle along with other health questions like how much daily exercise they got or medications they were taking. They were also asked about when they drank, how much they drank, and why they drank, such as whether for social reasons while they have fun with friends or to cope with a bad mood.
While you can do a blood test to precisely gauge when ovulation occurs, the researchers say they didn’t want to inconvenience the participants by having to trek into the lab every month, especially for consecutive days. Instead, they used did an at-home urine test using the Clearblue digital Ovulation tests that can be purchased over-the-counter at most pharmacies, and texted the researchers the results.
“The reason we used that is [those kits] have a very specific threshold that the computer reads,” says Eisenlohr-Moul. “It’s not a guessing game, the computer decides whether [the levels of luteinizing hormone] are above 40 mIU per mL, and if it is, it gives you a smiley face, and [the participant] sends that to us.”
After that, the researchers could see the general landscape of one’s menstrual cycle and mapped out drinking and motives to four menstrual phases: mid-luteal, which is between ovulation and menstruation; perimenstrual, immediately before and during menstruation; mid-follicular, which is before ovulation; and periovulatory, or around ovulation.
The mapping overall revealed participants reporting being more likely to drink in their mid-luteal phase but drinking more heavily on the weekends when in their periovulatory and perimenstrual phases. Social motives for drinking were higher on the weekends versus weekdays if they were in their periovulatory, mid-follicular, or mid-luteal phase, although this wasn’t really the case if they were in their perimenstrual phase.
“We kind of see these two patterns of findings where around ovulation, people are drinking for more social reasons, more for good positive emotions, whereas during the perimenstrual phase, they were drinking a little bit more for coping with bad emotions,” says Barone.
It’s not clear if the less drinking in the perimenstrual phase is because of lower social motives (i.e., you’re home alone feeling miserable and not sociable), but Eisenlohr-Moul suspects that might be the case for some individuals.
Be mindful of how your mood affects your drinking
While the study was a bit on the small side and may not be generalizable to all individuals who menstruate, it does help to begin to untangle the uncertainty surrounding how fluctuating hormones may guide drinking. Eisenlohr-Moul and McCrady recommend that if you’re someone who menstruates and you’re concerned with the healthiness of your drinking, pay attention to two things.
First, how the weekend ramps up your drinking and maybe make alternative, dry plans if you find that the weekend indeed, is a high-risk time for drinking. The second is to track how many drinks you have against your menstrual cycle, especially during times the urge to drink (such as a bad mood) may be particularly persuasive.
McCrady hopes the ongoing research effort will shed much-needed light on this issue and make people more aware of how the biological processes happening in their bodies influence behavior and, ultimately, their lifestyle.
“Women are at risk for drinking heavily, biological and psychological factors put them at risk,” she says. “I think awareness of those factors can help people modulate or moderate their drinking.”
