The midlife guide to drinking well
Experts tell Kate Spicer how listening to your hormones could help avoid hangovers from hell
‘White wine gives me nightmares, calf cramps and really hard hangovers’
‘People find their tolerance changes when oestrogen is low’
Having lunch with four men recently, it came to my turn to choose a bottle. As soon as I tasted the mouthpuckeringly dry Nebbiolo Italian red I was satisfied. This won’t give me a hangover, I thought, clocking the visible distaste from the Malbec and Shiraz loving males. My taste in wine has changed drastically since I hit perimenopause. I’ve grown to love almost gritty and clear reds because they keep my head clear during and after drinking. Show me a Shiraz and I start sneezing.
I am not alone. Hormonal changes and booze are a favourite topic among friends. “Red wine + menopause = not good news.” “Can’t drink beer any more, makes me violently ill.” “I’m more sensitive now and have become super-nerdy about what works for me. Good tequila and lighter reds.”
It might not be a randomised controlled trial, but safe to say, tolerance and sensitivity to alcohol changes in menopause. My appalling, call-me-an-ambulance hangovers after only a few glasses of wine stopped when I went on HRT, but still, I only have to look at white wine and feel the beginnings of a headache.
Alexandra Martin, the director of a bakery business in Devon, started noticing around her mid-40s that the glass or two of wine she looked forward to drinking to de-stress after work, “was starting to give me allergic reactions. Sneezing and almost flu-ey feelings. My reactions were so bad, it’s totally put me off.”
The new menopausal aversion to certain drinks is not a problem common to all women, some are just immune or choose to ignore it, as Jo – ex Mrs Ronnie – Wood likes to tell friends: “Didn’t have time for the menopause, I was on tour with the Stones.” And some women – among my acquaintance any way – believe it is the only way to get through the damn thing. “Oh, I’m drinking my way through mine,” a friend told me.
This isn’t quite as irrational as it sounds. David Nutt is professor of neuropsychopharmacology at Imperial College and says: “There are big changes in hormones, particularly progesterone, in menopause. High progesterone levels makes us calm, when progesterone falls anxiety goes up, it’s what causes the menopausal miseries.” So when people say they
are “drinking through it”, what they may technically be doing is trying to recreate the calm of progesterone.
This approach worries Dr Louise Newson of Newson Health, a GP who believes hormone replacement therapies are essential for an ageing woman’s health: “We see many women in my clinic who tell us they are drinking more alcohol to numb their symptoms and help them sleep. However, this can increase their future risk of osteoporosis and breast cancer, so it’s important that if women are struggling with menopausal symptoms, they receive individualised and evidence-based advice.”
In Prof Nutt’s new book, Drink? The New Science of Alcohol and Your
Health, his message is that we should drink significantly less. Menopause also “makes you more vulnerable to alcohol withdrawal”.
Reassuringly, even La Parisienne is not immune. Caroline de Maigret admits in her co-authored book about midlife, Older but Better, but Older, that she no longer drinks white wine because it gives her palpitations, “Which is too bad because I love it but now it gives me nightmares, calf cramps and really hard hangovers. Even a little wine leaves me feeling like I’m being hit on the head with a hammer. When 30-year-olds complain about hangovers, I’m like, ‘You just wait…’.
Menopausal or not, male or female, our endocrine system is knocked out of whack by alcohol.
Prof Nutt dedicates a section of his book to alcohol and sex hormones, which are thrown out of balance by booze at any time of life. He says: “Menopause is a massive disruption to your brain function. You live 30 years with all these hormones and then suddenly you have none and it can affect taste, your sensitivity to irritants, to flavours and different chemicals in a similar way that women crave odd things like pickled onions when they are pregnant.”
Then, throw in the inevitable ageing body. I remember my Dad announcing
“No more brown drinks” in his mid-60s, and in Prof Nutt’s book the reason is explained. The more complex, or aged, or colourful a drink is, the more compounds called congeners there are for the liver to process.
What struck me was how everyone’s experience was different. Anna
Tresserra-rimbau is a researcher in human nutrition at Rovira i Virgili University: “Our response depends on many factors, such as the amount of alcohol consumed, age, gender, genetics, body composition, medical history, drug use, and dietary habits and other factors.” These include loss of an essential alcohol-processing enzyme in women’s livers, dehydrogenase, and the disruption to our unique microbiomes. But, she adds: “The type of alcoholic beverages consumed is also important since some contain more contaminants or additives such as sulphites that may also explain part of the adverse effects.”
The EU’S “acceptable daily intake” is 0.7mg of sulphur per kg of body weight a day, which, with some commercially produced white wines, is no more than one large glass for a 10st woman. Could it be sulphites that cause the morningafter horrors, and not the booze itself?
Alexandra Martin doesn’t take HRT and says she can manage unhappy menopausal symptoms simply by “stopping drinking – the price I pay is too high. I now know it’s not the wine per se causing it, as I’ve started getting the same worsening of my symptoms from certain foods.”
“People find their tolerance changes,” says Dr Newson, “because the way the liver mops up and clears toxins is negatively affected when oestrogen is low.”
The same gut instinct that repelled me from certain wines drew me to ale for the first time in my life. Tresserrarimbau, co-author of a review paper called Beer Polyphenols and Menopause: Effects and Mechanisms, says that hops contain a number of phytoestrogens, including one of the most potent known, which “may be useful to relieve menopausal symptoms”, though in much lower concentrations than HRT. I ask if an ale a day might keep menopause symptoms at bay and she demurs, admitting the polyphenols have benefits, but: “The recommendation is not to encourage drinking.”
I mention this to Dr Newson who seems alarmed that someone might think real ale a good adjunct to HRT. But Richard Hamblin, who runs More Wine, which specialises in “low intervention” wines, says many of his customers are middle-aged women. “There’s a definite customer that finds her way to me who can’t drink red or white wine any more; they do seem to get on better with our wines. I can’t say whether it’s the power of placebo or the fact that they are drinking our simpler wines, ‘cleaner’ if you like, chemically speaking.”
Barry Williams, co-founder of Embrace Change residential retreats in the Loire, says: “We encourage guests to relax and have a great time, while educating them in effective strategies to cope with their menopause.” This includes how to reduce alcohol’s worst side effects.
De Maigret agrees, alcohol might be bad for our ageing bodies but it can, however controversial to say it, be a tonic (even if the doctor didn’t order it), “I actually enjoy the feeling of a hangover; you are dead in your body, yet alive with the good feelings and memories of a night out with friends when you didn’t care about anything except to party and laugh – just never with white wine any more.”