Sex and Gender Considerations on Alcohol Use and Health

Key points

  • The body's ability to process alcohol depends on many factors, including body size; amount of water, fat, and muscle; and hormones.
  • These factors can differ by sex and sometimes by gender.
  • Together these can lead to differences in how people process alcohol and how alcohol affects their health.
Group of four friends walking in a park.

Background

Alcohol can affect any part of your body. Excessive alcohol use increases your risk of developing a disease, getting injured, or dying sooner.

Factors that affect your body's ability to process alcohol:

  • The amount of alcohol you drink.
  • Time between your drinks.
  • Alcohol tolerance (needing to drink more alcohol than you used to drink to feel the same effects).
  • Whether you've eaten recently or have had other drinks, like water.
  • Taking certain hormones or medicines or using other drugs.
  • Body size and weight.
  • Body composition, including the amount of water, fat, and muscle your body is made of.

General differences in how people's bodies handle alcohol

Fact‎

The more alcohol a person drinks, the greater the risk of harmful health effects.

Differences in people's bodies affect how they process alcohol. Although not everyone identifies as a man or woman, most of the research on the effects of alcohol on the body has involved men and women. It shows that there are differences in how men and women process alcohol.

Why alcohol affects men and women differently

  • Men (on average) have larger body sizes, more muscle mass and weight, and less body fat than women.
  • Men and women have different hormone levels. Hormone levels can also vary for each person and can be affected by certain medicines.

How alcohol affects men and women's bodies differently

Compared to men, women generally:

  • Absorb more alcohol and take longer to process it.
  • Have higher blood alcohol levels after drinking the same amount of alcohol.

This is why women might experience:

  • The effects of drinking alcohol more quickly and for longer.
  • Certain harmful effects at lower levels of drinking.
    • But it's important to remember that people who aren't women still experience health risks from drinking too.

Alcohol can affect men's and women's health differently

On average, men tend to drink alcohol and binge drink more than women.

Men's health

Hospitalizations and deaths

Compared to women, men:

  • Are hospitalized for alcohol-related harms at a higher rate.
  • Have higher rates of alcohol-related deaths.

Motor vehicle crashes

People who drive while intoxicated from alcohol and are involved in deadly motor vehicle crashes are more likely to be men than women.

Cancer

  • Alcohol use increases the risk of cancer of the mouth, throat, esophagus,A liver, voice box (larynx), and colon and rectum—which are more common among men.12
  • Drinking alcohol may also increase the risk of prostate cancer.1
  • Of all alcohol-related cancers that affect men, liver cancer from alcohol use causes the most deaths.3

Women's health

Liver disease

Compared to men, women who drink have a higher risk of:

  • Developing cirrhosis (scarring of the liver) and other alcohol-related liver diseases.
  • Dying from alcohol-related liver diseases.4

Brain health

Alcohol can lead to a quicker decrease in mental functioning among women compared to men.

Heart health

Women who drink excessively have a higher risk of damage to the heart muscle at lower levels of alcohol use and over fewer years than men.

Cancer

  • Alcohol use increases the risk of several types of cancer, starting at different levels of alcohol use. The risk of some cancers, such as breast cancer (in women)B, increases with any amount of alcohol use.2
  • Of all alcohol-related cancers that affect women, breast cancer from alcohol use causes the most deaths.3

Additional gender-related considerations

Sexual and reproductive health

Alcohol use can reduce the function of sexual organs and the production of certain hormones. This can cause:

  • Erectile dysfunction in men.
  • Fertility problems in any person.

Also, any alcohol use during pregnancy can affect reproductive, infant, and family health, by leading to:

Risk-taking behaviors

Societal pressures and other community factors may influence people's decisions to take certain health risks. People may also be more likely to engage in certain health risk behaviors because of individual factors, such as when they drink excessively. This can put a person at risk of becoming ill, getting injured, or dying sooner.

In general, men are more likely than women to:

  • Misuse prescription drugs or use illicit drugs.
  • Have sex without protection.
  • Not wear a seat belt in a vehicle.

Some people who identify as being part of a sexual or gender minority group are also more likely to engage in these behaviors, like drug use or having sex without protection.

  • People who identify as a gender minority also have higher rates of excessive alcohol use compared to individuals who identify as cisgender.D This may be the result of social and structural issues, like stigma, discrimination, and lack of social and emotional support.

Sexual violence

  • Alcohol use, particularly binge drinking, can increase someone's risk for committing or experiencing sexual violence.6
    • Communities may have a general tolerance of sexual violence and may be influenced by societal norms that maintain differences in power based on one's gender.
    • Those factors can make it more likely for sexual violence to occur, especially when alcohol is involved.
  • Sexual violence is experienced more by:
    • Women compared to men.
    • Individuals who identify as a gender or sexual minority compared to individuals who identify as cisgender or heterosexual.E

Resources

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Content Source:
National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP); About the Division of Population Health; CDC Alcohol Program
  1. Of the types of esophageal cancers, only squamous cell carcinoma is related to alcohol.
  2. The risk of alcohol use leading to breast cancer in men has not been established.
  3. Alcohol use during pregnancy increases the baby’s risk of Sudden Infant Death Syndrome (SIDS), which is after birth.
  4. A person's current gender identity is the same as their sex at birth.
  5. A man who is primarily attracted to women or a woman who is primarily attracted to men.
  1. Bagnardi V, Rota M, Botteri E, et al. Alcohol consumption and site-specific cancer risk: A comprehensive dose-response meta-analysis. Br J Cancer. 2015;112(3):580-593. doi:10.1038/bjc.2014.579
  2. Centers for Disease Control and Prevention and National Cancer Institute. U.S. Cancer Statistics Data Visualizations Tool. U.S. Department of Health and Human Services. June 2024. Accessed June 25, 2024. https://www.cdc.gov/cancer/dataviz
  3. Esser MB, Sherk A, Liu Y, Henley SJ, Naimi TS. Reducing alcohol use to prevent cancer deaths: Estimated effects among U.S. adults. Am J Prev Med. 2024;66(4):725–729. doi: 10.1016/j.amepre.2023.12.003
  4. Ji H, Cheng S; Heart-Liver Axis Research Collaboration. Sex differences in prevalence and prognosis of steatotic liver disease phenotypes: Biological sex matters. J Hepatol. 2024;80(2):e68-e69. doi:10.1016/j.jhep.2023.08.013
  5. Moon RY, Carlin RF, Hand I; Task Force on Sudden Infant Death Syndrome and The Committee on Fetus and Newborn. Evidence Base for 2022 Updated Recommendations for a Safe Infant Sleeping Environment to Reduce the Risk of Sleep-Related Infant Deaths. Pediatrics. 2022;150(1):e2022057991. doi:10.1542/peds.2022-057991
  6. Basile KC, Smith SG, Liu Y, et al. Victim and perpetrator characteristics in alcohol/drug-involved sexual violence victimization in the U.S. Drug Alcohol Depend. 2021;226:108839. doi:10.1016/j.drugalcdep.2021.108839