If you have PCOS, you may have wondered if alcohol impacts symptoms or affects syndrome management. Curious about your favourite tipples’ impact? Keep reading to find out about PCOS and alcohol.
What is PCOS?
PCOS, or polycystic ovary syndrome, is an endocrine disorder that affects 1 in 10 people with ovaries in the UK. Symptoms vary from person to person and typically present around the time of puberty through to the early 20s. Symptoms can include acne, oily skin, fertility issues, excess hair on the face and more. Read more about PCOS symptoms, diagnosis and treatment in our PCOS 101: beginners guide.
Although there is no cure for PCOS, there are several treatments that may ease symptoms. Lifestyle changes are commonly recommended for PCOS management, but what about alcohol consumption?
PCOS and drinking alcohol: is it okay?
You aren’t alone in asking questions about PCOS and drinking alcohol. There are some considerations to make when deciding whether to drink with PCOS.
Blood glucose levels and insulin resistance
People with PCOS often have insulin resistance. Insulin resistance means that the cells of the body don’t react as expected to the insulin produced when blood sugar levels are at a certain level. This means that blood sugar levels stay high for longer than we’d expect after eating.
Moderate alcohol consumption raises your blood glucose levels and can impact insulin resistance. All alcoholic drinks contain some sugar, but some have more than others. It may be beneficial to be mindful of fortified wines, sherries, liqueurs, cider and pre-mixed drinks and cocktails if you have PCOS.
Alcohol is a depressant which means it can disrupt the neurotransmitters in your brain. Regular heavy drinking is linked to symptoms of depression, and people with PCOS are at a higher risk of depression and depressive symptoms.
Therefore, it may be helpful to be mindful of alcohol intake to help with your mental wellbeing.
Alcohol can have a negative impact on sleep in terms of both quality and quantity. Although falling asleep may come easy after drinking (known as decreased sleep onset latency), sleep disruptions and decreases in sleep quality are common.
People with PCOS are more likely to suffer from sleep disturbances and disorders such as sleep apnea and excessive daytime fatigue. Aiming to improve sleep quality and quantity can play a key role in PCOS management.
>> Read more | Sleep and PCOS: What’s the connection?
Advice in the UK suggests avoiding alcohol when trying to conceive so it may be sensible to avoid drinking if you’re trying to conceive, but advice varies from country to country. But, is there an impact of alcohol on fertility?
Studies have found that there is “no safe dose” of alcohol in regard to fertility. Plus, recent reviews have found that even light drinking reduces fertility in people trying to conceive. Speak to your doctor about alcohol consumption during conception if you have further concerns or questions.
>> Read More | PCOS and Fertility: the ultimate guide to conception
Non-alcoholic liver disease (NAFLD) is a term that describes a number of liver conditions. One thing these liver conditions have in common is that they are not caused by heavy alcohol use. NAFLD is more common in people with PCOS.
If you have NAFLD and PCOS then it is important to avoid heavy drinking because this can lead to the progression of liver disease.
>> Read more | HAES Health Sheets: Non-alcoholic fatty liver disease
What about metformin and alcohol?
Metformin is often prescribed to people with PCOS for insulin resistance management and to improve fertility outcomes. There are concerns about drinking alcohol whilst taking metformin.
Drinking alcohol can cause blood sugars to fall too quickly in people on metformin. Excessive alcohol intake whether it’s short-term binge drinking or frequent consumption is not recommended when taking metformin. The NHS recommends no more than 2 units per day whilst taking this medication.
There is also a risk of a rare but serious condition called lactic acidosis. This is the buildup of lactic acid in the blood which can happen when taking metformin. This is more likely to occur if you have kidney disease, liver disease, acute congestive heart failure or dehydration.
If you have recently undertaken exercise or haven’t eaten recently then avoid drinking whilst on metformin to reduce the risk of lactic acidosis.
Symptoms of lactic acidosis
If you suffer from any of the symptoms of lactic acidosis after drinking alcohol when on metformin, seek medical help immediately:
- Muscle pain
- Increasing drowsiness
- Abdominal pain or discomfort
- Slow or irregular heartbeat
- Breathing difficulty
Always speak to your doctor or healthcare professional about consuming alcohol when taking any medication.
What are the best alcoholic drinks for PCOS?
If you choose to enjoy an alcoholic drink, are there best or worst drinks for PCOS?
Beer and PCOS
Beer is made from grains (usually malt or barley) and therefore contains carbohydrates. So, drinking a lot of beer, especially without eating, may spike blood glucose levels. This can increase the amount of circulating insulin in the blood if you have insulin resistance and PCOS.
There is no specific research undertaken on the impact of beer on people with PCOS, so we can assume that common sense and national guidelines can be followed.
If you enjoy beer, as with all alcohol, enjoy it in moderation and try to consume it with a meal made up of fats, carbohydrates and protein to prevent blood sugar spikes.
Wine and PCOS
The sugar in grapes used to create wine turns into alcohol during the fermenting process.
There is minimal evidence suggesting that resveratrol (a chemical mostly found in red grapes) in red wine may have some health benefits. One study found that resveratrol may improve insulin and androgen levels in people with PCOS but huge amounts of wine would have to be consumed, likely counteracting any benefits!
Liquor or spirits and PCOS
Liquor or spirits like gin, vodka and whisky are low in sugar but are often mixed with high-sugar mixers. Consuming drinks with a large amount of sugar, especially on an empty stomach may contribute to symptoms of PCOS.
>> Read more | Drinks for PCOS: The ultimate PCOS beverage guide
How to drink alcohol safely with PCOS
If you choose to consume alcohol there are a few top tips to help you consume it safely.
This includes avoiding drinking on an empty stomach (particularly if you’re taking metformin)
Our top tips when drinking include avoiding drinking on an empty stomach and ideally with a balanced meal. Where possible opt for lower sugar options, avoiding sugary mixers. Finally, keep water on hand to stay hydrated.
If you’re taking medication and/or looking to conceive, always consult with a healthcare professional.
Overall, you can still enjoy an alcoholic drink if you have PCOS. However, whether you have PCOS or not, it is always advised to drink in moderation, stay hydrated and enjoy alcohol with food where possible.
Founder and Editor | Registered Associate Nutritionist
Founder of Be The Collective LTD [The PCOS Collective & The Endo Collective] Alex Okell ANutr is a London-based reproductive health nutritionist with experience in research, private practice and digital media. She holds a Master’s degree in Nutrition from King’s College London and has co-authored papers with the University of Cambridge, King’s College London, The Food Foundation and the Food Standards Agency. Alex offers 1:1 PCOS support in our virtual PCOS clinic.