For numerous women navigating midlife, alcohol tolerance can undergo surprising transformations during the perimenopausal phase. From sleep disturbances to histamine responses, specialists elucidate to journalist Rosamund Hall why wine might exert stronger effects and how to consume beverages more comfortably.
The Hormonal Turbulence of Perimenopause
Richa Puri, an independent prescribing pharmacist and women's health specialist, provides clarity on the physiological changes. "Perimenopause represents a turbulent period for many women, and as oestrogen levels begin to fluctuate, some discover they suddenly tolerate alcohol less effectively than before," Puri explains. "That can manifest as increased anxiety, hot flushes, histamine-type reactions such as skin flushing or itching, disrupted sleep patterns, and simply feeling disproportionately unwell the following day."
Wine can be especially triggering due to its content of tannins, sulphites, and histamines, with added sugar in certain drinks potentially driving inflammation, leading to symptoms like aching joints and puffiness.
Increased Drinking Risks During Hormonal Fluctuations
There exists a concerning risk that during this hormonal instability, women might actually consume more alcohol. Hormone health expert Dr Louise Newson references a 2023 survey by Newson Clinic involving nearly 1,200 women, revealing that one in three respondents reported drinking more since becoming perimenopausal or menopausal. Alarmingly, one in eight women regularly exceed the recommended intake of 14 units weekly to alleviate symptoms.
Newson highlights a specific vulnerability for women already grappling with addictive behaviours, which can intensify during perimenopause and menopause, likely due to the loss of sex hormones in the brain. Progesterone, estradiol, and testosterone all exert significant effects on brain chemistry, and when these hormone levels fluctuate or diminish, dopamine and other neurotransmitter levels can decrease. This hormonal upheaval, combined with life's pressures, can place women in a precarious situation.
Why Alcohol Effects Amplify in Midlife
Puri further elaborates on the physiological reasons behind heightened alcohol sensitivity. "Part of the explanation is that our liver must work harder to metabolise alcohol as we age, because the enzymes involved naturally decline," she states. "That can result in oestrogen lingering in the system longer, potentially aggravating perimenopausal symptoms."
Variations in Wine Impact: Histamines and Tannins
When discussing histamines and tannins, the focus primarily falls on red wines, which typically contain several to dozens of times more histamines than white wines. Histamines are naturally produced during fermentation and ageing processes, being far more prevalent in red wines as they are fermented with grape skins and seeds, rich in amino acids that convert into histamine during winemaking.
However, red wine enthusiasts need not abandon their preference entirely. Certain grape varieties tend to be more dominant, including merlot, cabernet sauvignon, malbec, and syrah, which also possess higher tannin levels. Instead, opt for younger, lighter-skinned varieties such as pinot noir or gamay, which are lower in both histamines and tannins, avoiding the big, alcoholic bruiser wines.
Guidance on White, Rosé, and Sparkling Wines
White, rosé, and sparkling wines generally contain lower histamine levels because their production processes involve minimal contact with grape skins. For sparkling wines, selecting bottles labelled "brut" or "extra brut" ensures lower sugar content. With white wines, most varieties are safe, but focusing on younger wines, indicated by recent vintages on labels, and dry styles is advisable.
Embracing a "less but better" philosophy proves beneficial, choosing only favourite dry white wines and occasional champagne for bubbly indulgence. Avoiding cheap pub pinot grigio aligns with this mindful approach.
Practical Drinking Recommendations
Heeding parental advice remains relevant: avoid drinking on an empty stomach and maintain hydration. Puri recommends, "Cut back a little, and have any alcohol with a protein-rich meal." Moderation involves focusing on what and how much you drink, and how it makes you feel. Pouring smaller quantities and savouring each sip can yield equal pleasure.
Alternating between alcoholic and non-alcoholic drinks is wise, though be cautious of "no-lo" beverages with high sugar levels. Remember, an opened bottle need not be finished immediately; simply re-cork and refrigerate for two to three days, applicable to both reds and whites.
Positive Outlook and Final Thoughts
Puri offers reassuring news: "For most women, this phase is temporary and, once they transition into menopause and oestrogen levels stabilise at a lower baseline, they often find they can enjoy the occasional glass of wine again, just not quite as they did at 21."
Mindful drinking is crucial for everyone, but alcohol can affect midlife women distinctly. Wine remains a joyous aspect of life, designed for sharing. Emphasising social connections over a bottle with friends and great food, or enjoying a glass in a scenic wine region, enhances the experience. Wine, consumed moderately, should not be about coping with stress but about being present in life. Ensuring women have accessible support during midlife, rather than muddling through, is a cause worth raising a glass to.
Recommended Wines for Gentler Drinking
Regis de Valliere Pouilly-Fuisse, Burgundy, France, 2024 - Tesco, £25, 13% ABV. A decadent yet refined chardonnay with aromas of ripe apples, spring blossom, and soft white peaches, featuring lively acidity.
'The Best' Gruner Veltliner, Morrison's, Austria, 2024 - Morrisons, £10, 11.5% ABV. A lower-alcohol, low-histamine white with crisp green apples, citrus, and white pepper notes.
Verdicchio dei Castelli di Jesi, Italy, 2024 - Co-op, £8, 12.5% ABV. An underappreciated Italian white offering juicy pineapple and lemon flavours.
Beaujolais-Villages, Louis Jadot, France, 2024 - Tesco, £13, 12.5% ABV. A light-tannin, low-histamine gamay with red cherries, strawberries, and raspberries, versatile with food.
Valpolicella Coffele 2024, Italy, 2024 - The Wine Society, £13.95, 12.5% ABV. Crafted by sibling winemakers, featuring sour amarena cherries, summer berries, and rose petals with balanced acidity.
Taste The Difference Chilean Pinot Noir, Valle de Bio Bio, Chile, 2024 - Sainsbury's, £9.50, 13% ABV. An affordable, bold pinot noir with dark cherries, plums, cloves, vanilla, and a soft finish.
