During his final weeks in office back in January, former Surgeon General Dr. Vivek Murthy, called for alcohol warning labels to highlight its cancer-causing connection. While the majority of Americans are largely unaware that alcohol consumption increases their risk of cancer, 45% agree that having more than two drinks a day is unhealthy, according to a Gallup survey.

Despite alcohol being a Group 1 carcinogen, meaning it is known to cause cancer in humans, and the World Health Organization declaring that no level of alcohol consumption is safe, drinking continues to rise. Binge drinking has increased among older adults, and alcohol-related hospital visits among middle-aged women spiked last year.

Historically, men have consumed more alcohol than women, according to the World Health Organization. Now, the Yale Program on Sex Differences in Alcohol Disorder reports that women in the U.S. have caught up to men, drinking and engaging in harmful alcohol use at the same rate. In 2024, the Centers for Disease Control and Prevention uncovered that between 2016 and 2021, rates of alcohol-related deaths increased by 35% in women, and 27% in men. Studies also show that emergency room visits related to alcohol use rose by 70% in women versus 58% in men from 2006 to 2014, while alcohol-related hospitalizations increased by nearly 70% in women versus 43% in men, from 2000 to 2015.

The Yale program, exploring the neurological drivers of drinking behavior and alcohol use disorder in women, has found that this increase in alcohol use and abuse among women comes with greater health effects seen at fewer drinks than men. Studies have shown that women who drink are at a disproportionately higher risk than men of brain damage, cognitive impairment, cardiovascular issues, liver damage, and worsened immune function. Alcohol also increases women’s risk of hormonal imbalances and menstrual irregularity, as well as several cancers including breast cancer.

Why are women drinking more?

There could be multiple factors influencing why women are drinking more: One of them being shifts in social norms, according to Sherry McKee, professor of psychiatry at Yale School of Medicine and director of the Yale program.

“Women are now earning more, delaying marriage, and delaying childbirth,” said McKee in the Yale School of Medicine (YSM) write-up on the program. “It’s thought that this might create more time and space for drinking.”

Shifts in how alcohol is marketed is another factor researchers are considering. “We’ve seen that marketing toward moms has normalized ‘wine mom culture,’” said Kelly Cosgrove, professor of psychiatry, of neuroscience, and of radiology and biomedical imaging at YSM.

It’s also become increasingly clear that the COVID-19 pandemic drove women’s drinking habits. A 2020 study revealed that the number of days women reported heavy alcohol use—four drinks or more within a couple hours—jumped by 41%.

“It had to do with the amount of time that people were home and the stress that they were under,” Marina Picciotto, professor of psychiatry at YSM, said.

Why alcohol hits women harder

It comes down to physiology: Women metabolize alcohol differently than men. That’s because they usually have a lower percentage of water in the body and more fat tissue than men, which results in less fluid to dilute the alcohol—causing a higher blood alcohol concentration (BAC). Additionally, the primary enzyme involved in the metabolism of alcohol can be as much as 40% less active in women, Yale reports.

That means that if a woman and a man of the same age and weight drink the same amount at the same rate, the woman will still have a greater BAC.

The dangers of alcohol use for women

Yale reports that alcohol-related deaths are rising faster among women—with less alcohol needed to get there. A 2023 study found that men need to drink at least 3.2 drinks per day to be at increased risk of premature death—but women only need to consume 1.8 for their risk to jump.

“Not even two drinks a day is putting a woman at significantly increased risk,” McKee said.

While it is known that alcohol can exacerbate mental health struggles, drinking more puts women’s mental health at greater risk, especially considering the reasons why women are turning to alcohol. The drivers of alcohol use differ among men and women, research shows, with men more often drinking to experience positive emotions and socialization, while women are often picking up a drink to manage their stress.

Women are also less likely to get help than men for alcohol use disorder, according to Yale, for multiple reasons. While social stigma does keep women from seeking treatment, Yale researchers emphasize that the sex-related differences in alcohol use are not often considered in research, diagnosis, and treatment.

A review in Frontiers in Psychiatry found that women comprise only 13% of participants in the research on alcohol withdrawal, while medication trials for treating alcohol use disorder have often focused mainly on men. Just 1% of study participants for the drug disulfiram, one of three FDA-approved medications for alcohol abuse, were women, while another FDA-approved medication, naltrexone, is more likely to have side effects in women such as nausea and sleep disturbances—making them less likely to continue treatment (research has not shown differences in men and women for the third FDA-approved drug, acamprosate).

Through the Yale program, researchers are hoping to create alcohol treatments that are better catered to women and their unique responses to drinking.

“We’re just at the beginning of really understanding what it is about the brain and body that differs between men and women who drink,” said Picciotto.

“We really need to be focused on a personalized medicine perspective—particularly in regard to addiction and alcohol,” McKee added.