134. My relationship with alcohol and health risks

Have you ever woken up after just one drink feeling wired, anxious, exhausted—and wondering why it didn’t feel “worth it” anymore? If alcohol suddenly feels different in your body during midlife, you are not imagining it.

In this episode, Sara continues an honest, compassionate conversation about alcohol in perimenopause and menopause—without shame, rules, or “shoulds.” This is not a sobriety episode. It’s a real talk about what alcohol actually does to a midlife woman’s body, why so many women are quietly drinking less, and how to make informed, intentional choices that truly support your nervous system, sleep, and overall well-being.

This conversation is especially timely during the holidays, when social pressure and tradition can make it harder to listen to what your body is asking for.

In this episode:

• Why alcohol disrupts sleep even when you think you slept fine
• How cortisol and adrenaline spikes lead to 2–3am wakeups and next-day anxiety
• The connection between alcohol, blood sugar swings, and midlife fatigue
• Why hot flashes, night sweats, and brain fog often worsen after drinking
• How hormone shifts make alcohol harder to process in perimenopause and menopause
• The long-term health risks of alcohol—including cancer risk women are rarely counseled on
• A powerful reframe: saying no as self-knowing, not deprivation
• Simple reflection questions to help you decide if alcohol truly supports the life you want

Connect with me, Dr. Sara Poldmae:

Website: https://risingwomanproject.com

Instagram:  https://www.instagram.com/drsarapoldmae 

Transcript

Sara Poldmae: 0:01

Sarah, welcome to menopause. Rise and thrive. I am Dr Sarah pulled May, and this podcast is your go to guide for navigating perimenopause and menopause. If you are feeling a little overwhelmed, trust me, you are in great company each week, I'll bring you expert advice, raw, honest conversations and simple tips to help you stay grounded and maybe even find some humor in the process. Let's rise thrive and tackle this wild ride together. Hi, ladies. I hope you are having an amazing holiday season. I believe this episode is going to air on Christmas, and I hope that, if you're listening, that you get some value from this and that you're surrounded by people that you love. Today's episode is going to follow up on a conversation I had a couple weeks ago with sobriety coach Maureen benkovich, where we talked about drinking specifically during the holidays, the social pressure, the traditions that one just won't hurt. And you know, all that energy that seems to go on during this time of year. And I wanted to keep this conversation going, not to tell you what to do, not to shame anyone, and definitely not to say that women should never drink, because I don't love the word should, but I do want us to talk honestly about what alcohol does to our bodies, especially in midlife, and why so many women are quietly saying, Hmm, this doesn't feel worth it anymore, including me. I'm saying that as well, and I want to start by being really clear and super humble here and authentic. I drink way less than I ever have, and I can't claim that I'm sober. I still say yes to alcohol sometimes, but my relationship with alcohol has definitely changed, not because I'm being good or not because someone told me I should, but because my body has made it very, very clear to me that alcohol is not my friend. So even if I have one drink, here's what happens. My sleep is absolute trash. I wake up at 2am 3am very wired, very anxious. My mind is racing the next day. I even feel anxious. I feel like a little edgy, maybe even a little flat, definitely tired, because I haven't slept well. And I always think like, Why did I do that? And I can't say I always think that there have been occasions where I've had a glass of wine early enough in the day that I don't feel the ill effects the next day. But I would say, 90% of the time when I try and have a glass of wine at dinner, I regret it. Anyone else feel that way in midlife? It feels like my nervous system just can't it. Can't do it anymore, right? It just basically says, Nope, that's not going to work for you anymore. So I often ask myself, like, why do I still sometimes say yes? And I think that's the conversation I wanted to bring to the table to explore, kind of out loud for my listeners, because I think it's the conversation that goes on in a lot of our heads. And I would say that I don't think when I say yes to alcohol, it's because I necessarily want alcohol. I don't know if that makes much sense, but I feel like it may be because of a few different things. Firstly, if it's at a party, I think that I say yes to alcohol because of FOMO, which you wouldn't think in midlife, that we would have a fear of missing out. But I'm human, right? So everybody's laughing, everybody's clinking their glasses, the vibe is good. And there's this little voice that just says, Oh, don't be the boring one. Or, you know, be nice to take the edge off. And sometimes I'll say yes, and then I remember, oh, right, the part that comes later. But more often than not, it's not out of, you know, a shame, or it's not out of saying no because I don't want to have fun. But I think that the reason I say no a lot of the times now is because I don't know, I just like respect myself and my body, because I know how alcohol makes me feel. So when I say yes, from fear of missing out later on, I'm like, well, I could have still participated and had a great time. And when I say no, it's because I remember what alcohol. Alcohol does for me in the short term and the long term. So again, I'm just kind of talking this out loud. I'm not scripted today, but I wanted to kind of go through what what's going on in my head. Another reason that I find that I say yes to alcohol is if I'm really stressed, sometimes I will say, and when I say sometimes this can be, like, once every few months, I will say, I'll just have a glass of wine, like, just to take the edge off. And unfortunately, that taking the edge off does not last very long, because then I end up on the flip side where I've actually put more of an edge on. I don't know if that makes sense to you, but I feel like the short lived, like little bit of laughter, giddy feeling that you get from alcohol just doesn't last that long, and then I end up in a worse state of stress and anxiety than before I had the drink. So I just find myself, the past few years, saying no, so so much more often than saying yes, alcohol is not necessarily a part of almost every dinner that I go out to, and that feels right for me. So another thing that I wanted to talk about is not just my experience, but what alcohol actually does to your body, regardless of whether it's you, me or someone else, especially midlife women, alcohol always disrupts deep sleep. Alcohol can make you feel sleepy at first. You may think that you've had a good night's sleep, but you you really don't get deep sleep while your body is processing alcohol. Alcohol definitely spikes your cortisol and adrenaline in the second half of the night, especially so you may find that you're waking up a few hours after you have alcohol, when your liver is really trying to get rid of the alcohol, your stress hormones are going wild. I am not sure if any of my listeners out there wear a whoop or any kind of app that tracks your resting heart rate, your HRV, your heart rate variability, your pulse. I mean, basically, if you're tracking these data biomarkers, so to speak, you will see that your body does not like alcohol. 100% doesn't like alcohol. Alcohol causes your blood sugar to go up, down and all around. It's definitely not great for your blood sugar. Alcohol dehydrates you, which, of course, affects your energy levels, gives you headaches, can affect your joints and even your skin. One thing I can say is that when I do whole 30 and I'm really cleaning up my act and I have no alcohol for an extended period of time, I definitely get a lot of comments on how beautiful my skin looks. So it's not just how you feel, it's actually what's happening in your body in midlife. Also, alcohol can definitely worsen hot flashes and night sweats. Not only have I experienced that, but I hear that from my patients all the time, and alcohol worsens brain fog. So if you've ever thought, why am I more anxious, tired and irritable the day after drinking? It is not in your head. So that's kind of the short term stuff. And midlife hits different because as our hormones start to shift and decline, your body becomes more sensitive to alcohol. Estrogen metabolism is definitely affected. Your liver is involved in processing extra estrogens and getting them out of your system. Your liver detox pathways get clogged up. Your gut health is affected by alcohol. Alcohol is not good for your gut and even your neurotransmitters like GABA and serotonin. Serotonin is actually made largely in the gut, so anything that you do that's not good for your gut health is going to affect your serotonin. So the same glass of wine that felt like fine a few years ago will hit harder, will last longer and disrupt more of your bodily symptoms, systems easier. It's just it's not a weakness, it's just biology. Your body has a lot to do. Your liver has a lot to do. Your body in general, has a lot to do during midlife. Don't make it any harder. If you're able to lessen your drinking, you're going to do your body a big favor. So I don't want to be doom and gloom, but those are more of the short term, like uncomfortable effects of alcohol. But I want to go into the long term health risks, not because I'm saying again that I want to make this dramatic. I don't want to make it, you know, this big, scary episode at all, because decreasing your alcohol by any amount is going to be good for your health. So this isn't about if you drink three drinks a week that you have to quit completely, but two drinks is better than three, one drink is better than two, and zero drinks is better than three, two or one. So just to get that out in the. Open alcohol is just not good for our health. In the long term, alcohol consumption has been associated with the risk of quite a few cancers. I think it's like six or seven, but breast cancer, colon cancer, liver cancer, esophageal cancer, head and neck cancers, and even what's considered moderate drinking can increase breast cancer risk significantly, especially in women. And you know, we think of the disservice that women have gone through thinking of how risky hormone replacement therapy was supposed to be, the conversations we've had over the past 25 years about estrogen causing cancer, yet nobody sits down at their doctor's office and hears that moderate drinking increases your breast cancer. So yeah, they've debunked the hormone replacement therapy myth that hormone replacement therapy causes cancer. But are we going to start talking about how alcohol causes cancer? I really want to know. I'm just curious again. This isn't about panic. It's about making informed choices. So you just deserve to know the trade offs. It's not about I have to be sober for the rest of my life. For some of you out there, it could very well be about that. For some of you out there, you may have a drinking problem. I'm not an alcohol and substance abuse expert. So that's not really what this particular episode is about. This is just about like kind of the thoughts surrounding alcohol, my personal thoughts, my personal experience, and then some of the proven health risks and some of the proven things that go on in your body when you drink alcohol. This is not a sobriety episode. Last week we talked more about sobriety, or about changing your relationship with alcohol. This week, it's more about just helping you know some of the why behind perhaps lessening your consumption. This is not a do not drink episode. That is certainly an option, and it is probably the healthiest option out there. But I want to be very clear, I am not the alcohol police. I am not taking your wine away. I am not saying you cannot enjoy a glass of wine. What I am saying is a few things, first, pay attention to how your body responds. And what I mean by that is pay attention to if your sleep is affected, because each time you say yes to alcohol, you're saying no to a good night's sleep, even if you're not noticing it, chances are you aren't sleeping as well. If you've had a glass of wine, even one so pay attention to how your body responds. And I always talk on this podcast about living intentionally and setting your days up so that you have the life that you know, that you deserve, that you want, and if alcohol fits into that mix. Great Again. I'm not the police here. I'm not trying to tell you what to do, but by paying attention, you can say to yourself, maybe in the morning, how do I feel? And maybe in the evening, say, did I spend my day in a way that felt intentional, or did my drink last night affect the way I spent my day. Let me repeat that. I think that that actually should be like a little video clip to share on social media. Pay attention if you had a drink the night before. When you wake up in the morning, perhaps spend just a minute or two writing down how you feel. Do you feel rested? Do you feel ready to take on the day in the same way that you would if you did not have a drink, and then in the evening, look back on that day and say, did alcohol affect the way that I spent my day? Did I spend my day intentionally, or did I not? So that, in and of itself, is a huge takeaway from this episode, because I think that's part of why I say no to alcohol more frequently is I just feel like almost any amount of alcohol affects how I live my life. So notice, if you're feeling that alcohol is truly helping you to relax, and notice how long that relaxation really seems to last. I don't care if you need to set a timer, but I want you to start paying attention to really how long did that sense of relaxation last? Did you feel more anxious afterwards? Just start asking yourself these questions, because I feel that that little moment of relaxation is is not nearly as impactful as the anxiety and stuff that follows alcohol. And know that choosing less or choosing differently is not a failure, it's wisdom. I think sometimes we feel like we have to defend our choices around alcohol, and no one needs to defend their choices about what they put in their body. No one needs to defend their choices about hormone replacement. Therapy or GLP ones. No one needs to defend their choices unless it's hurting someone else. That's my belief. Take it or leave it. But I feel the same way about alcohol, unless you're getting in a car and driving and hurting someone or making really irresponsible choices. If you choose to have a glass of wine, that is certainly your business. I just want you to make that choice with the information that you need. There are a lot of risks involved with drinking alcohol, even in what is considered a moderate amount, so just know that Coca Cola is not great for you either. Just know that. So I want to give just a gentle reframe, because I hope I didn't sound like I was going too far off on a soap soapbox, but I guess that's what podcasts are for, right? What if saying no is not deprivation, but self knowing? What if it's not about being good, but it's really about being kind to your nervous system. What if it's okay to be the woman holding a mocktail, sleeping well, waking up calm and actually enjoying her morning, enjoying her day? Because honestly, that's my favorite buzz, like a life well lived to me, means I can look back on each day and feel like the majority of the day I was really like, I was happy with the choices I made. I lived intentionally, and that may not be the conversation you want to have with yourself, and that's okay. I'm just sharing my experience, both as a healthcare practitioner and as a woman in midlife. This is an ongoing conversation, and one that I think women are quietly having more and more with themselves. And if this episode resonated, I'd love for you to share it with a friend who's been saying, I just can't drink like I used to, because that is the truth. Your body is telling you something, and if you want support navigating sleep, anxiety, hormones or your relationship with alcohol in midlife, that's exactly what I do inside my work. I help coach women in healthy choices, in living intentionally and just creating the life that they love. And I would love to help you. However, if you are struggling with an alcohol problem, I want to encourage you to find an expert in that subject matter, because you are not broken, you are not imagining it, and you are definitely not alone. I want you to feel heard. I want you to feel supported. If you are local to Maryland, we are having an event with Maureen benkovich, the guest from last week. So if you didn't hear the episode that came out, let's see, it'll be two weeks before Christmas. I don't know you'll have to do the math, but my my previous episode that aired just before this one with Maureen benkovich. Get to know her style. See how you'd like her. And if you are local to Maryland, please join us on January 5 at Meadow wellness in Annapolis. That is my Wellness Center. We are going to have an evening dedicated to an alcohol reset, and you can learn more about that in the show notes. I will share a link, and I hope that you join us, if you're close enough, if not just reach out, reach out to myself, reach out to Maureen. We want to help you to feel your best. And that does not mean going sober necessarily, but certainly making sure that your choices are informed and intentional. I hope that you have a wonderful holiday season. The holidays can be tough for a lot of people. They can also be miraculous for a lot of people, wherever you are in that spectrum, just know that I am here to support you. I love all of you, and I hope that you rise and thrive. You.