Many women in Ireland going through menopause experience emotional and physical symptoms that can be difficult to manage, from low mood and anxiety to poor sleep and brain fog. For some, these challenges can lead to unhealthy coping mechanisms, such as drinking alcohol more frequently or using medication or drugs to get through the day.
This page explores the link between menopause and addiction, why women in midlife may be more vulnerable to substance misuse, and how to recognise the signs of a developing a drug problem or alcohol addiction and what treatment options are available.
Hormonal Fluctuations and Risks of Addiction
While declining oestrogen levels during menopause don’t directly cause alcohol abuse or substance use, they can increase vulnerability by affecting the brain’s reward and stress systems. This may make it harder for some women to manage cravings or cope with emotional distress, contributing to a higher risk of problematic alcohol or drug use.
Data from a 2014 research study by the University of South Carolina shows that hormonal changes during menopause, especially declining oestrogen levels, can increase vulnerability to addiction. This makes it harder for some women to control their substance use and may lead to more compulsive patterns of drug or alcohol use. Recognising the role of hormonal shifts is key to understanding and addressing addiction during this life stage.
Menopause, the Brain, and Mental Health
Some evidence suggests that the hormonal disruption during the menopause transition causes changes to the structure and functioning of the brain. This does not necessarily explain all of the features of the menopause, but it highlights that this is also a neurological transition. Many symptoms of the menopause, such as hot flushes, difficulty sleeping, mood changes and memory issues, are neurological in nature.
The mental health burden of the menopause is evident. Women going through menopause may be at increased risk of developing conditions like anxiety, depression, sleep disorders and Alzheimer’s disease. Of these conditions, depression has the strongest evidence linking it to menopause.3,4
The health charity ASCERT, based in Northern Ireland, found that excessive alcohol intake during the menopause may exacerbate mood swings and depressive symptoms, potentially creating a cycle of emotional distress and increased drinking.
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Mental Health and Addiction Vulnerability
In women with pre-existing depression or low self-esteem, menopause can worsen existing problems and can increase the chances of a treated psychological condition coming back. For those women with no prior mental health issues, menopausal symptoms can increase the likelihood of mood changes.
Women going through menopause can be at greater risk of experiencing depression and anxiety. These conditions commonly co-occur with substance use disorders. If you are suffering from a mental health condition and develop addictive behaviours, interaction between these disorders can generate a vicious cycle with worsening symptoms. If you are suffering from addiction to alcohol, prescription medication or illegal drugs, alongside a mental health condition, this is known as a co-occurring disorder, or dual diagnosis.4
Alcohol Misuse and the Menopause
Alcohol misuse during the menopause can intensify many of the symptoms women already find difficult to manage – from sleep disruption and hot flushes to mood swings and weight gain. While using alcohol as a way to self-medicate may offer a perceived temporary relief of menopause related symptoms, alcohol is more likely to make things worse in the long run.
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Disrupted Sleep and Hot Flushes
Binge drinking or regular alcohol use can worsen hot flushes and night sweats. Because menopause already affects sleep patterns, alcohol can make it even harder to get proper rest, leaving you feeling exhausted and emotionally depleted.
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Weight Gain and Physical Changes
Menopause naturally slows the metabolism and reduces muscle mass, which makes it easier to gain weight. Alcohol is high in calories and low in nutrients, so regular drinking can contribute to unwanted weight gain, especially around the middle.
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Mood and Mental Health
Although some women drink to manage feelings of anxiety or low mood, alcohol can heighten mood swings and make depression related symptoms worse. Using alcohol as a coping mechanism to combat menopausal symptoms may offer short-term distraction but often leads to a cycle of emotional distress and dependency.
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Bone Health and Long-Term Risks
After menopause, bone density naturally declines, increasing the risk of osteoporosis. Drinking heavily can accelerate this bone loss, raising the risk of falls and fractures. There is also a higher risk of developing conditions such as breast cancer with increased alcohol consumption.
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How Alcohol Affects You
Everyone responds to alcohol differently. Your overall health, drinking habits, perimenopausal and menopausal symptoms can all influence how alcohol impacts you. Evidence consistently shows that drinking more during this stage of life raises the risk of both short- and long-term health problems.5
Menopause and Addiction Research in Ireland
In a 2021 research survey by the Irish Department of Health, women in Ireland reported that their menopausal symptoms were severe enough to interfere with daily life and activities in 78% of cases – a strain that may lead some to turn to alcohol or other substances as a coping mechanism.6
The Newson Health Survey, a study of nearly 1,200 women, revealed that one in three reported increased alcohol consumption since entering perimenopause or menopause. Additionally, one in eight women regularly exceeded the recommended weekly limit of 14 units, often using alcohol to alleviate symptoms like anxiety and poor sleep. The study highlights the association between menopause and increased risk-taking behaviours, including higher alcohol consumption, as women attempt to manage challenging symptoms.
Dr Louise Newson, the study lead, commented, “The changes experienced in the perimenopause and menopause can cause women a lot of discomfort and stress. As a result, they may turn to painkillers or alcohol to relieve these symptoms or, as our study shows, be more susceptible to substance abuse.”
While direct Irish-specific studies on menopause and alcohol consumption are limited, international research indicates a concerning trend that warrants further research and public health attention.
Recognising Addiction
Addiction is a chronic brain disease that can be difficult to recognise in yourself or those around you, especially in the early stages. Understanding that the menopause and hormonal fluctuations can trigger mental health conditions, like depression, which are linked to addiction, is a helpful starting point.
Early signs of substance misuse can often be very subtle and may be difficult to spot on your own. It can be helpful for older women and their family members to look out for changes in personality, behaviour and physical and mental health. In general, women suffering from addiction may:
- Struggle to control their substance use
- Experience cravings
- Participate in risky behaviours
- Withdraw from relationships, social life and work responsibilities
- Begin hiding items such as bottles or packets, or concealing certain actions
- Develop dependence, where they need the substance to go about daily activities
- Develop tolerance, where they need more of the substance to get the same effect
- Experience withdrawal, where they feel sick or unwell during periods away from the substance
- Notice a deterioration in general health and mental well-being
The early signs of substance misuse or addiction may be so subtle that it is difficult to recognise them. In such cases, those around you may begin to notice these changes before you are aware yourself. Listening to their concerns can help you to seek help earlier, if you are ready to engage in treatment.7
Getting Help
It can be overwhelming to know where to start when you are seeking guidance for addiction. Once you notice a change in your menstrual cycle, it may be helpful to assess how you are managing your menopause symptoms, and in particular, identify which of these may be making addictive behaviours worse.
If you are looking for more information on different forms of addiction, credible sources can include health, government and charity websites. If you would like to discuss treatment options, it is important to speak with medical professionals, such as your GP. You can also contact us to find out more about our comprehensive care programme.
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Treatment Options for Menopausal Addiction Symptoms
If you are concerned that you may have developed an addiction to alcohol or drugs, do not feel like you have to manage this alone. The exact nature of your treatment will vary depending on the diagnosis provided by a healthcare professional to ascertain the nature of your addiction. Alongside medical support, psychological therapies and emotional support can play a vital role in helping women manage the mental health challenges that often arise during this stage of life. Treatment options may include:
- Counselling
- Individual talking therapies, such as cognitive behavioural therapy (CBT)
- Residential rehab
- Free mutual support groups, such as Alcoholics Anonymous
Hormone Replacement Therapy (HRT)
If you are experiencing addictive behaviours or mood disorders during the menopause, treatments targeting menopausal symptoms, such as hormone replacement therapy (HRT), may also be helpful.1
Hormone Replacement Therapy (HRT) can ease some of the physical and emotional effects of menopause, which may reduce the risk of turning to alcohol or drugs as a coping mechanism.
Despite its potential benefits, a Department of Health and Social Care report in the UK found that only 15% of women aged 45 to 64 received HRT in the past year.
How Can Smarmore Castle Help?
At Smarmore Castle, our experienced and empathetic team are committed to delivering high-quality, personalised support for addiction and co-occurring disorders. We offer medically supervised detox, inpatient rehabilitation programmes and aftercare support to promote successful and long-lasting recovery.
Speaking to our team can help you find a treatment plan that best suits your needs. If you are unsure of the level of support you will require, our team can guide you through this.
Call or email us today to learn more about our personalised treatment plans.
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References
- British Menopause Society. What is the menopause? (PDF) [Accessed June 2025].
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Mosconi L, Berti V, Dyke J, Schelbaum E, Jett S, Loughlin L, et al. Menopause impacts human brain structure, connectivity, energy metabolism, and amyloid-beta deposition. Scientific Reports. 2021;11:10867.
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Swaminathan A, Lepping P, Kumar G. Menopause and Mental Health. The Obstetrician & Gynaecologist. 2023;25(3): 229–238.
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National Institute on Drug Abuse. Co-Occurring Disorders and Health Conditions. [Accessed June 2025].
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C. Lillis, M. McNamara, J. Wheelan, M. McManus, M.B. Murphy, A. Lane & P.M. Heavey. Experiences and health behaviours of menopausal women in Ireland. SHE Report 2021 (PDF). [Accessed June 2025].
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[Legg, T.J. PhD, PsyD, and Tyler, M. What Are the Early Signs of Addiction? [Accessed June 2025].
