Janine Duncan had, by her own admission, always been a heavy drinker.
“I’m part of Generation X and was brought up with a certain alcohol culture, the ‘we can drink as much as men’ type thinking,” says the 52-year-old.
Working in real estate, where heavy drinking was normalised, and then having two sons, which exposed her to “mummy wine culture”, meant her consumption went unnoticed.
But when she entered her 40s, something changed.
“I was experiencing anxiety and brain fog. I wasn’t sleeping well. I was having terrible night sweats that were waking me up 10 times a night, and I was having horrendous periods,” she says. These symptoms fuelled more drinking.
“I was in a high-powered role and under a lot of pressure from work. I’d get in the door, start cooking dinner, pouring lots of wine. I’d still go to bed at 9.30pm, but I would drink a bottle in that time easily.”
What Duncan didn’t realise until later was that she was in perimenopause – and her experience was far from uncommon.
Drinking to cope
A 2025 survey from Macquarie University of women over 40 in Sydney found many respondents, like Duncan, were self-medicating menopausal anxiety symptoms with alcohol.
Menopause typically occurs between the ages of 45 and 55, but symptoms can start appearing earlier during perimenopause.
Professor Rebecca Mitchell from Macquarie University’s Health at Work Research Centre led the study alongside the Northern Sydney Local Health District Alcohol and Tobacco Program team.
She says its findings are particularly significant in light of broader drinking trends in Australia.
While overall consumption of alcohol has declined over the past few decades, older women are bucking this trend. According to 2022 research, one in five Australian women aged 40 to 65 are binge-drinking, a statistic that’s up from 2001.
Research on menopause and alcohol is still emerging but one 2025 study of almost 1000 British women found that while some used alcohol to cope, others avoided it entirely because it worsened menopausal symptoms.
Meanwhile, a longitudinal analysis of over 3000 American women found that while women who identified as excessive drinkers were more likely to decrease their drinking over all stages of menopause, those who identified as non-excessive drinkers were more likely to increase consumption in the early peri- and postmenopausal stages.
Eventually, Duncan visited her gynaecologist, who helped her connect the dots between her worsening menopause symptoms and alcohol (and also put her on hormone replacement therapy). She challenged herself to 100 days alcohol-free and never looked back.
Now over two years sober, the experience has been life-changing.
“The improvement in my mental health has been second to none. It’s the best thing I ever did for it. My only regret is I didn’t stop sooner,” she says.
How alcohol affects menopausal symptoms
Alcohol has a negative effect on some of perimenopause and menopause’s most common symptoms, says Dr Erin Morton, adjunct associate professor at the University of Southern Queensland and founder of Bespoke Clinical Research.
Symptoms like hot flushes, night sweats, depression and anxiety are worsened by drinking, even though alcohol may feel like it can help in the short term, she says.
In the long term, alcohol can also have an effect on things postmenopausal women are already at greater risk of, says Morton.
“Alcohol can cause issues with bone density, so that enhances the chances of osteoporosis. It also has issues with heart disease, with our diabetic and cardiovascular functions affected by our hormones dropping, there’s increased cholesterol, increased blood pressure,” she says.
And, Morton says, alcohol is a group 1 carcinogen, where even small amounts can increase the risk of cancer.
Caroline Gurvich, a clinical neuropsychologist and an associate professor at Monash University, says age can reduce people’s ability to metabolise alcohol, particularly women.
She also says the transition occurs at a life stage when many are “stretched and stressed”, raising teenagers, caring for elderly parents and navigating busy careers.
On the other hand, she says “there are some women who have the capacity for freedom that they might not have had for years, and so they’re re-engaging in their social life. And in Australia, that often entails alcohol”.
Knowledge is power
Mitchell says a key takeaway from the Macquarie survey was the power of information.
After receiving a brief intervention (receiving information that alcohol increases the severity of menopausal symptoms), researchers found respondents’ intention to decrease alcohol consumption rose.
“It was not every woman, not every time, but it’s very significant,” she says.
Mitchell says there are currently no clinical guidelines for perimenopause in Australia, which can mean women don’t receive the right treatment for their symptoms, or that they are dismissed.
While she thinks awareness and education around menopause have increased over the past decade, stigma – around menopause and alcohol consumption in women – persists.
Gurvich encourages women struggling with menopausal symptoms to know “there is help available, whether it’s in the form of hormone therapy or psychological help”, and to avoid relying on alcohol where possible.
“That is going to be much more beneficial in the short and long term compared to using alcohol as a coping strategy,” she says.
Dr. Nicole Lee, chief executive of not-for-profit Hello Sunday Morning, says it can be helpful to talk to others, since women who drink at risky levels tend to do so alone. Hello Sunday Morning’s Daybreak App offers free 24/7 peer support to those looking to change their relationship with alcohol.
“There’s a whole load of lifestyle changes that can be really beneficial,” Lee says.
“Making sure you’ve got a good sleep routine – if you’re having sleep problems, go talk to your doctor about it. You don’t have to suffer through that.
“Do things that bring you joy. Yoga, if you’re into that, meditation, things that are ‘me’ time, and things that replace the relaxing effects of alcohol.”
Where to learn more and get help
National Alcohol and Other Drug hotline 1800 250 015
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