Drinking is a well-established and pervasive characteristic of American life. People commonly usher in the new year with a glass of champagne. Alcohol is expected at most social events, including weddings, birthday parties, and sporting events. Many restaurants designate special times or days devoted to drinking, usually for a lower cost to attract a bigger crowd.

Such normalization of drinking can make it challenging to recognize when someone is drinking at excessive levels. And even though alcohol consumption has been associated more with men, societal norms and perceptions are evolving, shedding light on the complex relationship between women and drinking.

Cultural norms play a significant role in shaping women’s attitudes toward alcohol. For example, wine is often part of everyday meals and social gatherings in Mediterranean countries like Italy and Spain, which gives such recurring drinking an aesthetic of worldliness and sophistication.

Meanwhile, the burgeoning use and far reach of the internet and social media has contributed to the ethos around drinking for women. Mommy wine culture is a phrase popularized in the mid-2010s and used to describe moms needing a regular drink to cope with the stresses of motherhood and childcare. The phrase was portrayed in online memes, clothing, and accessories. Unfortunately, what may have started as a light-hearted joke has shed light on worrisome trends in the consumption of alcohol by women.

In 2022, 66.4 million women (and girls) ages 12 years and older reported drinking in the last month, while 27.5 million women (and girls) 12 years and older reported binge drinking.1 The increase in alcohol use and binge drinking by women has been well documented. From 2000 to 2016, the percentage of men who reported any drinking stayed mainly the same; however, for women, it increased by 6%, and binge drinking for women increased by 14%.2

Risks

Alcohol affects women differently from men, and women are at greater risk for developing alcohol-related problems than men. Among these factors is the average body size of men compared with women. Men generally weigh more and have less water in their bodies than women. As a result, the alcohol in a woman’s body is less diluted, creating more significant exposure to the toxic effects of alcohol and its byproducts. In other words, in women, alcohol is absorbed faster and stays in the body longer.

People who drink are at a higher risk of developing cancers of the liver, mouth, throat, esophagus, and colon. An association also exists between alcohol use and breast cancer.3,4 Although prevalence rates show that women are less likely to drink than men, the gender gap is narrowing. In 2020, the percentage of men who reported drinking in the past month was 55% and 46% for women.2

Drinking is also associated with co-occurring mental health disorders such as generalized anxiety disorder, social anxiety disorder, panic disorder, mood disorders, posttraumatic stress disorder, sleep disorders, and psychotic disorders. Even in the absence of a formal psychiatric diagnosis, people often report difficulty with sleep and anxiety-like symptoms that may emerge even after a single heavy drinking episode. “Hangxiety” is a colloquial term used to describe these symptoms.

Drinking to Cope

Research suggests that, compared with people who drink for pleasure, those who drink to cope have a higher risk of developing alcohol use disorder. Although the reasons why people drink vary, studies have found that women are more likely to drink to cope than men.5

Other factors may be associated with using alcohol as a coping mechanism. Women are statistically more likely to experience childhood abuse or sexual assault than men. And, in recent years, studies have found rates of depression, anxiety, eating disorders, and suicide are climbing among teenage and young adult women.5

During the COVID-19 pandemic, social isolation, employment insecurity, and overwhelming household and childcare demands amplified stress levels for women.6 Women were more likely than men to experience layoffs or leave their jobs to care for children when schools and childcare centers closed. They often took on more responsibilities, like running errands for immunocompromised relatives. In many cases, having that extra glass of wine or a couple more cocktails provided some relief when coping with the increased demands.7

Pregnancy and Alcohol

Alcohol is a potent teratogen, an agent that interferes with fetal development. Alcohol exposure at any point during pregnancy can impair development. Prenatal alcohol exposure is the leading cause of preventable birth defects and neurodevelopmental disabilities and can lead to fetal alcohol spectrum disorders (FASDs). FASDs, a spectrum of conditions caused by prenatal alcohol exposure is an umbrella term, not a diagnostic term. Alcohol exposure in utero can result in damage to the brain, central nervous system, organs, and limbs. It is the sole cause of FASDs. The impairments associated with FASDs are lifelong conditions. While there is no cure, FASD-informed interventions and support services can improve affected individuals’ developmental, educational, and social outcomes. FASDs are preventable if a developing baby is not exposed to alcohol.8

All people of reproductive age are at risk of an alcohol-exposed pregnancy if they drink alcohol, are able to become pregnant, and are not using contraception correctly and consistently. About half of all pregnancies in the United States are unintended, and many pregnant people continue to drink during critical periods of early fetal development. Some people might assume that FASDs can occur only among children of certain types of people who drink. Yet alcohol use during pregnancy occurs in every social, economic, and demographic group, among social drinkers as well as those who binge. In a 2022 Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention researchers found that nearly 1 in 7 pregnant people reported current drinking and about 1 in 20 reported binge drinking during the past 30 days. Pregnant people who experienced frequent mental distress (14 or more days of poor mental health in the past 30 days) and those who did not have a regular health care provider were more likely to report alcohol use.9

Common reasons people might drink during pregnancy include the following:

  • Conflicting advice. Even today, some people may incorrectly say it is okay to drink to relax or that a small amount of alcohol is not a problem.
  • Coping mechanism. Research shows that women are more likely to drink in response to stress and negative emotions, whereas men are more likely to drink to enhance positive emotions or conform. Further, women who use substances experience higher rates of mood and anxiety disorders than men.
  • Substance use disorders (SUD), including alcohol use disorder. Differences in how women and men perceive and present their problems to health care professionals can make it more challenging to identify women’s SUDs. Men tend to identify substance use as a source of problems, while women will attribute issues to health and mental health concerns (e.g., anxiety or depression) rather than substance use.

Positive Trends

Despite existing concerns, several positive trends have emerged in recent years. For example, mindful drinking encourages people to actively ask themselves questions about why they drink. People who are practicing mindful drinking aim to be more aware of how much alcohol they are drinking and its impact on their lives. A core tenet of this mindfulness practice is that the person should be nonjudgmental when asking these questions.

Another recent trend has been abstaining from alcohol for some time, typically a month. Abstinence commonly occurs during January as people resume their routine lives following the holiday celebrations. Dry January allows people to evaluate the benefits of not drinking. The number of people participating in Dry January in the United States grew from 21% in 2019 to 35% in 2022.10 In many cases, it is considered a short-term test of willpower. However, according to a recent study, many experience lasting benefits, including drinking less than before and forming new, healthier habits. A related and popular term is sober curious. Coined by author Ruby Warrington, “[Being sober curious] means, literally, to choose to question, or get curious about, every impulse, invitation, and expectation to drink versus mindlessly going along with the dominant drinking culture.”11

The alcohol industry has also taken notice, capitalizing on the NoLo movement. The NoLo movement refers to the consumption of no- and low-alcohol drinks containing little to no alcohol content. This movement is attributed to younger generations, who appear to focus more on physical and mental health than older adults. A recent Gallup poll found a decrease in drinking among adults under the age of 35. They also found that among those who do drink, they drink less frequently and are less likely to drink to excess. Conversely, alcohol use among those 55 and older has increased.12 Another popular alternative to alcohol-containing drinks is mocktails. Mocktails are flavorful, non-alcoholic drinks that may include juices, herbs, and soda and are typically made in the same way as their alcoholic counterparts—blended, shaken, or stirred.

Despite concerns, several positive trends are apparent when it comes to women and reduced alcohol use. Additionally, the widespread popularity of the self-care movement has made alternative coping strategies more readily available.