By Petra Coveney: What Does alcohol actually do to your brain? And why does it feel worse in menopause?
This festive season is associated with parties and social events where alcohol is freely flowing and - unless your religious beliefs or serious health risks - you may feel obliged to drink.
Don't get me wrong - I like a glass of fizz to celebrate a special occasion or wine in a restaurant. But I don't like the effects it has on me, especially since perimenopause.
I would fall asleep instantly after a glass of vino, head pounding with a migraine and hot flushes all night causing fatigue and dehydration the next day. Needless to say my brain fog and short term memory retrieval became worse. Not exactly fun.
But why does this happen?
This extract from part of an article below published in The Guardian/Observer newspaper is revelatory and includes quotes from researchers Emily Palmer and Rayyan Zafar, Imperial College London.
“Alcohol is a ‘dirty drug’,” says Emily Palmer, a researcher at Imperial College London, who studies hangovers. “It impacts multiple systems in the brain.”
Scientists are not exactly sure what is going on in our bodies during a hangover, but they do know it is caused by a variety of biochemical and neurochemical changes. “It doesn’t just affect the liver or the brain,” says Palmer, “it affects almost every organ.”
This Christmas, many of us will be celebrating with a drink or two or three...
“You have your first drink and a neurotransmitter called gamma-aminobutyric acid – or Gaba – is released in the brain,” says Rayyan Zafar, a neuropsychopharmacologist at Imperial College London and researcher for the charity Drug Science.
“Gaba slows the brain,” he continues. “It works on receptors in the cortex, specifically parts involved in the thinking processes and control.”
"The brain just shuts down. That’s why people call alcohol a depressant."
Gaba reduces a nerve cell’s ability to send and receive chemical messages throughout the central nervous system. So, for the first one to three drinks, as Gaba is released you feel relaxed, says Zafar.
At the same time, you get a rush of dopamine. “You feel good, you feel relaxed, and you want more,” says Zafar. But as you continue to drink the alcohol binds to glutamate receptors in the brain – which are important for memory formation. Their electrical activity is suppressed, “essentially blocking the formation of memories,” says Zafar.
The alcohol moves from your cortex, which controls behaviour, to the cerebellum, which is in charge of movement, motor coordination and balance.
Next, alcohol intoxication hits the medulla, right in the middle of the brain. It controls autonomic systems including heartbeat, breathing and blood pressure. “The brain just shuts down,” says Zafar. “That’s why people call alcohol a depressant; not because it makes you feel depressed, but because it depresses the whole central nervous system.”
Hangovers
The liver eliminates around one unit of alcohol an hour, then the hangover kicks in. Vomiting, explains Zafar, is an evolutionary survival tactic that has developed as a way of ejecting harmful substances from the body. Perhaps a small comfort when your head is hanging over the toilet bowl.
Alcohol is metabolised by the enzyme alcohol dehydrogenase (ADH). As ADH breaks down the ethanol, it forms acetaldehyde, a poison and carcinogen. When blood alcohol content reaches zero, hangover symptoms are usually at their worst, as at that point all of the alcohol has been converted to acetaldehyde, which changes the way DNA functions,” says Zafar. Alcohol damages mitochondrial DNA. Mitochondria are the energy-producing machines in our cells, and even slight damage can lead to toxicity in the brain.
“If you regularly drink enough to cause a hangover, we think that damage may build up,” says Palmer, “resulting in cognitive decline and early memory loss.” Alcohol also suppresses the release of vasopressin, a hormone that tells the kidneys to retain fluid, so urination increases. The resulting dehydration can leave you feeling thirsty, tired and headachy.
“We think hydration is super-important,” adds Zafar. “And by hydration, we don’t just mean water. We also mean sodium, chloride and potassium.”
When your body is damaged, your immune system is activated. It sends out inflammatory cells which attack bacteria or heal damaged tissue. “When you drink alcohol, the gut signals that it has a poison inside it,” says Zafar. “In response, your immune system ramps up to try and reverse the toxicity. This can lead to too much inflammation.”
The body has turned on itself. The inflammatory response can cause nausea, vomiting, headache, confusion, mood changes, cognitive impairment, and learning and memory deficits. Regularly drinking to excess can also lead to chronic inflammation, which is linked to diabetes, cancer and heart disease.
Congeners, found in darker drinks, are a byproduct of the fermentation process. They are complex organic molecules with toxic effects including acetone, acetaldehyde, fusel oil, tannins and furfural. Whisky has been found to have 37 times the amount of congeners as vodka, and studies show that drinks with more congeners causes a worse hangover.
Why does alcohol affect us more in Menopause?
The information below is sourced from Healthline and a range of medical journals.
As women (and men) age, their bodies become more sensitive to the effects of alcohol. Our whole metabolism slows down which makes it harder to process the toxic content of alcohol.
Your cartilage and tendons lose water as you age, which causes your body to hold less water. The less water in your body, the harder it is for your body to dilute alcohol. You're more likely to feel dehydrated.
Alcohol affects women more than men because they usually have a lower body weight. This means we absorb alcohol more quickly.
Women also have less of the alcohol dehydrogenase (ADH) enzymes in their stomach. As a result, our bodies can’t handle alcohol as well.
Hot flashes and other symptoms
Some menopausal women might find that alcohol triggers their symptoms.
Drinking alcohol increases the risk of disturbed sleep. Red wine is also seen as one of the most common triggers of hot flashes.
Wine is worse than many other forms of intoxifying liquids because it contains high levels of sugar. So in addition to the affects of the alcohol you are also experiencing a sugar high and then a low. In the menopause, sugar can also cause belly bloating and triggering digestive sensitivities and exacerbating our menopausal symptoms. We also know that our gut health directly affects our mental health, so if alcohol is disturbing the chemical balance in your gut we are likely to feel more low mood, lethargic and sluggish the next day.
Practice makes perfect!
However, if you do enjoy drinking, here is some positive news. Women in one study in the USA who drank alcohol at least once a month, were less likely to have hot flashes than women who abstained entirely. Their hot flashes were also less severe.
And, according to a 2017 literature review, the nutrients and hops found in beer may help to relieve hot flashes and other common symptoms. Many women choose to drink low alcohol beer because the hops helps them to sleep.
In my January Dry blogpost I'll share some research on which are the best alcoholic drinks to consume in the menopause - and the tastiest non-alcoholic drinks.
Have a happy holiday. xxx