Menstrual cycle phases may be linked to increased alcohol craving and drinking

Alcohol craving and drinking: Women have exhibited increased alcohol use, binge drinking, and related problems during the past decade; however, there is little research investigating sex differences in risks for hazardous alcohol use. New research shows that ovarian sex hormone fluctuations may contribute to risks for alcohol craving, drinking, and binge drinking. These results will be shared at the 48th annual scientific meeting of the Research Society on Alcohol (RSA) in New Orleans, Louisiana.

“Prior evidence has shown that ovarian sex hormones such as estradiol and progesterone may influence alcohol craving, intake, and urges to drink, with fluctuating influence throughout the menstrual cycle,” explained Layne Robinson, a clinical psychology doctoral student at the University of Kentucky. “This is particularly concerning as women have higher risks for many alcohol-related problems sooner and at lower drinking amounts compared to men, including liver cirrhosis, heart disease, and brain damage. Additionally, women report finding it more difficult to quit drinking, and relapse more frequently following periods of abstinence than do men.”

Robinson will discuss this research at the RSA meeting on Sunday, 22 June 2025.

For this preliminary study, researchers assessed changes in craving and alcohol intake during the menstrual cycle in 61 naturally-cycling women 21-35 years of age. The young adult women, who reported regularly drinking alcohol at least two times per week, were recruited via community advertisements. They provided daily self-reports of alcohol use and craving, daily salivary samples for hormone analyses for 35 consecutive days, and performed urinary ovulation tests during days 12-35.

Results indicate that menstrual cycle phases, particularly those where estrogen is high and progesterone is low – late follicular, peri-ovulatory phases – may be risky for increased craving and drinking for alcohol.

“Overall, craving and alcohol use have been found to be increased when estradiol levels are high and progesterone levels are low, and this risk diminishes when progesterone levels are high,” said Robinson. “We know that increases in estradiol, the most prominent form of estrogen, can alter dopamine activity in the brain. These changes in dopamine neurotransmission have been found to heighten reward sensitivity, a key mechanism of substance craving and use. The effects of progesterone on the brain and risk for drinking are less clear. However, previous research has found that increases in progesterone may protect against the risky profile of increases in estradiol.”

Also Read: Study Identifies Structural Changes in Women’s Brain during Menstrual Cycles

Robinson hopes that better understanding of sex-specific risks for drinking will contribute to a reduction in women’s hazardous drinking. “If women were aware of risky periods for drinking and alcohol craving, such as certain menstrual cycle phases or reproductive periods, they may be able to take precautions to reduce their drinking,” she said. “Mental health professionals would be able to more accurately assess and understand women experiencing alcohol-related problems. It is also possible that hormone-stabilizing medications could be successful in aiding treatment for alcohol use disorders in women.” She called for more research to better understand the role of hormones in risks for drinking, and to consider how their associations could inform related assessment, prevention, and intervention practices. Newswise/SP