Menopause, Hormones & Wine

Menopause is actually the time that periods stop altogether. We call the run up to this the ‘perimenopause’. I’ve noticed, talking to women who come and see me at the surgery, that this can be a really difficult time. One of the commonest complaints women come to me about during this time, other than irregular periods, is worsening of headaches or new terrible headaches. This is an even bigger problem the day after one or two glasses of wine, which would previously have had no untoward effect. The enjoyment of a small glass of wine with friends can wreak havoc during the night and the next day with crashing headaches and a feeling of a super-sized hangover.

Women ask me why they suddenly just cannot tolerate alcohol any more.

Some women swear only certain types of wine have this severe headache inducing effect. It is true that different wines contain different amounts of tannins and sulphites which can certainly cause headaches and more acidity in the stomach. When combined with fizzy drinks, which contain carbonic acid, this acidic effect can even be more pronounced, and drinking on an empty stomach cause a more acidic environment. This acidity could certainly contribute to feelings of nausea and feeling sicky. So sticking to drinking alcohol with food seems to help a bit. Drinking on an empty stomach can become a bit of a no-no.

One of the enzymes which breaks down alcohol in our bodies to get rid of it is called alcohol dehydrogenase. Certain genetic factors play a role in how much of this enzyme we have in our bodies naturally . In fact, a friend of mine with Chinese heritage has so little alcohol dehydrogenase she gets flushed and feels violently sick and giddy with just one sip of wine. The level of this enzyme rapidly starts to decline around the age of 40-50 years and particularly faster in women than in men, where the enzyme levels fall off a little later. The decline in this enzyme can contribute to the toxic effects of alcohol as our bodies just can’t metabolise the alcohol away as efficiently as it once did.

Women’s bodies also tend to get quite dehydrated around the time of the perimenopause. Our muscle mass declines and our fat levels can go up, and the percentage of our bodies made up of water goes down too. So alcohol levels can build up in our blood more easily as it doesn’t dissolve in the fat. Drinking more water and staying hydrated can help. Certainly having a glass of wine on a hot day where all you have had are a few cups of tea and coffee (caffeine is also a massive cause of dehydration), can also be a big trigger for those horrible headaches. Alcohol also completely interferes with our REM sleep phases. So disruption of our deep sleep is likely to contribute to headaches the next day too.

So there are some explanations to these perimenopause headaches. The trick is to try and find out what triggers them for you.

Everything in moderation!

Dr Q