A Certain Age: alcohol and midlife

Part 7 of the ‘Women & Alcohol: A Life in Balance’ series

If there’s one thing I’ve learned writing about women and alcohol, it’s that our relationship with drinking isn’t static — it evolves as we do. The impact shifts as we move through life’s stages, especially with the unique twists that come with being a woman.

Perimenopause can feel like a moving target. Hormones shift, sleep patterns change, and what once worked for you—whether that’s a calming glass of wine or your usual self-care routine—suddenly doesn’t feel the same. I gave up drinking in my forties. It wasn’t a decision as such, I just noticed that drinking was becoming less appealing, the recovery times were prohibitive, and the hangovers were getting worse. It just wasn’t worth the effort anymore.

Like me, many women find that drinking is one of the first things they notice changing during perimenopause. A drink that used to feel relaxing now seems to worsen hot flushes, disrupt sleep or leave behind an anxiety ‘hangover.’ And it’s not in your imagination—biological changes in midlife genuinely alter how alcohol affects your body and mind.

Oestrogen and progesterone don’t just influence fertility. They affect brain chemistry, liver function, sleep and even how your body regulates temperature. When these hormones fluctuate in perimenopause, alcohol’s impact intensifies.

These hormonal changes can make alcohol cravings stronger, especially when it’s used to calm restless nights or racing thoughts. For women in recovery, this phase can be especially tough — the combo of hormonal shifts and stress can increase the risk of relapse. Perimenopause can feel like alcohol withdrawal or increased the desire for something to ‘take the edge off’. That’s why support and self-care are so important now, not just for women in recovery, but for all of us.

Many women find their tolerance is lower than it used to be, with even small amounts of alcohol producing stronger effects. Sleep is often disrupted too. While a glass of wine might help you drift off more quickly, it usually leads to restless nights and early waking, often made worse by night sweats. Mood can also be harder to manage. Alcohol interferes with serotonin, the brain’s ‘feel-good’ chemical, which makes post-drink crashes more common. And because your body processes alcohol more slowly in midlife, hangovers can feel heavier, with lingering fatigue, headaches and brain fog that stretch well beyond the morning after.

Alcohol also dilates blood vessels and raises body temperature. For women already navigating hot flushes, this can make them more frequent or more intense. Night sweats often worsen too, leading to interrupted sleep and the exhaustion that follows the next day.

Of course, every woman’s experience is different but it’s not unusual to hear women describe the same pattern: one glass of wine might be manageable, but two almost guarantees waking up in the early hours, overheating and unable to settle. The sense of being robbed of restorative rest can make the following day a struggle. For many of us, perimenopause hits just around the time as the sandwich years begin: our kids become teenagers or our parents need more care and support or we’re peaking in our careers - or all of the above at once! Just when we feel we need that mood-altering, warm-and-fuzzy-making, relaxation-inducing drink the most, it betrays us.

As if that wasn’t bad enough, perimenopause can heighten irritability, low mood and anxiety. Alcohol may feel like a short-term fix, but the rebound effect often makes things worse. Many women talk about the next-day anxiety that seems to strike harder than ever before, bringing racing thoughts, a tight chest and a sense of dread that lingers long after the drinking has ended.

This reaction isn’t a sign of weakness—it’s the result of hormonal changes colliding with alcohol’s natural effect on the nervous system. During this life stage, your body is already more sensitive, and alcohol simply amplifies the strain.

Beyond the immediate symptoms, alcohol can make some of the long-term health risks of midlife more serious. Many women notice weight gain around perimenopause, and alcohol adds empty calories while also disrupting metabolism, making those extra pounds even harder to shift. Bone health is another concern. Falling oestrogen levels naturally reduce bone density, and alcohol makes this worse by interfering with the way your body absorbs calcium.

As we continue to age, our bodies process alcohol differently. For women over 60, health issues, medications and loneliness can all influence drinking habits. Bereavement, empty nesting and retirement are all well-known triggers for increased drinking, but alcohol’s effects on things like bone density, liver health and memory also become more serious at this stage.

Cardiovascular health becomes more important after menopause too. Risks such as high blood pressure, irregular heart rhythms and cholesterol changes are more likely, and regular drinking increases the burden. Breast cancer risk also rises in midlife, and alcohol is a known contributor, even at low levels of consumption.

On the other hand, social drinking can be a positive way to stay connected and avoid isolation. It’s about finding a healthy balance that works for you — no guilt, no shame. But what many women discover as they mature is that drinking less often brings a sense of relief rather than deprivation. Better quality sleep, calmer moods and more consistent energy are some of the most common rewards.

The good news is that you don’t need to give up alcohol completely to notice a difference. Small, intentional changes can bring significant benefits – something we’ve noticed during Dry January campaigns.  Keeping track of when you drink and how you feel the next day can highlight patterns quickly, making it easier to spot what helps and what hinders. Experimenting with alcohol-free alternatives can preserve the ritual of sharing a drink without the negative after-effects, and many women find these swaps surprisingly satisfying.

If you do choose to drink, having alcohol earlier in the evening rather than just before bed can reduce the impact on your sleep. Staying hydrated and pairing alcohol with balanced meals can also help stabilise mood and energy levels. Some women find that deciding in advance how much they’ll drink gives them a greater sense of control, reducing the chance of regret. And if alcohol is making perimenopause symptoms harder to manage, it’s worth discussing with your GP or a menopause specialist, particularly if you’re considering or already using HRT.

This shift is not about restriction, but about freedom. Freedom from anxious mornings, broken nights, and the nagging feeling that your body isn’t coping as it once did. By choosing to reduce alcohol, you give yourself the chance to feel more present, more balanced and more in tune with the changes your body is moving through.

What I’d like you to take away is this: no matter your age or stage, your relationship with alcohol can change — and it’s okay to re-evaluate and adjust. Hormones, stress and life pressures happen, be kind to yourself.

If you’re navigating midlife in recovery, remember - you’re not alone. This stage is challenging, but it can also be a time to reclaim your wellbeing.

What’s coming in the final blog?

‘The Final Chapters: aging with grace’ A look at three life events that can affect our alcohol consumption as we mature