MEDICAL RISKS FOR WOMEN WHO DRINK ALCOHOL

OBJECTIVE:To summarize for clinicians recent epidemiologic evidence re garding medical risks of alcohol use for women. METHODS: MEDLINE and P sychINFO, 1990 through 1996, were searched using key words ''women'' o r ''woman,'' and ''alcohol.'' MEDLINE was also searched for other spec ific topics and authors from 1980 through 1996. Data were extracted an d reviewed regarding levels of alcohol consumption associated with mor tality, cardiovascular disease, alcohol-related liver disease, injury, osteoporosis, neurologic symptoms, psychiatric comorbidity, fetal alc ohol 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 pr imarily reviewed. MAIN RESULTS:Women develop many alcohol-related medi cal problems at lower levels of consumption than men, probably reflect ing women's lower total body water, gender differences in alcohol meta bolism, and effects of alcohol on postmenopausal estrogen levels. Mort ality and breast cancer are increased in women who report drinking mor e than two drinks daily. Higher levels of alcohol consumption by women are associated with increased menstrual symptoms, hypertension, and s troke. Women who drink heavily also appear to have increased infertili ty and spontaneous abortion. Adverse fetal effects occur after variabl e amounts of alcohol consumption, making any alcohol use during pregna ncy potentially harmful. CONCLUSIONS: In general, advising nonpregnant women who drink alcohol to have fewer than two drinks daily is strong ly supported by the epidemiologic Literature, although specific recomm endations for a particular woman should depend on her medical history and risk factors.