Does Alcohol Affect PCOS & How? All You Need To Know

If you’ve decided to change your diet and lifestyle habits to effectively manage PCOS (Polycystic Ovary Syndrome) you may as well want to learn about the potential effects of alcohol on this condition. Does alcohol affect PCOS at all? Do you have to give up drinking completely or are there any benefits to alcohol in relation to PCOS?

That’s what you’ll find out in this article where I discuss the effects (both positive and negative) of alcohol on PCOS based on the latest research and I’ll give you some tips on how to make healthier choices regarding drinking alcohol.

You can also find more tips on how to fully reverse PCOS through dietary changes here: ‘The Best PCOS Diet (Ultimate Guide)’

How does alcohol affect PCOS?

Liver health
Blood sugar control
Weight management
Sleep
Mental health
Gut health
Fertility & hormone balance

✕ Liver health

Maintaining optimal liver health is absolutely essential for all human beings since the liver is responsible for more than 500 functions in the body. But if you suffer from PCOS you may need to put even more emphasis on keeping your liver in a good condition for a couple of reasons.

One of the many liver functions in the body is the ability to regulate hormone levels in the blood. Since the liver can transform and eliminate excess amounts of sex hormones, thyroid hormones and ‘stress’ hormones, it may also contribute to hormone imbalances if it doesn’t function properly.

That’s why optimizing liver health is one of the key aspects of a successful PCOS management strategy and balancing hormones. However, the liver is also the main organ responsible for processing and eliminating toxic substances in the body, including alcohol.

Unfortunately, this also means that drinking alcohol can negatively impact your liver health and even lead to serious liver damage and dysfunction. There are many liver diseases caused by alcohol consumption but one of the most common ones and usually the first to occur is fatty liver disease.

This condition can be particularly dangerous for women with PCOS as a large proportion of them already suffer from non-alcoholic fatty liver disease. According to research, the main contributors to the increased risk of liver disease in women with PCOS are insulin resistance, obesity and hyperandrogenism.

Alcohol consumption can, therefore, even increase those risks and worsen many of the PCOS symptoms.

✕ Blood sugar control

It is now well recognized that insulin resistance and impaired blood sugar control are closely linked to the development of PCOS. You can find much more information about this issue in my previous article ‘PCOS Insulin Resistance Explained & How To Reverse It’.

But simply put, insulin resistance is a condition when your cells don’t respond to insulin properly. This can lead to high levels of insulin in the blood and too much insulin can make your ovaries overproduce androgens (the ‘male’ hormones) aka PCOS symptoms.

Because insulin production is triggered by an increase in blood sugar levels (from the food you eat) your diet is the key player in controlling your blood glucose and insulin levels. Unsurprisingly, foods that are high in simple sugars can worsen your condition by spiking your blood sugars and triggering insulin release.

While alcohol itself is actually not that high in sugar (distilled liquors usually contain 0 carbohydrates), you can easily end up with an extremely sugary alcoholic drink just by adding a mixer (sodas, juices) or ordering a sweet cocktail, beer or sweet wine.

Those types of drinks can have a massive impact on your insulin levels and lead to worsening of your PCOS symptoms.

On the other hand, too much alcohol can cause your blood sugar levels to drop too low (which is also dangerous) as it prevents your liver from producing glucose. In both cases, alcohol consumption can interfere with your body’s blood glucose management and affect your hormones.

✕ Weight management

PCOS and insulin resistance are also closely related to metabolic abnormalities that may increase the risks of obesity and the inability to lose weight in women with this condition. Unfortunately, being overweight is not only the consequence of PCOS but also one of the contributors. That’s because excess body fat (especially visceral ‘belly’ fat) increases insulin resistance and inflammation.

As multiple studies have demonstrated, weight loss (even by 5%) can significantly reduce many of the PCOS symptoms and therefore it remains the primary strategy in the management of PCOS in overweight women.

However, effective weight loss and sustainable weight maintenance can be only achieved through appropriate lifestyle modifications including diet, exercise, stress management and sleep but alcohol consumption can negatively impact all of those factors.

One way in which alcohol consumption may lead to weight gain is simply its high-calorie content (7kcal/1g). When combined with mixers (sodas, juices, coke) or drank as a cocktail, the calorie content increases even more (sometimes up to 700kcal/drink). Here’s a list of some popular alcoholic beverages and their average calorie content.

1 serving (drink)	calories
Beer	153 kcal
Cosmopolitan	146 kcal
Gin & Tonic	170 kcal
Long Island	276 kcal
Margarita	168 kcal
Mojito	143 kcal
Pina Colada	526 kcal
Rum & Coke	185 kcal
Sex on the Beach	326 kcal
Tequila Sunrise	232 kcal
Vodka & Tonic	189 kcal
White Russian	568 kcal
Wine	128 kcal

source: USDA

By consuming large amounts of alcohol or by drinking too frequently, your overall calorie intake can very easily exceed your calorie output which naturally results in gaining weight.

While alcohol is very calorically dense, at the same time it provides almost no nutritional value to your body in comparison to other foods (it’s very low in nutrients). This is also why alcohol is sometimes referred to as ‘empty calories’.

Additionally, it’s been shown that drinking alcohol increases hunger, appetite and cravings, especially for salty, sugary and fatty foods. That’s because alcohol signals to the brian to activate the ‘starving mode’ which basically tells you to eat more food (and usually not the most nutritious one).

Unfortunately, it’s also very common to make poor food choices the next day (or even a couple of days) due to hangover symptoms, dehydration, sleep deprivation and general lack of motivation. You’re also less likely to exercise and stick to your healthy habits when you’re not feeling your best.

As a result, all of those factors can have a massive impact on your weight and consequently your PCOS symptoms.

If you want to get some tips on how to effectively manage cravings you can read my previous article ‘PCOS Cravings: How To Reduce Appetite & Excessive Hunger‘.

✕ Sleep

You may already know that the role of sleep in general wellbeing, as well as PCOS management, is absolutely essential as it basically affects every single function in our body including hormone regulation, stress and metabolism.

It’s been shown that even short-term sleep deprivation can significantly impact our hormones including insulin, cortisol (the ‘stress’ hormone) and ghrelin (the ‘hunger’ hormone). All of which are closely linked to PCOS and its symptoms.

Getting sufficient high-quality sleep should therefore remain a priority for women with PCOS who are trying to balance their hormones. Unfortunately, the data also shows that PCOS is a risk factor for sleep disorders such as insomnia and sleep apnea due to hormonal abnormalities.

For this reason, you may want to minimize any potential sleep disruptors if you suffer from PCOS. Keeping this in mind you should note that whenever you consume alcohol your sleep gets seriously compromised. Not only in terms of the duration (when you stay up late) but mostly in terms of the quality.

Even if you fall asleep quite easily after a couple of drinks (alcohol can have sedative effects) it can still mess up your natural sleep cycle which goes through different stages (light, deep REM) all of which are essential for optimal health.

According to research, it appears that the restorative sleep stage is affected the most by alcohol consumption before bed (decreased by 24-39%) which can lead to other negative consequences including hormone imbalance and worsening of PCOS.

✕ Mental health

Since alcohol is a type of psychoactive substance with the ability to impact our mood and behavior, it is not surprising that alcohol predominantly affects our brain and mental health.

There is solid evidence showing how excessive alcohol consumption can cause permanent changes in brain function and even lead to brain damage. Additionally, it is also clear that there is a strong association between alcohol consumption and increased risk of depression.

While many people turn to alcohol to quickly relieve stress and cope with anxiety and depression, it usually has the opposite effect and leads to even worse mental health overall (with an increased risk of addiction).

The statistics show that a high proportion of women with PCOS (up to 50%) already suffer from anxiety and depression which is believed to be caused by hormonal imbalances and increased stress levels associated with the syndrome.

Therefore, limiting alcohol intake in women with PCOS is recommended in order to minimize the risks of mental health problems and experiencing depressive symptoms.

✕ Gut health

Although gut health, in general, is a very wide and complex topic, it is now becoming very clear that the state of our microbiome (the bacterial colony in our guts) plays a huge role in our overall health, wellbeing and risks of disease.

Keeping the gut bacteria in balance is important for all individuals aiming for optimal health but if you suffer from PCOS you may want to focus on this aspect even more as the evidence has found a relationship between the state of microbiome and PCOS.

According to studies, women with PCOS tend to have dysbiosis (imbalance of microbial communities) and their gut bacteria are also less diverse. As a result, such disruptions in the gut microbiome appear to promote inflammation and contribute to the syndrome’s development and progression.

It is also the reason why women with PCOS are recommended to improve their gut health and modify their microbiota through dietary and lifestyle changes.

However, alcohol has been shown to have negative effects on gut health as it may disrupt the microbial balance, increase permeability of the intestinal lining ( creating ‘leaky gut’) and cause inflammation.

Chronic inflammation in the body can cause a series of health problems in women with PCOS including overproduction of androgens (the ‘male’ hormones) that are responsible for the majority of the symptoms.

For this reason, limiting the consumption of inflammatory food and drinks, including alcohol, may help manage PCOS and reduce its symptoms.

✕ Fertility & hormone balance

Disrupted menstrual cycle (irregular periods, amenorrhea) is one of the 3 official Rotterdam criteria to be diagnosed with PCOS. That’s because serious hormone imbalances such as PCOS affect the reproductive system and can lead to irregular ovulation and missing periods.

Therefore, women with PCOS are at increased risks of inability to conceive and other fertility issues. However, this doesn’t mean that they are permanently infertile. By restoring hormonal balance and regulating the menstrual cycle, most women with PCOS are able to experience a healthy pregnancy.

While there are many factors that can affect your hormones (both positively and negatively), diet certainly plays a big role, too. Alcohol has been shown to have strong negative effects on hormone regulation and fertility for a number of reasons.

First, it can disrupt your ovulation and menstrual cycle as it can interfere with your sex hormone levels (testosterone, estrogen, progesterone). There is also strong evidence showing that women who drink alcohol regularly have much lower chances of conceiving and their time of getting pregnant is also significantly extended.

Additionally, alcohol consumption in pregnancy (including early pregnancy) can seriously affect the baby’s health development and cause birth defects. That’s why complete abstinence at conception and during pregnancy is recommended ensuring a complete safety of the fetus.

Even if you’re not trying to get pregnant at the moment, but you suffer from PCOS, you may want to consider limiting your alcohol intake as it can help you restore your hormonal balance.

Benefits of alcohol:

Health benefits
Social benefits

✓ Health benefits

On one hand, there are many reasons why limiting alcohol appears to be a good idea for women with PCOS but on the other hand, some research suggests that moderate alcohol consumption may even offer some health benefits.

There is evidence suggesting that drinking alcohol in moderation may reduce the risks of type 2 diabetes, heart diseases and depression. However, it all comes down to the amount and type of alcohol that is being consumed (not to mention other lifestyle habits that are being applied).

Therefore, I wouldn’t recommend consuming alcohol for the sake of its potential health benefits as it’s hardly considered a ‘health food’ but there might be other reasons why having an occasional drink or two might be beneficial for you.

✓ Social benefits

I personally believe that living a healthy lifestyle means finding a balance in all aspects of life including physical, mental, emotional and spiritual health. This also includes connecting with other people, building relationships and having a good time with your family and friends.

Since alcohol is a part of many cultural traditions and forms of entertainment it may still play an important role in your overall wellbeing. If going out with your friends or celebrating with your family involves drinking alcohol (and you enjoy it) you shouldn’t feel restricted, anxious, stressed or avoid those events completely as it may have the opposite effect on your wellness.

It’s all about finding balance, seeing what works for you and what makes you feel the happiest. I personally never drink alcohol on my own as I only like it for the ‘social benefits’ so when there is a social occasion, I love having a few drinks and a good time with my friends.

Whether it’s going out partying with your girls, having a romantic date with some wine, watching an important game with some beer or traveling and exploring new flavors, you can still live a healthy balanced lifestyle and manage PCOS with some alcohol involved (as long as it’s in moderation).

If you decide to include alcohol in your diet, there are a few things to consider to limit the potential risks and negative effects of alcohol on PCOS.

Things to consider:

Personal limit
Type of alcohol
Mixers
Food intake
Water intake
Metformin

• Personal limit

One of the most important things is knowing your own limits and how you personally respond to different amounts of alcohol. We are all different and while the official guidelines recommend no more than 1 alcoholic drink per day for women, your personal tolerance could be completely different (and most likely is).

If you suffer from PCOS and you are actively trying to balance hormones and improve health, drinking even just 1 alcoholic beverage every day may not be the most efficient strategy and the limit is most likely to be much lower.

I personally find that even 1 drink per week is a bit too much for me as I can feel how it impacts my other lifestyle aspects.

Therefore, it’s good to monitor your own body responses to alcohol and how it affects your mood, sleep, dietary choices, stress, energy levels and even PCOS symptoms.

• Type of alcohol

Another thing to consider when you decide to have a drink is what type of alcohol you actually choose. There are so many different kinds of alcohol and they all may affect your body in a different way.

Different types of alcohol vary in the amounts of calories, sugar, nutrients, congeners and alcohol percentage they contain. It is therefore worth considering how those characteristics may relate to PCOS and making a decision based on those criteria.

I’ve created a detailed list of different types of alcoholic beverages and cocktails discussing their effects on PCOS in my article ‘The Best & Worst Alcoholic Drinks For PCOS (Complete List)’ where I also give you some tips on how they can be best enjoyed with minimal risks.

• Mixers

While the type of alcohol you choose to drink plays a big role, it is equally (or even more) important in what form you actually consume it. Since most alcohols are combined with other ingredients such as mixers (coke, soda, juice) or incorporated into specific cocktail recipes, you can expect that their overall nutritional profile and effects on health will also drastically change.

Therefore, you want to be cautious of what else is included in your drink as most mixed drinks and cocktails, in general, are extremely high in sugar and other food additives that may negatively impact your condition. You can check out some PCOS-friendly cocktails and mixers in my complete list here.

• Food intake

The way in which alcohol affects your body is also dependent on other factors including what and how much food you eat. Drinking on an empty stomach to compensate for the extra calories obtained from alcohol is one of the worst things you can do as the alcohol gets quickly absorbed into your bloodstream.

This can be not only dangerous to health but it also usually results in overeating and consuming even more calories in the end. Therefore, it’s best to be prepared by eating a healthy balanced meal that will slow down the absorption of alcohol, keeps you full and satiated and decrease the risks of cravings and overeating.

Make sure you eat a meal with some good source of protein (to keep you satiated), some healthy fats (to slow down the stomach emptying) and some fiber (to slow down the absorption). On the other hand, try to limit foods that are high in sugars and refined carbohydrates (white flour, bread, pasta) as they may cause blood sugar fluctuations and increased hunger.

Foods that are high in sodium (such as salty snacks and fried food) should also be minimized while drinking as sodium can speed up the absorption of alcohol into your bloodstream but it can also enhance the dehydrating effects of alcohol.

• Water intake

It is well known that alcohol has strong diuretic effects which basically means that it makes your body exclude more liquids at a faster rate. Therefore, drinking alcohol can easily make you dehydrated if you fail to sufficiently replace any water losses.

Dehydration from alcohol consumption is also the reason for most of the headaches and hangover symptoms you experience the next day. But other than that it can also disrupt your hormones and increase oxidative stress in your body both of which have been linked to skin problems such as acne (another common feature of PCOS).

It is therefore particularly important to be mindful of your water intake whenever you decide to drink alcohol to prevent those risks due to dehydration. To make it easier, it’s a good practice to have a glass of water with every alcoholic drink you consume. You can also swap the mixers in your drinks for some sparkling water or Seltzer soda to stay hydrated.

It is also important to replenish your fluid losses, electrolytes and nutrient losses from drinking alcohol the next day to speed up your recovery. One of my life hacks is to have an electrolyte drink (developed for athletes) or coconut water (naturally high in electrolytes) the next morning.

I love:
LMNT Electrolyte Drink Mix (best ingredients)
Earth Circle Organics Coconut Water Powder (best taste/quality)

• Metformin

If you take Metformin, which is a commonly prescribed drug for women with PCOS and insulin resistance, you also want to be very cautious with your alcohol intake as they don’t mix together well.

It is generally not recommended to drink alcohol while taking Metformin as it may cause multiple negative side effects including gastrointestinal distress, hypoglycemia (low levels of blood sugar) and lactic acidosis (build-up of lactic acid).

Lactic acidosis can be particularly dangerous as it causes imbalances in the body’s pH levels which may lead to permanent damage of organs and blood vessels.

Therefore, it is best to seek professional advice from your doctor or healthcare provider regarding the safety of alcohol consumption while taking Metformin.

Does alcohol increase the risk of PCOS?

According to research, increased alcohol consumption appears to be a risk factor for developing multiple ovarian disorders including Polycystic Ovary Syndrome (PCOS). Exposure to alcohol may disrupt the menstrual cycle, reduce ovulation and contribute to hormone imbalances in premenopausal women.