Can a woman's menstrual cycle make her more susceptible to the effects of alcohol?

April 29, 2005

Dear Cecil:

Although I realize you don't have firsthand knowledge of women's monthly cycles, I feel confident that you will be able to answer my query, o wise one! Does alcohol affect you differently depending on which week of your cycle you're in? A girlfriend of mine told me that you will get drunk easier closer to ovulation and also will be more susceptible to a hangover. She also said that researchers think that speech patterns can be affected during different stages of the cycle (i.e., you have a greater chance of stumbling on words, stuttering, etc). I've done a little home research on the alcohol consumption part of this question and I'm starting to think she is correct. Do I have a valid excuse for getting tipsy or stuttering?

No offense, Lea-Anne, but you don't have to be female to have firsthand knowledge of a woman's monthly cycle, any more than you need a driver's license to have firsthand knowledge of a car wreck. I'd say the real question, alcohol aside, is: Does the menstrual cycle cause some women to exhibit behavior that in ages past got them sent to live for a week in a hut? Spoken like a true male chauvinist pig, you may say. Perhaps, but wait till you hear about Sandie Craddock, the barmaid from hell..

First, tipsiness. Over the past 30 years a fair amount of research has focused on the relation between the menstrual cycle and alcohol, the chief question being whether booze intake causes higher blood alcohol levels during different stages of the process. One widely cited study (Ben Jones and Marilyn Jones, 1976) claimed that it did--specifically, that during the premenstrual phase (days 21-28), when sex hormone levels fluctuate markedly, women absorbed alcohol into their bloodstreams faster and to a greater degree than earlier in the cycle. In a follow-up investigation, Jones and Jones found that women's reaction times after drinking slowed more during the premenstrual phase than at other times.

Aha, you're thinking, my home research confirmed! Unfortunately, hardly anyone was subsequently able to reproduce these results, including Jones and Jones, and the current consensus is that any apparent cyclic changes were the result of methodological flaws. (Interestingly, imbibing women generally do reach higher blood alcohol levels than men, even when the amount of booze is adjusted to reflect body weight; it's just that the menstrual cycle has no bearing on the matter.) A study of women pilots operating a flight simulator after drinking (Mumenthaler et al, 2001) found that while they did relatively poorly when cross-eyed, their performance didn't track their menstrual cycles except on a couple of tasks. Speech pathologist Ellen-Marie Silverman published research in the 70s and 80s suggesting that women had a harder time talking during the premenstrual phase, but her work was ignored, and as far as I know the issue was never settled. Research on menstruation and hangover is likewise slim.

So never mind alcohol, stuttering, and so on for now. Can the menstrual cycle make a woman just plain nuts? Up to 85 percent of menstruating women report having one or more symptoms of premenstrual syndrome, but the list of PMS complaints is so nonspecific--fatigue, irritability, forgetfulness, etc--that probably 85 percent of men would qualify were it not for the monthly timing angle. Things get more interesting when we restrict the discussion to premenstrual dysphoric disorder, a condition affecting the 2 to 10 percent of women who suffer cycle-related emotional and behavioral upset so severe as to be disabling. PMDD isn't currently an official mental disorder--the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, the formal guide to insanity, lists the condition in an appendix and suggests it needs more research. Some psychiatrists have denounced the idea that menstrual hormones can cause mental illness, saying it's an excuse to discriminate against women and dismiss their other mental-health concerns.

In some instances it may be more than that. Consider Regina v. Craddock, a UK criminal case from 1981. Sandie Craddock, a 29-year-old London woman with dozens of criminal convictions, was charged with murdering a fellow barmaid. At trial an expert testified that all her crimes--as well as her numerous suicide attempts--occurred at roughly 29-day intervals, i.e., in sync with her menstrual cycle. Agreeing she wasn't in control of her faculties, the court reduced Craddock's charge to manslaughter and freed her on probation provided she remained on hormone therapy. Sometime later Craddock's dosage was reduced; during her next cycle she threatened to kill a cop who had allegedly insulted her three years earlier and was arrested while lying in wait for the officer with a knife. Upshot: probation again. Two lessons: (1) Think seriously about the timing of your next trip to England. (2) Menstruation-related conditions, however preposterous or politically incorrect they sound, may have some basis in fact.

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