PCOS and Alcohol

Introduction

The following article puts light on the association of PCOS and consumption of alcohol in an attempt to better understand the impact of ethanol on women’s fertility, fluctuation in hormonal balance and underlying issues. Alcohol consumption represents a major concern with a substantial portion of women of reproductive age involved in addictive habits of drinking.

What is PCOS?

Polycystic ovary syndrome (PCOS) is a hormonal imbalance that affects how a woman's reproductive system functions. It causes high levels of testosterone, which can cause unusual side effects like excess hair growth and acne, as well as irregular menstrual periods and obesity. Polycystic ovary syndrome is treatable with birth control pills or medications to manage high cholesterol and hormones for women. Some women may need medication or surgery to shave off excess hair around the face or underarms by using lasers or electrolysis.

Symptoms

The common symptoms related to PCOS are:

  1. Skipped/ Irregular periods: Women with PCOS tend to have fewer periods. This is because there is a lack of ovulation that prevents the uterine lining from shedding every month
  2. Central Obesity: 80% of women with PCOS experience weight gain around the abdominal region
  3. Acne: Breakouts on face, chest and upper back have been reported due to an increase in male hormones
  4. Heavy Bleeding: The periods are usually heavier because the uterine lining builds up for a longer period of time
  5. Hair growth: Hyperandrogenism is observed due to excessive presence of male hormones such as testosterone, androsterone and androstenedione in women resulting in hair growth on their face and body
  6. Male pattern baldness: Hair gets thinner on the scalp and chances to fall out are increased
  7. Migraines/ Headaches: Fluctuations in the hormones trigger headaches in some females

Heavy drinking often worsens PCOS symptoms

Alcohol consumption may be largely linked to having Polycystic Ovarian Syndrome (PCOS), as its common symptoms are linked to high insulin levels. This is because women suffering from PCOS usually have higher than average levels of insulin which is produced in the pancreas that helps the cells to convert glucose into energy. Many women with PCOS are insulin resistant which in turn leads to high blood sugar, the body tries to counteract this by pumping out loads of insulin to keep blood sugar steady. Additional androgen hormones are produced by the ovaries in response to higher levels of insulin, which is where many PCOS symptoms stem from.

Blood sugar is greatly affected by the food and drinks we consume. A diet high in refined carbohydrates is obviously going to be an issue. Likewise, there are certain contents of alcoholic beverages such as resveratrol in red wine which are thought to alter insulin levels in the body.

The National Institute of Alcohol Abuse and Alcoholism has addressed the concern that regular heavy drinking is responsible for causing irregular or skipped periods. Alcohol is known to temporarily increase oestrogen and testosterone levels and disturb the typical hormonal fluctuations that take place during an ovulation cycle.

Alcohol drinking does affect menstrual cycle, general health and PCOS symptoms in spite of the fact that drinking is restricted to one glass of wine a week or vodka every night.

Lower levels of progesterone

Serum progesterone levels in PCOS women are low and as a result of this they are anovulatory or non-ovulatory. Luteal concentrations of progesterone in women with PCOS are similar to those of normal women.

In women with PCOS, multiple small cysts accumulate in the ovary and none of the cysts or follicles are capable of growing to a size that would trigger ovulation. As a result of this, the levels of progesterone, oestrogen, LH and FSH levels are imbalanced.

Ethanol affects oestrogen metabolism

Heavy drinking disturbs the communication between the endocrine, nervous and immune system thus causing hormonal imbalances which leads to some serious psychological and physiological problems.

Ethanol influences oestrogen metabolism by causing an increase in aromatase activity in the liver and other tissues, stimulating conversion of androgens to oestrogens. It is important to stress that alcohol ingestion, even in insufficient amounts, causes permanent tissue damage and can disrupt the delicate balance critical to maintain human female reproductive hormonal cycles.  

If you’re worried about you or your loved one’s alcohol intake

The struggle with PCOS is real and cutting back on alcohol intake to gain more control over the symptoms can help. Medications like metformin prescribed for PCOS usually do not go very well with alcohol. Mixing alcohol and medications is a risky business. Always make it a priority to limit alcohol drinking and be in check with the concerned doctor when on certain tablets.

Due to PCOS a woman's ovaries do not function properly because of the high levels of insulin in her blood. The ovaries become non-functional and stop releasing eggs, so she has trouble getting pregnant.

Encouraging your loved ones suffering from PCOS to undertake a healthy lifestyle can have positive effects on PCOS symptoms. Managing blood sugar and cutting down on alcohol intake reduces the likelihood of liver issues which can in turn lead to better quality of life.

Conclusion

PCOS is a condition that can affect your menstrual cycle, fertility, and future baby success. While there can be numerous symptoms that are related to PCOS, the general idea is that you have to live with these symptoms.

PCOS symptoms may take time to go away completely but improving the overall lifestyle in terms of diet and exercise can further help to reduce insulin resistance over time. Including physical activity, limiting alcohol intake, reducing stress levels and adopting a healthy diet can have a noticeable improvement on ovulation and help it become more regular.

References

  1. de Angelis C, Nardone A, Garifalos F, Pivonello C, Sansone A, Conforti A, et al. Smoke, alcohol and drug addiction and female fertility. Reprod Biol Endocrinol [Internet]. 2020 Dec [cited 2022 Nov 26];18(1):21. Available from: https://rbej.biomedcentral.com/articles/10.1186/s12958-020-0567-7
  2. Chang RJ, Kazer RR. Polycystic ovary syndrome. GLOWM [Internet]. 2014 [cited 2022 Nov 26]; Available from: https://www.glowm.com/section-view/item/300

Tasneem Kaderi

B.D.S., PGDHHM, PGDMLS, PGDCR-PV

Tasneem is a dental practitioner since 5 years in India. She is also a Medicolegal consultant plus Hospital and Healthcare Administrator since 2 years. She has a diploma in Clinical Research and Pharmacovigilance and is working as a Data Analyst for Medical Devices at 3Analytics, California. An avid reader and optimist at heart, loves to scribble here and there.

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