title: Medical risks for women who drink alcohol.
abstract: OBJECTIVE
  To summarize for clinicians recent epidemiologic evidence regarding medical risks of alcohol use for women.
  
  
  METHODS
  MEDLINE and PsychINFO, 1990 through 1996, were searched using key words "women" or "woman," and "alcohol." MEDLINE was also searched for other specific topics and authors from 1980 through 1996. Data were extracted and reviewed regarding levels of alcohol consumption associated with mortality, cardiovascular disease, alcohol-related liver disease, injury, osteoporosis, neurologic symptoms, psychiatric comorbidity, fetal alcohol syndrome, spontaneous abortion, infertility, menstrual symptoms, breast cancer, and gynecologic malignancies. Gender-specific data from cohort studies of general population or large clinical samples are primarily reviewed.
  
  
  RESULTS
  Women develop many alcohol-related medical problems at lower levels of consumption than men, probably reflecting women's lower total body water, gender differences in alcohol metabolism, and effects of alcohol on postmenopausal estrogen levels. Mortality and breast cancer are increased in women who report drinking more than two drinks daily. Higher levels of alcohol consumption by women are associated with increased menstrual symptoms, hypertension, and stroke. Women who drink heavily also appear to have increased infertility and spontaneous abortion. Adverse fetal effects occur after variable amounts of alcohol consumption, making any alcohol use during pregnancy potentially harmful.
  
  
  CONCLUSIONS
  In general, advising nonpregnant women who drink alcohol to have fewer than two drinks daily is strongly supported by the epidemiologic literature, although specific recommendations for a particular woman should depend on her medical history and risk factors.
authors.affiliation: Health Services Research and Development, Medicine Service, VA Puget Sound Health Care System, Seattle Division, WA 98108, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Bradley
authors.forename: S
authors.initials: S
authors.lastname: Badrinath
authors.forename: K
authors.initials: K
authors.lastname: Bush
authors.forename: J
authors.initials: J
authors.lastname: Boyd-Wickizer
authors.forename: B
authors.initials: B
authors.lastname: Anawalt
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000209:etiology; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000209:etiology; D005833:Genital Neoplasms, Female / Q000209:etiology; D006801:Humans; D008107:Liver Diseases / Q000209:etiology; D008297:Male; D015663:Osteoporosis, Postmenopausal / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology; D012309:Risk-Taking; D012727:Sex Characteristics