Alcohol and PCOS: Can I still drink alcohol with PCOS?
Whilst it is common knowledge that excessive alcohol intake can have lots of negative consequences on overall health, perhaps what is less clear is if alcohol and PCOS can be a safe combination or whether you should cut it out completely. In this post we will answer this question, and explore the possible effects of alcohol on PCOS symptoms, as well as share some tips and tricks on how to reduce your alcohol intake, if that is one of your goals. Let’s dive in.
General health recommendations on alcohol consumption
NHS guidelines recommend up to 14 units of alcohol a week as a safe volume for women to minimise health risks such as heart disease, mood disorders, and even some cancers (1). If you’re not sure how much a “unit” is, here are a few conversions to help:
One small shot of spirits: 1 unit
One small glass of wine (125ml, ABV 12%): 1.5 units
One medium glass of wine (175ml, ABV 12%): 2.1 units
Bottle of larger/cider/beer (330ml, ABV 5%): 1.7 units
Alternatively, have a go at using this units calculator to check how much you’re drinking: Unit calculator | Alcohol Change UK. NHS guidelines also recommend spreading out the consumption of units over 3 or more days with several alcohol-free days and no binge drinking.
Alcohol and PCOS
When it comes to dietary advice for PCOS it is clear that what we eat can make a difference to PCOS symptoms, but what about what we drink? In particular, is there a link between drinking alcohol and PCOS symptoms? Let’s take a look at some of the things you need to consider..…
Blood sugar spikes and insulin resistance
If you have PCOS and insulin resistance then alcohol may cause havoc with your blood sugar control. Some sweet alcohol such as cider, beer and cocktails, made with fruit juices and sweet mixers can cause spikes in blood sugar. However, moderate alcohol consumption can also cause a quick increase in insulin leading to a significant drop in blood sugar levels (2). This may all sound a little confusing! The takeaway message is that to prevent dramatic dips and spikes in blood sugar, avoid drinking on an empty stomach and opt for low sugar alcoholic drinks and mixers - keep reading to hear more about these!
Sleep disruption
Whilst many people believe that alcohol can help them drop off at night, alcohol has actually been shown to disrupt sleep quality (3). Furthermore, low blood sugar and the need to pee more - thanks to diuretic effects of alcohol – could also lead to disrupted sleep and waking in the night. If you have PCOS you may already struggle with sleep issues, so including strategies to optimise your sleep is important.
Interaction with metformin
Metformin is a drug most commonly given to people with type 2 diabetes to regulate blood sugar levels, and is increasingly also used to manage PCOS (4). Drinking while on metformin can increase your risk of developing dangerously low blood sugar levels, commonly referred to as hypos (hypoglycemia), as well as a rare condition called lactic acidosis. This is characterised by a buildup of lactic acid in the blood (5). While symptoms of these are similar to being drunk, such as drowsiness, confusion or blurred vision, if you start feeling unwell, stop drinking, eat a high carbohydrate meal and seek medical assistance. To avoid the risk of these side effects, if you have been prescribed metformin, it is recommended to not drink more than 2 units per day (6) and certainly to avoid drinking on an empty stomach (7). You may even choose to avoid alcohol altogether.
Fertility
Evidence for the impact of alcohol on fertility in people with PCOS is mixed. Some studies show adverse effects of moderate consumption, and some report no significant impact (8). Therefore, UK national PCOS guidelines recommend moderating alcohol consumption in order to optimise health while trying to conceive, so sticking to the UK national guidelines would seem reasonable (9). NHS guidelines recommend eliminating it completely when trying to conceive (10), due to the risk of harm alcohol can cause if passed onto the unborn baby, though this isn’t directly linked to the impact of alcohol on fertility, but on having a healthy pregnancy.
Mood
Anxiety and mood disorders are more common in people with PCOS (11), and drinking more than the recommended alcohol intake recommendations is associated with an increased risk of depression, anxiety, and other mental health issues (12). Therefore, it may be sensible to keep an eye on how much you are drinking and avoid binge drinking to optimise your mental health and reduce the dreaded anxiety and low mood of a hangover.
With all that being said, if you do find yourself feeling worse for wear the morning after an evening of drinking, ensure to fuel up on a nutritious breakfast to bring your blood sugar levels back up again. If you need inspiration, head over to our PCOS breakfast ideas blog post.
Do I need to stop drinking alcohol if I have PCOS?
While it is not necessary to cut out alcohol completely, keeping an eye on how much you drink and how often you are drinking is recommended to manage the effect alcohol has on various PCOS symptoms discussed above, and you may feel that cutting out alcohol altogether works best for you and your symptom management.
Best choices of alcohol for PCOS
Bearing in mind all the above potential impacts that drinking alcohol can have on PCOS symptoms, you may still choose to enjoy a drink every now and then. We know that a glass of wine or low sugar cocktail from time to time can help to relax, unwind or be a source of enjoyment during celebrations with friends. So if you do choose to mindfully include some alcohol in your diet, are there any types that are better to have?
Clear liquor: One small shot of clear liquor such as white vodka, tequila and gin contain no sugar and also have low amounts of congeners, a chemical compound responsible for hangovers (13). Any of these can be mixed with a splash of soda water and squeeze of fresh lime juice to be enjoyed on a summer evening.
White wine: Dry wine has the lowest sugar content and therefore reduces the risk of rapid spikes in blood sugar.
Red wine: Red wine is associated with multiple health benefits as it contains many beneficial nutrients and antioxidants, such as resveratrol) found in the grape skin.In fact one study carried out in people with PCOS suggests that resveratrol can help reduce levels of androgens and improve insulin sensitivity (14), however the amount of resveratrol used, 1500mg, would be equivalent to nearly 3 bottles of wine! Definitely not within sensible drinking recommendations!
Tips to reduce alcohol intake
Start slowly: Reducing or stopping the amount of alcohol you consume can be a big change, and may not be an easy one. Try gradually reducing the amount you drink and alternating between an alcoholic and a non alcoholic drink or water next time you’re out.
Telling friends: If you find it a struggle to moderate drinking in social situations, then telling friends that you are trying to reduce your drinking may well help, as they can keep you accountable. You may even find that some of your friends want to join you in cutting back on alcohol.
Enjoy the benefits: When creating a new healthy habit, you may start to save money as well as notice a number of improvements to the way you feel, due to improved sleep, energy and overall health. Enjoy these benefits and you may well never look back!
Experiment with non-alcoholic drinks: As a result of more people trying to cut back on alcohol or becoming more sober-curious, there are increasingly more non-alcoholic drinks sold in supermarkets, pubs and bars. You could even try making a mocktail creation of your own - check out our mocktail recipes suggestions below.
Recipe mocktails
Elderflower spritz: Mix elderflower cordial, a wedge of fresh lime and fresh mint leaves with sparkling water. This refreshing mocktail is perfect on a hot afternoon.
Raspberry and apple spritzer: Mix lemon juice, raspberries, ice and mint with apple cordial and sparkling water. Another refreshing mocktail, and frozen raspberries make just as good an alternative if you don’t have any fresh berries.
Cranberry and pineapple punch: Mix two parts sparkling cranberry juice to one part pineapple juice, frozen cranberries and orange zest. Garnish with curled orange peel if you are hosting, everyone is bound to be blown away!
Peppermint white russian: One for the coffee cream lovers. Pour your coffee shot over ice, mix through vanilla and peppermint extract and float with heavy cream. If you feel it’s too thick without the alcohol to thin it out, add some water to your liking … and CHEERS!
So what’s the bottom line on PCOS and alcohol?
Alcohol doesn’t have to be the enemy. One or two drinks enjoyed at social occasions can be part of a healthy balanced lifestyle. If you are looking to reduce the impact alcohol has on your PCOS symptoms, start by considering how much and how often you are drinking as well as the type of alcohol you drink, and aim to stick to the guidelines of 14 units per week. Opt for our PCOS friendly alcohol recommendations and mocktails to avoid any dreaded hangovers and sluggishness of having one too many.
If you're looking to reduce your intake or cut it out completely, this can be difficult, so having a support group of friends with a similar goal can really help. If you need some extra support with this or want to discuss other dietary strategies to help you manage your PCOS symptoms, you can book a FREE discovery call to learn more about a 1:1 appointment.
For further information about health implications of drinking alcohol, and tips to reduce your alcohol intake, please visit: Drinkaware.co.uk
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