For many women, May, which is Women's Health Month, is a time to prioritize their well-being. For some, that might mean taking a closer, more personal look at their alcohol use.
Alcohol consumption is rising overall — particularly binge drinking — and many people may have a perspective on alcohol that doesn't align with medical guidance, especially when alcohol use is deeply embedded in social life and often encouraged.
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“Women’s health is family health. It’s generational health,” Dr. Lisa Saul, an experienced OB-GYN and UnitedHealthcare’s chief medical officer of women’s health, told NBCUniversal Local in an interview. “It's important that we draw attention to some of the aspects of women's health that don't candidly get talked about a lot, and alcohol use in women is one of those things."
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Alcohol use post-pandemic: A lasting shift
The COVID-19 pandemic didn’t just reshape routines and relationships, it also transformed drinking habits for many. Isolation, stress and the convenience of drinking at home led to a rise in alcohol consumption that for many has continued beyond lockdowns.
From "Zoom happy hours" to increased social acceptance, alcohol became a coping mechanism during a challenging time.
"There's something about those patterns that were established during the pandemic that persisted," Saul said. "I just think it's time for everyone to take a look at how they approach their own alcohol use."
A 2024 study by Keck Medicine of the University of Southern California found that from 2018 to the height of the pandemic in 2020, heavy alcohol use in the U.S. rose by 20%. Overall alcohol use increased by 4%, with adults aged 40 to 49 experiencing the largest jump in heavy use. The increases were sustained in 2022.
Despite the well-documented dangers, alcohol remains the centerpiece of celebrations. Drinking is deeply embedded in everyday life and often in ways that disguise the health risks. Phrases like “wine o’clock” or “mommy juice” have normalized regular drinking as harmless or even as self-care, Saul said.
Hospital admissions due to alcohol for middle-aged women have remained elevated since an increase during the pandemic. A 2023 report in JAMA Network Open found that the rate of alcohol-related deaths is rising faster among women.
"It's easy to normalize a certain level of drinking and not realize that the amount of drinking that you're doing might be classified as binge drinking," Saul said.
How alcohol affects women’s bodies — and pregnancy
Women metabolize alcohol differently from men. Due to differences in body composition, including higher fat distribution and lower body water content, alcohol has a more powerful effect and tends to stay in women’s systems longer.
“It doesn’t take as much alcohol for women to have an impact,” Saul said.
That’s one of the reasons why public health guidelines are different for women. The Centers for Disease Control and Prevention defines binge drinking for women as having four or more drinks on one occasion, and heavy drinking as more than eight drinks in a week. For men, the CDC defines binge drinking as 5 or more drinks on one occasion, and heavy drinking as more than 15 drinks in a week.
Those thresholds are easier to reach than many realize, Saul warns.
Binge drinking is on the rise, particularly among women ages 18 to 25 and middle-aged women. And in certain life stages, such as pregnancy, risks become even more serious. Yet public opinion often blurs that fact, Saul said, leaving some women unsure whether an occasional drink during pregnancy is harmful.
Saul, however, is unequivocal.
"As physicians, we know that there's no safe amount of alcohol" during pregnancy, Saul said. "It's not the alcoholic person that is largely an issue here. Any amount of alcohol and pregnancy can cause complications."
Racial disparities in health care
Studies repeatedly show that Black women face disproportionate risks from alcohol-related health issues, including alcohol-related death, despite generally consuming less alcohol than white women.
In addition to socioeconomic challenges, Saul points to longstanding issues such as medical racism, implicit bias and limited access to culturally competent care as contributors to worse health outcomes and lower trust in providers for Black women and other women of color.
A 2024 study in JAMA Network Open found that implicit bias among health care providers negatively affects communication with Black patients. This can lead to missed diagnoses and inadequate treatment for conditions like substance use disorders.
"Women, in general, don't feel like they're being listened to … but women of color, particularly, are not listened to and are often dismissed," Saul said. "It's a combination of being at higher risk for poor health outcomes and also being at higher risk for not seeking care … when help is needed because of experiences of not being listened to anyway."
Saul said she's experienced some of those inequities herself in the past but sees hope from women in health care to address them.
"There is an amplified message that we're hearing from women saying these experiences are not OK. We want different. We want better. We have questions. We want answers," Saul said.
Alcohol's health toll
In January 2025, the U.S. Surgeon General issued a landmark "Alcohol and Cancer Risk" advisory highlighting the link between alcohol consumption and cancer.
Alcohol is the third leading preventable cause of cancer in the United States, following tobacco and obesity. Alcohol is responsible for nearly 100,000 cancer cases and approximately 20,000 cancer-related deaths each year, according to the report.
Even light to moderate drinking can increase the risk of developing at least seven types of cancer: breast, colorectal, esophageal, liver, mouth, throat, and larynx cancers.
However, public knowledge of these risks is limited. A 2019 survey by the American Institute for Cancer Research found only 45% of Americans believed alcohol significantly impacts cancer risk — compared to 91% for radiation, 89% for tobacco, 81% for asbestos and 53% for obesity.
Beyond cancer, alcohol also carries other long-term health risks, including alcohol-related dementia and weight gain due to excess calories, both of which can contribute to chronic illness over time, Saul said.
How to improve your health
For women who want to evaluate their drinking, Saul recommends a simple step: visit the CDC’s "Check Your Drinking" alcohol assessment tool for a confidential self-check.
She also recommends trying alcohol alternatives, such as nonalcoholic cocktails or wine, and, if needed, reaching out to a primary care provider or employee assistance program.
"The best thing to do is not feel shame," Saul said. "The purpose of this is really to educate and elevate this as an issue so that we can all move towards a better sense of wellness and health."
Wellness isn’t about perfection. It’s about paying attention to all the details of your overall health, even if small, and making incremental changes one day at a time to avoid feeling overwhelmed, Saul said.
"The choices we make every day may not feel like they're consequential or life-threatening or life changing ... from what we choose to consume to how much sleep we get at night, to the things we worry or stress about, they are all little components of makes us well or not well," Saul said.
