It's Not Just the Wine

PLUS: What research reveals about menopause and drinking + menopause care shouldn't depend on your zip code

Estimated reading time: 3 minutes

​
👋 Hello friends!

Welcome to the July 7th edition of Menopaussible—bringing you the news you can use and the ⚡ energy ⚡ you need to support your menopause journey. I'm Maria Caracci Ciccolella—mindset coach and menopause advocate. (Connect with me on IG or LinkedIn!)

Have I told you lately how much I love summer? Sure it gets a little hot, but there is just something about the season that brings a sense of more ease and freedom: weeks capped off by backyard happy hours and weekends that invite gatherings where friends can "rosé all day."

Enjoying a cocktail with friends used to be oh-so care-free—and then it wasn't. Suddenly even that one drink made you question its worth the next day—or even within hours. Quick-forming headaches, sleepless nights, and suddenly that hot jalapeño margarita that was your summer go-to cocktail is no longer on the menu.

What's changed you ask? How is it that the same two glasses of wine that used to be nothing now wreck the next two days?

Hint: if you've subscribed to this newsletter, you have already become acquainted with part of the reason. And as always, we'll get into why.

Your Liver Isn't Putting Up With Your Shenanigans Anymore

For those of us raised to be conscious of our alcohol consumption—especially when having to operate a motor vehicle—we are keenly aware that the liver plays a major role in the breakdown of alcohol. In fact, the liver is the primary organ responsible for breaking down roughly 90% of the alcohol you consume, leveraging specific enzymes—alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH)—in a 2-step process. As a rule of thumb, the average woman metabolizes roughly one standard drink—a 5 oz. glass of wine or 1.5 oz of 80-proof liquor—per hour.

All that begins to change in midlife as both age and reduced estrogen lead to declining liver enzyme activity—specifically ADH—causing it to process alcohol differently. For some, this means feeling the impacts of alcohol more swiftly; for others, feeling them long after the drinking has ceased. Further, with body composition shifts driving more fat mass accumulation (and less water mass), alcohol becomes more concentrated in the bloodstream per drink—leading to more potent effects.

The Double Whammy of Menopause and Alcohol

It's bad enough that you can't enjoy alcohol the way you used to—but alcohol isn't going to make your menopause easier either. Moderate to heavy drinking can intensify symptoms, notably:

• Increased frequency and intensity of hot flashes and night sweats, as alcohol causes body temperature to rise
• Mood swings and anxiety. That same drink which acts as a depressant early in the evening—taking the edge off—can lead the brain to rebound into a hyper-stimulated state once it wears off. If you've woken up in the middle of the night with racing thoughts and feelings of panic after an evening of drinking, you can tip your glass to alcohol.
• Increased sleep disruption. Menopause has already made sleep difficult—adding alcohol to the mix only multiplies the opportunities for the above, making a good night's sleep harder to come by and your next day harder to get through.

What No Longer Serves Us

I know many of you right now may be shaking your head—menopause seems to be stealing all the joy—but is it? Or is the body inviting us to look at a habit that may no longer be serving us as well as it used to? Perhaps even holding us back from something greater just over the horizon.

Here's the part worth sitting with: the case for reconsidering alcohol in midlife goes beyond menopause symptoms. The research is clear that even moderate drinking carries increased risks of certain cancers, heart disease, and bone fractures—all areas where menopause is already shifting your baseline. That's not a reason to panic. It's a reason to be honest with yourself.

So what do you do with that? A few questions worth asking—about alcohol, or honestly, about any habit that's starting to cost more than it returns:

• Does it still feel good—or does it just feel familiar? There's a difference between something you genuinely enjoy and something you reach for because it's always been part of the rhythm.
• What are you actually getting from it? Connection, decompression, ritual? Those needs are real. Are there other ways to meet them that don't come with a two-day recovery?
• What becomes possible without it? Better sleep, more energy, clearer mornings—what opens up?

This isn't about deprivation. It's about choosing deliberately instead of defaulting on autopilot.

All the Paussibilities

Your body changed the terms on something that ran for years without question. And alcohol is just the most obvious example. Midlife has a way of surfacing a longer list of things we're still doing out of habit, out of comfort, or out of an identity that no longer quite fits. The late nights. The way we work. The relationships we maintain on inertia.

The question isn't whether to grieve what's changing. It's whether you're willing to get curious about what's on the other side of it.

But first things first. Be honest:

PLUS:

The Drink You're Using to Cope May Be Making Things Worse

A 2025 peer-reviewed study published in a SAGE Open journal surveyed 936 women aged 40–65 and found direct associations between menopause symptoms, alcohol use, and mental health. Nearly 29% of women reported using alcohol to manage menopause-related discomfort—including hot flashes, sleep disruption, and mood changes—despite evidence that alcohol reliably worsens each of those symptoms over time. The finding matters because it names a pattern many women recognize but haven't examined: reaching for a coping tool at exactly the stage of life when their bodies are least equipped to handle it. The study is a useful reminder that what feels like relief in the moment often isn't.
​
​
​Your Menopause Care Shouldn't Depend on Your Zip Code

Menopause legislation is quietly moving through statehouses across the country—and the numbers driving it are hard to ignore. According to recent reporting in the Arizona Daily Star a, 1 in 5 women has delayed or skipped menopause treatment due to cost, and only 26% have insurance coverage for hormone replacement therapy. More than half of U.S. states have now introduced or passed some form of menopause-related legislation, covering everything from workplace accommodations to treatment coverage. Progress is uneven and still largely state-by-state — but the political will is building. This is a story worth watching.

The Bold Retirement Dispatch Elaine Belansky, PhD Most retirement newsletters are about money or hobbies. This one is about the part nobody prepares you for: who you are when the career ends. The Bold Retirement Dispatch is a Monday morning newsletter for professional women 50+ navigating the identity, purpose, and structure side of this transition. Real talk, psychology-grounded tools, and the occasional hard question — from a retirement coach and former university professor who has been through it herself. Join 1,000+ women who are figuring out what comes next. Subscribe​