Women's Brains Harder Hit by Alcohol

By: Annette Kornblum

Women suffer for brain impairment from alcohol.
Women suffer for brain impairment from alcohol.
©iStockphoto.com/Emre ARICAN

It has long been known that alcohol takes a greater toll on the bodies and it has long been known that alcohol takes a greater toll on the bodies and minds of hard-drinking women than their male counterparts. Now scientists are peering into the brains of alcoholics for clues about the price of excess on thinking, balance, and motor capacity.

What are they learning? That women do not handle alcohol as well as men and face greater risks of potentially irreversible brain damage, as well as other serious health problems, including liver damage, heart disease and cancer.

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Two new studies detected deficiencies in the gray and white matter and cerebrospinal fluid of alcoholic subjects. All are critical to brain function.

What's more, according to NIH researcher Daniel Hommer, the detrimental effects of chronic alcohol abuse are causing organic damage at younger ages than once thought.

By their 30s, women alcoholics who began drinking 5-10 years before may already be having trouble getting their act together. This includes trouble completing simple problem-solving tasks and impulse control, as in saying no to unwanted sexual advances and yes to keeping commitments at work and home.

No matter that women tend to begin their drinking careers 10 years later and drink less than men. In a recently published article in the Journal of American Psychiatry, Hommer and his colleagues found evidence of brain-related deficiencies in hard-drinking women.

"It's the first time that it's been shown that the part of the brain that does thinking, the cerebral cortex, is more affected in women alcoholics than men," says Hommer. "Hopefully, this will make people aware that heavy drinking in the 20s is dangerous — and that includes binge drinking."

The 36 alcohol dependent women enrolled in the Hommer study were recruited from an inpatient treatment program in Bethesda, Md., and compared after a minimum of three weeks of abstinence with men and others with no history of alcohol or other drug problems. Each were either binge drinkers or consumed the equivalent of 11-12 drinks a day — enough to experience withdrawal symptoms and blackouts. Their brain function was measured by MRI (magnetic resonance imaging), which took account of brain shrinkage and tissue damage to gray and white matter. Hommer says that on average, the MRIs showed up to an 11% loss in brain matter and size compared to healthy female subjects and men.

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Why are women more affected by alcohol?

The results of the NIH study are consistent with other research that shows women do not hold their liquor as well as men. Women are thought to be more sensitive to the effects of alcohol because they are smaller in size and have a lower proportion of body water relative to fat than men. They also have lower concentrations of a metabolizing enzyme which helps to break alcohol down. As a result, they become inebriated more easily. Monthly hormone fluctuations also affect alcohol metabolism and can make blood alcohol content levels jump faster than in men.

Scientists believe that more studies on alcoholic women are needed after short and long periods of sobriety to determine the effects of alcohol on thinking ability, motor skills, and balance — and whether the effects are reversible.

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Why? "In alcoholic men, even when sober, they still have impaired balance, which has implications for broken hips in older age and other potentially life-threatening health problems such as a decline in mental abilities," says Edith Sullivan, associate professor of the department of psychiatry and behavioral sciences at Stanford University and an investigator in an alcohol-related study at Stanford Research Institute. "We don't know whether this is also true in alcoholic women."

Hommer thinks his study should prompt researchers to look to other forms of treatment for women who may have alcohol-induced brain damage. "Women alcoholics do not have a good track record of recovery," he says. "The existing methods aren't working. The thinking has always been that they need different treatment but...we also need to look at the biological reasons as well."

How Alcohol Affects the Brain

Alcohol can wreak havoc on the brain: everything from self-control to loss of inhibitions. Alcohol depresses the central nervous system, lowers inhibitions, and impairs judgment. Drinking can lead to risky behaviors, including unwanted sexual advances, having unprotected sex, or playing around with a gun. In 1998, 35.8 percent of traffic deaths of 15- to 20-year-olds were alcohol-related.

Source: CSAP, SAMHSA, HHS.

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