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I’m a Registered Dietitian dedicated to helping you eliminate your PCOS symptoms with sustainable and realistic nutrition changes.

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PCOS and Alcohol: What’s The Best Drink for PCOS?

With the warmer weather here, that usually means more cookouts and social gatherings. And for many of us, that often comes with more social drinking. Or maybe you just love the occasional girls night out with some cocktails?!

But if you have polycystic ovary syndrome, you may be wondering: is beer bad for PCOS? Do PCOS and drinking alcohol mix? Or maybe you’re wondering what the best drinks for PCOS are? Or how does alcohol affect periods?

As a PCOS dietitian, I’m a big believer that everything can fit into a healthy diet. With some mindfulness, you can still manage your PCOS while enjoying the foods and drinks you love. 

If you want the scoop on everything you need to know about alcohol and PCOS, keep reading!

Women cheers with mixed cocktails while smiling.

Can Alcohol Make PCOS Worse? 

You probably already know that 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. This is defined as 1 drink per day for women and 1 to 2 drinks per day for men. One drink equals 12 oz beer, 5 oz wine, or 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. 

While some of the benefits (and downfalls) of alcohol will be outlined below, if you are not a regular drinker or don’t already consume alcohol it’s not recommended to intentionally start drinking alcohol to try to improve your health.

Blood Sugar Levels 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, 2).

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 alcohol is generally pretty low in carbs. It also interferes with your liver’s ability to produce glucose to maintain your blood sugar levels. 

Overall, moderate alcohol intake has been associated with a reduction in insulin resistance and decreased risk of type 2 diabetes (3, 4, 5). 

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 (6). 

Fertility 

PCOS is unfortunately the #1 cause of anovulatory infertility. Research is mixed on whether or not alcohol affects female fertility. Heavy alcohol use, or binge drinking, does seem to decrease fertility. Most experts do recommend avoiding alcohol if you’re actively trying to conceive. (7, 8)

Heart Health and Cardiovascular Disease

Moderate alcohol consumption may have some health benefits by raising HDL (good) cholesterol levels. However, excessive alcohol consumption can raise blood pressure levels and another type of fat in the blood called triglycerides. 

High triglycerides, especially paired with high LDL (bad) cholesterol and low HDL (good) cholesterol can increase your risk of heart attack or stroke. (9, 10)

Stress Levels

Most people associate alcohol with its ability to lower their stress levels, but it can actually have the opposite effect. Alcohol may increase cortisol levels (aka our stress hormone), which can worsen PCOS symptoms.

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. 

Drinking alcohol may make you fall asleep quicker by acting as a sedative, but it usually can cause 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. 

The calories from alcohol are what we’d call “empty calories” because they don’t really provide much nutrition in them. Eating more calories than what our bodies need on a routine basis can lead to weight gain, which may worsen PCOS symptoms. This may be something to be mindful of if weight loss is one of your goals.  

Mental Health

Women with PCOS have higher rates of depression and anxiety. Many people report that alcohol increases these feelings. 

Common Medications – Metformin, Ozempic, etc.

If you’ve been prescribed any sort of medication for PCOS, such as Metformin, Ozempic, Wegovy, or Mounjaro, you’re likely 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 (low blood sugar levels).

Another rare side effect of Metformin is lactic acidosis; heavy alcohol intake can increase the risk of this. 

Always talk to your doctor about the risks of drinking if you’re taking prescription medications. 

Wine glass with red wine being actively poured into the glass

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 other factors may be involved as well (such as healthy diet and exercise) (11). 

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 contains gluten usually.

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 will have a smaller 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

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. 

Take caution if you have fatty liver or are taking medications 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 high sugar mixed drinks that can raise blood sugar levels quickly. Dry wines, light beers, and hard liquor are lowest in carbohydrates. Red wine may have added health benefits due to its higher antioxidant content.

Disclaimer: this is for educational purposes only and not meant to be misconstrued for medical advice. Always discuss the consumption of alcohol with your healthcare provider. 

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