If you're currently undergoing hormone replacement therapy (HRT), you may be wondering if that glass of wine with dinner or occasional happy hour indulgence could be impacting your results. The short answer? Yes, alcohol can interfere with your hormone therapy, often in ways you might not expect. Even moderate drinking can influence hormone levels, liver function, sleep, and overall treatment efficacy.

At Genesis Lifestyle Medicine, we understand that hormone therapy is a deeply personal journey—and one that deserves the best chance at success. Our experienced providers take a holistic approach to your health, which includes educating you on lifestyle factors like nutrition, stress, and alcohol use that can affect your results. So, let’s take a deeper dive into how alcohol consumption may be influencing your hormone therapy outcomes.

Can alcohol consumption affect hormone therapy results?

Yes, alcohol consumption can directly interfere with the way your body processes and benefits from hormone replacement therapy. Since alcohol alters hormone metabolism, impacts liver function, and triggers hormonal imbalances, it can reduce the overall effectiveness of your treatment and even worsen the symptoms you're trying to improve.

It disrupts hormone metabolism

Your liver plays a key role in processing both alcohol and hormones. When you drink, your liver prioritizes metabolizing alcohol over other substances—like estrogen or testosterone. This can delay the breakdown and clearance of hormones, causing fluctuations in your hormone levels and reducing the predictability and effectiveness of your therapy.

It stresses the adrenal glands

The adrenal glands produce several important hormones, including cortisol, which helps regulate stress, blood pressure, and metabolism. Alcohol consumption can suppress adrenal function, potentially leading to adrenal fatigue. This affects your energy levels and immune response and can throw off the delicate hormonal balance HRT is trying to restore.

It raises cortisol levels over time

While a drink might temporarily relax you, alcohol leads to elevated cortisol (stress hormone) levels hours after consumption—especially the next morning. This spike in cortisol can worsen fatigue, mood swings, anxiety, and weight gain, making it harder for HRT to work.

It impairs sleep quality

Quality sleep is essential for hormone regulation. Alcohol may help you fall asleep faster, but it reduces REM sleep and increases nighttime wakefulness. Poor sleep undermines your body’s natural hormonal rhythm, which can blunt the positive effects of hormone therapy and increase symptoms like irritability, brain fog, and low libido.

It worsens menopausal and perimenopausal symptoms

If you’re using hormone replacement therapy to manage symptoms of menopause or perimenopause, alcohol can intensify hot flashes, night sweats, anxiety, and depression. It acts as a vasodilator, which can trigger temperature fluctuations and disrupt neurotransmitters that affect your mood. Over time, these effects can significantly undermine your therapy’s goals.

How much is too much when drinking?

The National Institute on Alcohol Abuse and Alcoholism defines high-risk drinking for women as more than seven drinks per week or more than three drinks on any single day. For men, it’s more than 14 drinks per week or more than four per day. However, when undergoing hormone therapy—especially during perimenopause or menopause—your body is more sensitive to alcohol, so even moderate drinking may interfere with your treatment.

To minimize the impact on your HRT, aim to:

• Limit yourself to no more than one drink per day
• Avoid drinking on back-to-back days
• Stay hydrated and eat nutrient-rich meals before and after drinking

Signs and symptoms indicating alcohol is interfering with HRT:

• Increased fatigue despite consistent treatment
• More frequent or intense hot flashes
• Mood swings or irritability after drinking
• Difficulty sleeping through the night
• Unexplained weight gain or food cravings
• Reduced libido or sexual dysfunction
• Persistent brain fog or memory issues
• Anxiety or feelings of depression after drinking
• Blood pressure fluctuations
• Poor immune response or frequent illnesses

How to get the most out of HRT

To support your hormone therapy and feel your best, it’s important to take a proactive role in your daily habits. Your lifestyle plays a powerful role in how well your body responds to HRT.

• Stay mindful of your alcohol intake: Cutting back on alcohol doesn’t mean cutting it out entirely—unless your provider recommends it. Practice portion control, pace yourself during social events, and always hydrate before, during, and after drinking. Consider alcohol-free alternatives or “dry” weeks to give your system a break.
  
• Nourish your body with whole foods: Alcohol depletes essential vitamins—especially B vitamins and vitamin C—which are necessary for hormone production and liver detoxification. Make sure your diet is rich in lean proteins, leafy greens, healthy fats, and antioxidant-rich fruits. This will support your hormone balance and your liver’s ability to process HRT.
  
• Prioritize restorative sleep: Make quality sleep a non-negotiable part of your self-care routine. Avoid alcohol before bed, establish a calming nighttime ritual, and aim for 7-9 hours of uninterrupted rest. Good sleep enhances hormone regulation.
  
• Exercise regularly: Physical activity improves energy and mood and supports healthy hormone levels. Whether it’s strength training, walking, or yoga, aim for at least 150 minutes of movement each week to help your body adapt to HRT.
  
• Stay in close contact with your provider: At Genesis Lifestyle Medicine, we tailor your treatment to your evolving needs. If you notice any changes in your symptoms or if you’re unsure how lifestyle habits—like drinking—are affecting your results, check in with your provider. Adjustments can be made to ensure you continue to feel your best.

Hormone therapy can be life-changing—but only when your body is in a position to receive its full benefits. Schedule a consultation at Genesis Lifestyle Medicine. We’re here to help you optimize your HRT journey by addressing every aspect of your lifestyle, including alcohol use. With the right guidance, you can feel more in control of your health and empowered.