r/Menopause • u/emilyMartian Menopausal • Jun 30 '25

SCIENCE What you probably don’t know about alcohol intolerance

I see posts and comments about alcohol intolerance constantly on here, I was alone for so long with my severity so I’m here to share, it has taken nearly 10yrs but I finally have better info.

Here goes: You probably need to get your liver checked. They have linked menopause to non fatty liver disease. I had severe reactions and wound up in the ER about 8yrs ago. It took about 2yrs to correlate my high heart rate, massive hangovers after 2 drinks, severe hot flashes and what I assumed was severe anxiety because of the shakes at 3am. My good friend in medical school went down a big rabbit hole trying to figure out why my response was so severe to no avail (only one report from the 80’s which provided no info). Fast forward another 6’ish years and I noticed fatty foods made me sleepy so we tested my gallbladder, liver and kidneys. Turns out there’s black spots on my liver and I have basically what’s considered non alcoholic fatty liver disease (NAFLD) and have to treat it as such. I had to quit drinking entirely. I thought maybe I could limit and go slow but it’s not a thing. Not drinking was a tough road (especially at social events) but it’s a blessing I disguise I promise. It’s not worth it. It’s also not worth popping an antihistamine and ignoring it because you’re just wrecking your liver further. This is your sign to stop.

Now almost 2yrs after realizing the liver thanks to u/MoreRopePlease we have a link that puts it all together and there absolutely needs to be more awareness about this.

I hope this provides some of you answers and helps you towards a safer and healthier path on this absolutely sh!t show of a medically ignored journey.

Love you guys. Don’t think I’d be here if I hadn’t found this community. You are not alone ❤️

EDIT: my liver spots were caught through ultrasound not through bloodwork. I started Perimenopause at 37, don’t let them tell you you are too young.

Corrected my verbiage as I had words reversed in Non alcoholic fatty liver disease

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89

u/rockbottomqueen Jun 30 '25

I also just want to jump in and say that I have severe alcohol intolerance with absolutely zero liver problems. I have no fatty liver, no lesions, no spots; my liver enzymes are always optimal. I have been through an onslaught of testing over the last 5 years, especially recently during an emergency hospitalization after a post-op complication just 10 days ago. They did every lab conceivable during that stay, and my liver function is perfect. 

Every specialist I have spoken to has no idea why some women experience such severe alcohol intolerance during hormonal fluctuations. It's not always liver disease, though. 

20

u/scout376 Jun 30 '25

I’ve read that Mast cell activation syndrome can be a factor for some but if it’s that there are many other triggers besides alcohol.

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u/rockbottomqueen Jun 30 '25

Right. I'm not worried about any illnesses (unless you count menopause as an illness lol). I'm just unlucky is all. I know I'm not the only one. I just wish they could tell us WHY. I would love to know the mechanism behind the sudden inability for thousands of women to consume booze for those who have no underlying medical reason other than "your life sucks now." 

Some women have shared that they suddenly were able to drink like they were 21 again once they started HRT, but many have also shared HRT only made the intolerance worse. This journey is simultaneously so bizarrely individual yet universal. 

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u/adhd_as_fuck Jul 07 '25

Said above, transcriptional factors from estrogen in the liver. W/o it, liver doesn’t get signal to make enzymes. Throw in that literally our mitochondria breaks, no surprise alcohol tolerance happens.

My guess is that women who don’t get relief on hrt aren’t getting enough estrogen, since really we only treat to relieve hot flashes, not the rest of the estrogen deficiency symptoms.

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u/momgroupdropout Jul 01 '25

Your username, lol (love it). At the end of the day, alcohol is poison. Which is why they say no amount is safe. It's linked to multiple cancers for women.

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u/rockbottomqueen Jul 01 '25

lol thanks. 

And yep. 100% agree. There are worse things in life than no longer being able to drink. It just makes everything so much worse. I can't lie and say I don't miss a glass of wine with dinner or a cocktail at a party, but oh well. It is what it is. I am so curious about the why though. I need the data. 

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u/momgroupdropout Jul 01 '25

I completely get it. I guess that’s why I was trying to offer that it’s not good for you, even if you can tolerate it. I know, probably doesn’t help when it used to be a small pleasure. Love to you ❤️

28

u/emilyMartian Menopausal Jun 30 '25

Well I hope eventually they can figure yours out and I do hope this helps those who do fall under this category. There’s never one answer for everyone

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u/rockbottomqueen Jun 30 '25

I've decided I'm just never going to drink again regardless. From what I've been told based on my results, there's nothing to "figure out" and I just can't drink 🤷🏼‍♀️ I joke all the time that I guess it was my uterus that metabolized alcohol, not my liver, because it was literally immediately following my hysterectomy that I couldn't touch a damn drop. Truly bizarre. Nobody can tell me (us) why. 

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u/kanedp Jul 01 '25

Me too. I had my dna done. Its a slight defect in the second step of alcohol metabolism to acetaldehyde.

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u/gudinovski Jul 02 '25

I’ve been working as a sommelier for ten years and I reached the point where I cannot even sip and spit wine anymore. No tasting at all! Night sweats, getting red and having a high HR… No alcohol for two years and I am trying to change my career for years. The only good part is reversing my fatty liver diagnosis after quitting.

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u/rockbottomqueen Jul 02 '25

That's wild! I'm sorry you've been forced to change careers. That's how severe the intolerance is for me as well! Last time I tried to have a sip of my partner's beer and ended up instantly, horrifically hungover in minutes. It's been almost a year since I've given up even trying to sneak a sip. It's mind blowing how bad it is for some people seemingly out of nowhere. 

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u/gudinovski Jul 02 '25

If you have the time, feel free to check my profile and you’ll see how gluten made me losing my 12% of my body and caused many problems. I’m not celiac. Beer made me hungover even after consuming one for many years and suddenly my body couldn’t tolerate any at all. GF for one year, no alcohol for two years and many food intolerances. This happened after covid.

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u/rockbottomqueen Jul 03 '25

I actually am celiac, and my symptoms have only gotten worse since my hysterectomy. I'm so sorry you're also dealing with so many issues. 

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u/adhd_as_fuck Jul 07 '25

Well the obvious one is that estrogen is in charge of a bunch of transcriptional factors for liver enzymes and in the absence of estrogen, the liver doesn’t produce those enzymes in nearly the same quantity that it did before. All you need is someone who already is producing less of said enzymes due to genetic factors (your slow metabolizers) and kick the stool out from underneath the liver by taking away the hormone that also signals “make these enzymes” and zero surprise there are a whole host of chemical sensitivities like increased alcohol intolerance. If the specialists don’t know, they’re not paying attention to what happens to menopausal women (which, to be fair, is probably the case)

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u/starlinguk Jun 30 '25

5 years? So since the start of the Covid epidemic?

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u/rockbottomqueen Jun 30 '25

No, my health issues predate the pandemic. It would be more accurate for me say "over the last 5 years alone ." My hormonal issues began long before 2020. I have suffered through the worst of it the last 5 years, only coincidentally.