Hi, I’m Alyssa! AKA, The PCOS Nutritionist Alyssa!
I’m a Registered Dietitian dedicated to helping you eliminate your PCOS symptoms with sustainable and realistic nutrition changes.
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PCOS + Alcohol: Should I Still Drink If I Have PCOS?
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PCOS and alcohol…do they mix? Will drinking alcohol make my PCOS symptoms worse? These are some questions I get asked as a registered dietitian who also has PCOS.
In this post, I’m going to answer all of your questions about alcohol and PCOS! We’ll cover the pros and cons of drinking alcohol and how it can affect your PCOS symptoms. Then, we’ll talk about the best way to consume alcohol if you choose to do so. Let’s dive in!
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How Does Alcohol Affect PCOS Symptoms
You probably already know that polycystic ovary syndrome (aka PCOS) can present differently in people with the condition. So some of the things I’m going to mention below may not apply to you, but it’s always good to be aware of! I’m a huge fan of knowing the consequences of my actions (good or bad!).
First things first though, we’ll talk a lot about the term moderate alcohol consumption…but what exactly does that mean?
Moderate alcohol consumption is defined as up to 1 drink per day for women and 1 to 2 drinks per day for men.
One drink may not be as much as you think it is either. The real definition of one alcoholic beverage is:
- 12 oz beer
- 5 oz wine
- 1.5 oz hard liquor
And no, that doesn’t mean that you should save all of your daily drinks for one Saturday night out, girl.
For some people with PCOS, alcohol can have a significant impact on these symptoms:
- Blood sugar levels
- Fatty liver
- Fertility
- Heart health
- Stress levels
- Mental Health
- Sleep Quality
- Weight
- Medication Interactions
Alright, let’s dive into how alcohol can impact each of these common symptoms of PCOS.
Blood Sugar and Insulin Resistance
Approximately 70% of those with PCOS are insulin resistant, and more than half of those with PCOS will develop type 2 diabetes by age 40 (1).
A lot of people are under the impression that alcoholic beverages are loaded with sugar so it will increase blood sugar and insulin levels. This isn’t necessarily true though.
Alcohol itself can actually cause your blood sugar to go too low (hypoglycemia). This is because a lot of alcoholic drinks, such as wine or hard liquor, are generally pretty low in carbs. Alcohol also interferes with your liver’s ability to produce glucose to maintain your blood sugar levels.
On the other hand, some higher carb alcoholic beverages, such as beer or cocktails made with fruit juice, soda, or other sweet mixers, may cause your blood sugar levels to spike.
According to the research, moderate alcohol intake has actually been associated with a reduction in insulin resistance and decreased risk of type 2 diabetes (2).
This doesn’t mean that you should start drinking though if you don’t already. If you do consume alcohol in moderation already though, choosing lower sugar drinks will help to keep blood sugar levels more stable – more on this to come!
Nonalcoholic Fatty Liver Disease
Women with PCOS are at a 4 times higher risk of having non-alcoholic fatty liver disease (NAFLD) than those without PCOS. Drinking alcohol can worsen liver health and it’s generally not advised to drink at all if you already have fatty liver.
Fertility
PCOS is unfortunately the #1 cause of anovulatory infertility. Research is mixed on whether or not alcohol affects female fertility. Regular heavy drinking, or binge drinking, does seem to decrease fertility. Most experts do recommend avoiding alcohol if you’re actively trying to conceive (3).
Heart Health and Cardiovascular Disease
Moderate alcohol consumption may have some health benefits by raising HDL cholesterol levels aka your good cholesterol. However, excessive alcohol consumption can raise blood pressure levels and another type of fat in the blood called triglycerides.
Stress Levels
Most people associate alcohol with its ability to help them wind down and lower their stress levels. In actuality, it may have the opposite effect. Alcohol can increase cortisol levels (aka our stress hormone), which can ultimately worsen PCOS symptoms.
Mental Health
Women with PCOS have higher rates of depression and anxiety. Many people report that alcohol increases these feelings.
I’m definitely someone who struggles with lingering anxiety the day after a few drinks (hello, hangxiety).
Sleep Disturbances
If you’ve ever had issues sleeping, it could be due to your PCOS. Women with PCOS are at an increased risk for difficulty sleeping and sleep disorders such as sleep apnea.
Although drinking alcohol may make you fall asleep quicker by acting as a sedative, research shows it usually causes disrupted sleep patterns as the night goes on.
Weight Gain
Drinking alcohol can cause you to take in more calories than your body needs – either from the alcohol itself or from impulsive food choices when you’re tipsy. Helllllllo late night fast food!
The calories from alcohol are what we’d call “empty calories” because they don’t really provide any nutrients. Eating more calories than what our bodies need on a routine basis can lead to weight gain, which can worsen PCOS symptoms. This may be something to be mindful of if weight loss is one of your goals.
If weight loss is your goal, read some of my top tips here: 10 Tips To Lose Weight With PCOS.
Medication Interactions
If you’ve been prescribed any sort of medication for PCOS, such as Metformin, Ozempic, Wegovy, or Mounjaro, you may be wondering if alcohol is a good idea.
These medications are designed to lower blood sugar levels and alcohol may enhance that effect…which increases the risk of hypoglycemia (aka low blood sugar levels).
Another rare side effect of Metformin is lactic acidosis, which is the buildup of lactic acid in the bloodstream. Heavy alcohol intake can increase the risk of lactic acidosis.
Use caution with alcohol and prescription medications such as Metformin. Many healthcare providers recommend limiting your intake to one drink per day or abstaining from alcohol entirely. Always talk to your doctor about the risks of drinking if you’re taking prescription medications.
Should I Still Drink If I Have PCOS?
As someone who understands PCOS and lives with this hormonal disorder, I get it.
The good news is that or most people with PCOS, cutting alcohol out of your life completely isn’t usually necessary. Although, if you find that you feel better when you avoid alcohol, do what works best for you!
For those who do decide to indulge in an alcoholic drink, there’s some tips that I’d recommend considering. The first is which type of alcohol you’re choosing. Let’s talk about the best drink choices for PCOS.
Best Alcohol For PCOS
Alright, so now that we’ve talked about some considerations, if you’ve decided that you’re going to have a drink, which drink is good for PCOS?
Wine
While wine is made from grapes, which are carbohydrates, the carb content is actually pretty low in a 5 oz serving of wine. That’s because the grapes go through a fermentation process that changes the carbs over to alcohol.
Most dry wines (white or red) and champagnes are low in carbs – ranging from 1 to 5 grams of carb per 5 oz glass of wine. The exceptions are dessert wines or wines marked as sweet or semi-sweet (such as Sherry or Port wines). These sweeter types of wines may have up to 20 grams of carb per serving.
What about red wine and PCOS? The topic of red wine comes up often when it comes to health.
Some research has shown red wine can reduce the risk of heart disease since it’s high in certain compounds called flavonoids. Flavonoids act as antioxidants and are helpful in lowering inflammation.
But research has not been able to clearly show whether red wine exclusively causes the reduced risk of heart disease or if other factors, such as a healthy diet and lifestyle changes, may be involved as well (4).
The bottom line is that if you prefer wine, a dry red wine is likely the best option since it’s lower in carbs and higher in antioxidants. Another good option is a dry white wine or champagne. But in reality, if you enjoy dessert wine and you’re drinking in moderation, it’s likely not going to make or break your health goals.
Beer
Beer is made from grains (usually barley), hops, yeast, and water. It’s often higher in carbohydrates than wine or liquor is. Beer also typically contains gluten, which isn’t necessarily a reason to avoid it, but something to be aware of if you’re intolerant.
Carb content can vary depending upon the type of beer and the alcohol content. Light beers (such as Michelob Ultra or Coors Light) usually have 2 to 5 grams of carb per 12 oz serving. Light beers generally have less of an impact on blood sugar levels compared to other beer options.
Regular beer (such as Budweiser or Corona) usually have between 6 to 15 grams of carb per serving. Craft beers tend to be higher in carbs, especially if the alcohol content is higher. A traditional IPA can typically range from 15 to 25 grams of carb per 12 oz serving.
Depending on the beer choice and its carb content, it may have an impact on blood sugar levels.
The bottom line is that if you prefer beer, a light beer is going to have the smallest impact on your blood sugar levels.
Hard Liquor
Hard liquor, such as vodka, gin, rum, or tequila have no carbs in them thanks to the distillation process. But most people tend to mix hard liquor with something to make it more palatable (hey, margaritas!).
High sugar additions in mixed drinks like tonic water, juice, regular soda, or other high sugar mixers can increase blood sugar levels.
If you choose to drink hard liquor, be mindful of mixers and opt for low-sugar mixers such as soda water or diet sodas. For example, swapping your typical vodka and cranberry juice for a vodka with soda water and a splash of cranberry juice is a better option.
Lots of companies are now offering hard seltzers or pre-made liquor drinks (such as White Claw, High Noons, Spindrift Spiked, Truly). These often contain 2 to 5 grams of carb per serving.
The bottom line is that if you prefer hard liquor, these generally have zero or a small amount of carbs and will not have a large impact on your blood sugar levels. However, high sugar mixers will impact blood sugar levels.
Tips For Drinking Alcohol With PCOS
If you choose to enjoy a drink occasionally, here are my best tips for how to enjoy:
- Drink in moderation: this is key for overall health
- Hydrate: remember to also include water when drinking
- Eat: don’t drink on an empty stomach. Have your drink alongside a meal to maintain more balanced blood sugar levels
- Be mindful: opt for lower calorie or lower carb options when possible and be mindful of the amount of sugar in mixers
Swap Your Cocktails for Mocktails
If you’re thinking that you want to decrease your alcohol intake, but you enjoy having a festive drink in your hand for social occasions, try non-alcoholic drinks or mocktails!
The time has never been better for people who are limiting or avoiding alcohol. There are several non-alcoholic drinks available on restaurant menus or in your local grocery store.
Many popular brands offer non-alcoholic and lower calorie versions of their drinks now. These are my favorite non-alcoholic seltzer and non-alcoholic IPA beer.
But if I’m being honest, mocktails are super easy to make at home and usually more cost effective too! Some mocktails can even have some benefits for your hormone health and PCOS. Including these mocktails when you’re looking for a fun drink is one of the best ways to support your hormone health.
Blackberry Lemonade Cortisol Mocktail
Sleepy Girl Mocktail (Viral Recipe!)
Key Takeaways
Having alcoholic drinks can be a big part of social gatherings for some people. It’s safe for most people with PCOS to drink alcohol in moderation.
Exercise caution if you have fatty liver or are taking medications, such as Metformin, that can alter your blood sugar levels.
If you choose to have an occasional drink of alcohol, drink it in moderation, not on an empty stomach, and drink water as well.
Be mindful of sugary mixers in cocktails that can make your blood sugar rise quickly. Dry white wines or red wines, light beers, and hard liquor are lowest in carbohydrates. Red wine may have added health benefits due to its higher antioxidant content.
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Disclaimer: this is for informational purposes only. It does not substitute for or replace professional medical advice for polycystic ovarian syndrome (PCOS) or any other medical condition. Always discuss with your healthcare provider.