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Why are women more sensitive to alcohol?

This is probably due to the difference in average size between men and women - the same amount of alcohol is spread over a smaller volume of blood

By Marit Selvin

Men consume more alcohol than women, but women are more prone to the clinical complications caused by excessive drinking. This fact is probably due to the fact that in women the breakdown of alcohol is less efficient than in men. Drinking the same amount of alcohol by the members of both sexes will result in a higher alcohol level in the blood of the woman than in the blood of the man. In the study, the results of which were published in the April issue of the journal "& Experimental Research Alcoholism: Clinical", the reasons that may cause a difference in the effect of alcohol on the two sexes were examined.
In the study, carried out by a group of researchers led by Charles Lieber from the Alcohol Research Center in New York, it was found that the difference lies in the breakdown mechanisms of alcohol in the stomach. In women, it turned out, a lower percentage of alcohol is broken down in the stomach than in men, so the amount of alcohol left in the blood is greater.

In previous studies that focused on the effect of alcohol on the liver, it was found that alcoholic women are more likely to develop serious liver diseases, compared to alcoholic men. The minimum amount of alcohol that causes the appearance of liver cirrhosis (cirrhosis) in women is 2 to 3 times smaller than the minimum amount that causes the appearance of the disease in men. Women are also more sensitive to the toxic effects of alcohol on the brain, heart, muscles and pancreas.

It is customary to attribute the higher sensitivity of women to several reasons. One is body measurements. On average, women are smaller than men and weigh less, so the same amount of drink concentrates in the women in a smaller blood volume. Second reason: women have more fat tissue - relative to body weight - compared to men. The volume of fat in the body is inversely proportional to the volume of water, while alcohol is more soluble in water than in fat. Since in women the volume of water in the body is relatively small, the alcohol is absorbed less.

Another possibility, examined in the current study, is a slower breakdown of alcohol in the digestive system of women. Some of the alcohol breaks down in the stomach before entering the bloodstream. The breakdown is done by the enzyme alcohol dehydrogenase (ADH). The breakdown in the stomach reduces the amount of alcohol entering the blood and thus acts as a protective mechanism against an excessive increase in the concentration of alcohol in the blood. Normal activity of ADH is therefore essential for maintaining a low concentration of alcohol in the blood. Lieber's team studied the activity of the enzyme, to determine if the difference in the effect of alcohol lies in this activity
on both sexes.

"In previous experiments, we found that in women the activity level of the ADH enzyme is lower than in men, so less alcohol is broken down in their digestive system and more reaches the blood system, when both sexes consume exactly the same amount," Lieber explains. "We also found that in chronic drinkers - men and women - after drinking large amounts of alcohol, ADH activity decreases significantly and the alcohol level in the blood increases. These two factors work together in women, and as a result alcoholic women completely lose the protective mechanism in the stomach and the level of alcohol in the blood after drinking is the same as that obtained by injecting alcohol directly into the vein."

In the current study, Lieber and his team examined three subgroups of the enzyme, with the aim of more precisely characterizing their mechanisms of activity. It turned out that one of the three subgroups was mainly responsible for the difference between men and women. In women, its level in the stomach is significantly lower than in men. Furthermore, it was found that this subgroup is active at relatively high alcohol concentrations. From this it follows that the breakdown of alcohol in women is less effective than in men precisely at high alcohol concentrations; At low concentrations the difference is not significant. "The difference between the sexes is expressed in drinking wine (which has an alcohol concentration of about 10%) and drinking spirits (which has an alcohol concentration of up to 40%)," Lieber says. "But there is no difference if you drink, for example, beer, where the alcohol concentration is only 5%."

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