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Everything Your Nutritionist Wants You to Know About PCOS and Alcohol

PCOS alcohol

Let’s be real – most of us enjoy the occasional drink.

But just like food preferences, folks vary in their liking for alcohol. Regardless of your stance and habits, being informed about alcohol consumption recommendations can be valuable at any time.

For those with polycystic ovary syndrome (PCOS), knowledge of the benefits and risks of alcohol intake becomes particularly crucial. PCOS is a syndrome influenced by genetics, lifestyle habits, and metabolism that leads to complex hormonal imbalances in the body. Given that alcohol is a significant (yet, often overlooked) aspect of lifestyle, learning about safe consumption in PCOS can have a transformative impact on your symptoms, metabolic health, and well-being.

I am a Halifax dietitian and, in this article, I will teach you everything you need to know about PCOS and alcohol.

Can you drink alcohol with PCOS?

A frequent concern I hear from my clients with PCOS is that they believe alcohol isn’t good for PCOS. But truly, it’s a little more complicated than that. It really depends on the type of alcohol, how much, the setting, and your lifestyle.

As a Registered Dietitian, my biggest concern when it comes to alcohol and PCOS is that alcohol is highly associated with insulin resistance. Alcohol intake can truly send your blood sugars on a rollercoaster, exacerbating insulin resistance. Monitoring your alcohol consumption is crucial, especially if you have insulin resistance or diabetes. And we know that about 70% of people with PCOS have insulin resistance.

My second biggest concern is that alcohol interacts with several medications and supplements. If you’re taking any medications or supplements to manage your PCOS or related conditions, you should check to ensure there are no adverse interactions with alcohol. Chances are you’ll discover some sort of interaction.

However, I also recognize that we are social beings, and that alcohol can be a symbol of celebration, socializing, and relaxation. I understand that abstinence is not a realistic target for many! I’m here to give some realistic advice.

Alcohol PCOS

How much is too much?

Canada’s Guidance on Alcohol and Health provides evidence-based advice on how much alcohol we should be drinking:

Key points include:

  • 0 drinks per week is best! Not drinking has benefits, such as better health, and better sleep.
  • 2 drinks or less per week — You are likely to avoid alcohol-related consequences for yourself or others at this level.
  • 3–6 standard drinks per week — Your risk of developing several types of cancer, including breast and colon cancer, increases at this level.
  • 7 standard drinks or more per week — Your risk of heart disease or stroke increases significantly at this level.
  • Consuming more than 2 standard drinks per occasion is associated with an increased risk of harm to self and others, including injuries and violence.

Overall, the evidence does truly show that no matter where you are on the continuum, for your health, less alcohol is better.

Let’s discuss the nuances in PCOS.

Tips for drinking alcohol with PCOS

Here are my tips for consuming alcohol safely with PCOS, if you choose to do so.

What are the best alcoholic drinks for PCOS?

  • Choose low-sugar options: Sugary cocktails and mixed drinks can contribute to empty calorie intake and may not be the best choice for you, especially if you have insulin resistance. Opt for PCOS alcohol drinks with lower sugar content and consider using sugar-free mixers like diet soda, club soda, diet tonic or water.
  • Liquor has less sugar than beer and wine: Clear spirits like vodka, gin, and tequila generally have no sugar or carbohydrates. Consider making sugar-free mixers using spirits, rather than drinking beer or wine, which are higher in carbs.
  • Avoid high-calorie cocktails: Cocktails with creamy or sugary ingredients, such as piña coladas or margaritas, can be high in calories, sugar, and salts, and may not be the best choice for you with PCOS.
  • Red wine: Red wine may have some health benefits thanks to its rich antioxidant content. Choose a dry red wine with a lower sugar content for maximum benefit.

Some of the best alcohol for PCOS:

  • Vodka soda lime (vodka, soda water, fresh lime, and rosemary)
    • 0g sugar
    • 100 calories
  • Red wines (Cabernet Sauvignon, Pinot Noir, and Merlot)
    • Cabernet Sauvignon, Pinot Noir, and Merlot typically contain less than 3g/L residual sugar
    • 100-300 calories per glass
  • Dry white wines (Sauvignon Blanc, Chardonnay, Pinot Grigio)
    • Sauvignon Blanc, Chardonnay, Pinot Grigio typically contain less than 2g sugar per serving
    • 100-300 calories per glass
  • Dry Prosecco
    • 1g sugar
    • 80 calories
  • Rum and diet Coke
    • 1g sugar
    • 100 calories
  • Gin and sugar-free Tonic
    • 1g sugar
    • 100 calories
  • Michelob Ultra Beer
    • 2.6g carbs
    • 95 calories
PCOS Alcohol

Watch your blood sugar

Drinking can affect your blood sugar for up to 12 hours. Certain types of alcoholic beverages, like cocktails, sweet wines, or beer, can rapidly elevate insulin levels, leading to a subsequent drop in blood sugar a few hours later. Additionally, alcohol can impede the liver’s capacity to generate glucose, further contributing to low blood sugar levels.

This is dangerous, as you may unknowingly become hypoglycemic during sleep (if you are drinking in the evening, as most of us do)!

To mitigate this risk, always consume your alcohol alongside a meal, preferably a well-balanced one. At the very least, make sure you’re having a protein-rich snack with your drinks (like cheese or nuts).

If you have diabetes with your PCOS, test your blood sugar before going to bed after a night of drinking. If it is in the 5.6-7.8mmol/L range, you may be fine. Eat a bedtime snack to raise it if it is lower than that. Try snacks such as half a sandwich; yogurt; or cereal with milk, cheese with crackers, or apple with peanut butter.

Restricting your intake of sugary mixed drinks, sweet wines, and large beers can also be beneficial in preventing these scary fluctuations.

Caution with alcohol and metformin in PCOS

Alcohol can increase the risk of lactic acidosis, a very rare but very serious side effect associated with metformin. Symptoms of lactic acidosis include weakness, fatigue, dizziness, lightheadedness, muscle pain, trouble breathing, and stomach discomfort. Lactic acidosis is a medical emergency that must be treated in a hospital. 

Both alcohol and metformin are metabolized by the liver. It’s generally recommended to use caution with alcohol while on metformin. Moderate alcohol consumption is often considered okay, but heavy drinking should be avoided.

Ask your doctor for regular liver blood tests to monitor your lactic acid levels and liver health if you take metformin and drink heavily. 

Alcohol and PCOS

Best timing for drinking with PCOS

Practice moderation by limiting the amount of alcohol consumed in a single sitting. This can help prevent excessive fluctuations in blood sugar levels and hormonal balance. Sip and savour your drinks, rather than chugging them. Give your body time to process and metabolize each drink.

As mentioned earlier, if you choose to drink alcohol, consider doing so with meals and snacks. Having food in your stomach can slow down the absorption of alcohol, potentially reducing its impact on blood sugar levels.

Also, drink plenty of water before, during, and after consuming alcohol to stay hydrated. This can help counteract the dehydrating effects of alcohol.

Take care of your mental health

Alcohol is a central nervous system depressant and has been linked to an increased risk of depression and anxiety. Women with PCOS are already more susceptible to mental health conditions, and drinking alcohol really increases that risk.

While some people may use alcohol as a temporary means of coping with stress or negative emotions, it can ultimately contribute to the development or exacerbation of mental health disorders.

If you drink alcohol, take care of your mental health. If you or someone you know is experiencing mood issues related to alcohol or in general, seek support from healthcare providers, counsellors, or mental health experts.

Alcohol and its effects on PCOS fertility

Unsurprisingly, heavy drinking has negative effects on fertility. Multiple studies report reduced fertility and an increased risk of miscarriage in women who drink heavily. One study showed that women who drank more than 14 servings of alcohol a week had an 18% decreased chance of conceiving.

PCOS Alcohol Fertility

However, the effects of low-moderate alcohol consumption on fertility are inconsistent in the research. There may be some evidence for not needing to avoid alcohol entirely when it comes to fertility. Women with PCOS might constitute one of the groups where modest alcohol consumption could be of benefit. But, more research is needed in this field to draw major conclusions.

There is very strong evidence to show that alcohol causes harm to the growing fetus. If you are actively seeking to become pregnant, or are pregnant, you should abstain from alcohol. And when breastfeeding, not drinking alcohol is safest.

The bottom line: Is alcohol bad for PCOS?

If you have PCOS and enjoy drinking alcohol, do so in moderation and use the tips listed above to drink safely (never drink on an empty stomach, stay hydrated, and choose low-sugar beverages).

If you need support with your PCOS diet connect with a dietitian. To book with me, click here. I am a registered nutritionist in Halifax specialized in women’s health and I’d be thrilled to guide you along your health journey.

Looking for more PCOS nutrition treatment tips?

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What are you waiting for? Get your copy HERE for delicious recipes, simple hacks, and tips for eating well with PCOS.

Your Guide to Thriving with Polycystic Ovary Syndrome

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