Men and women are different.
This is not news; the quite prominent (add also valuable and often enjoyable) differences are apparent to most of us but not, it seems, to many medical researchers who continue to structure many of their studies around men.
Medical science seems to view research through glasses that make women mostly invisible. Regardless of the reasons, designing scientific research which includes more women has begun to increase only in the past five years or so.
In some very key areas pertaining to alcohol -- most notably coronary artery disease -- the cardio-protective effects of moderate drinking have been confirmed by studies on women. Moderate alcohol consumption works not only by increasing the "good" HDL cholesterol and decreasing the stickiness of blood platelets, but also by helping a woman's body convert some of her androgens (male hormones) into estradiol, the most prominent of the estrogen female hormones. This conversion of androgen offers a substantial degree of protection for heart attack risk in post-menopausal women.
In several other areas of great health significance to women, most notably in the areas of breast cancer and Fetal Alcohol Syndrome (FAS), the science has been inconsistent, sensationalized in the media and frustratingly too incomplete for women to use in making personal health choices.
Women:
-- produce more estrogens than androgens, which affect the course of many diseases, notably cardiovascular disease and many cancers;
-- are, on average, 15 percent smaller than men;
-- have a higher percentage of their body weight as fat: 25 percent as compared with 15 percent for men;
-- have a smaller percentage of body fluids: 50 percent as opposed to 60 percent.
These differences have important consequences for a woman's drinking habits. Since a given "drink" will produce a higher blood alcohol concentration (BAC) in smaller people than larger ones, a woman's definition of "moderate" will, in general, be lower than a man's.
But body composition may also be an important concern. Since alcohol tends to concentrate in body fluids (and tends to avoid fat), the same drink may produce a higher BAC in a 145-pound woman than in a 145-pound man. However, individuals vary greatly in their ability to metabolize alcohol. As we mentioned earlier, women may also metabolize alcohol more slowly than men due to lower levels of alcohol dehydrogenase in their stomach linings.
As noted in this book's chapters on moderation and on cirrhosis, the peak concentration of blood alcohol may be the determining factor in alcohol's health effects with 0.046 BAC being some sort of threshold. This is only a hypothesis and needs more research to confirm or disprove.
Research also indicates that women:
-- tend to absorb alcohol more rapidly at mid-cycle ovulation and just before menstruation;
-- metabolize alcohol more slowly when they are taking birth control pills and
-- who are alcoholics tend to develop more masculine characteristics due to atrophy of the ovaries.
Alcohol abuse by men also has consequences that have not been widely publicized. As the Porter commented to Macduff in Shakespeare's Macbeth, alcohol "provokes the desire but takes away the performance." This is, perhaps, the best known of alcohol's reproductive consequences and does not require a medical study to prove. It may also be nature's way of protecting future generations, because research has shown that high levels of alcohol can produce deformed sperm.
In addition, chronic male alcohol abusers:
-- have higher estrogen levels;
-- develop shrinking of the testes;
-- lose pubic hair and develop feminine characteristics including enlarged breasts;
-- are frequently impotent and
-- lose the ability to produce sperm (deformed or otherwise).
Sperm counts can be decreased significantly at a level of about 50 grams of alcohol per day (about four to five drinks per day on average) which -- while producing normal sperm -- can affect overall fertility.
Why have the media, the government, and the alliance among advocacy groups and religious organizations focused on women and not men? It could be just one more way to keep women barefoot and pregnant according to an article co-authored by Jeanne Mager Stellman, associate professor of clinical public health at Columbia University and Joan E. Berlin, associate director of the Women's Rights Project of the American Civil Liberties Union. In their article, first published in the June 4, 1990, New York Times, the writers said that the results of junk science and media sensationalism "can be awesome. At best they [women] will suffer the anxiety that even moderate normal activity can damage their real or potential offspring. At worst, women will be treated as walking wombs, perpetually pregnant until proved otherwise, with pregnancy police peeping in at every door and restricting every activity -- except when they need them cheap."
"Women's drinking and birth defects are big news," the women said citing a New York Times Sunday magazine article which said that even a single drink during pregnancy could cause FAS and birth defects.
"But the research upon which these broad generalizations are based shows no such thing," Stellman and Berlin said. "In one set of studies, the authors [of the magazine article] clearly state that their data could not be interpreted below a three-drink-per-day level. They noted, moreover, that the `strongest predictors of a child's IQ were other factors: maternal education, mother-infant interaction, paternal education, race and birth order.' Is it the occasional glass of wine or social factors...that should have been highlighted?"
Stellman and Berlin charged the media with ignoring men's reproductive issues. "The discussion of women and alcohol shows that bias still taints journalism and the interpretation of science. Today, we ridicule the notion that it was once `scientifically' demonstrated that women are less intelligent because of smaller brain size and that education made women infertile. Pseudoscientific theories about poor blood, watery muscles and brain `lateralization' have all been asserted to `prove' women's biological and social weakness."
Unfortunately, as you will read in this book (and experience in our largely techno-illiterate media) the alcohol-control alliance is not beyond using "junk science" to advance its agenda.
"We've become a society drunk not on alcohol but on random `factlets' wrested from scientific journals before the ink has dried," wrote Stellman and Berlin. "Science does not grow from `factlets' dripping from laboratory spigots; research is more than `Eureka' in bathtubs -- no matter how many reporters record the event. Science is the accumulation of verifiable knowledge."
In their article, the two women cite evidence that junk science is still being used against women.
"...even the prestigious New England Journal of Medicine recently [in 1990] ran a widely reported editorial emphasizing the relative inability of the female digestive system to metabolize alcohol efficiently compared with the male. These grandiose conclusions were based on a study of 20 men and 23 women --12 of whom were alcoholics and all of whom were hospitalized for gastric dysfunction!
"Where was the usual caution and prudence in the New England Journal over the over-extrapolation of data from hospitalized patients to the healthy population, and why was this story front- page news?
"The assertions about biology in general, and their role as child bearers, now threaten our civil liberties and the gains we have made."
The article cites two cases:
(1) A Nevada woman lost custody of her newborn child because she drank some beer the day she went into labor. Since hospital workers smelled alcohol on her breath, she now has to prove herself a fit mother.
(2) A pregnant Wyoming woman was jailed for prenatal child abuse when police smelled alcohol on her breath when she went to them seeking protection from an abusive partner.
In a more recent case in 1991, two waiters in a Seattle restaurant were fired after they harassed a pregnant woman who ordered a single mixed drink. The woman, who was then overdue for delivery, was subjected to a harangue about the hazard she was presenting to her unborn child; the waiters' diatribe included thrusting a government warning from a beer bottle in the woman's face.
This seemed too extreme even for Michael Jacobson, who heads one prominent alcohol-control advocacy group, The Center For Science In The Public Interest, which has helped to whip up much of the anti-alcohol hysteria. In an interview with Wine Business Insider shortly after the incident, Jacobson stressed that "she seems to have been a good girl" by abstaining during the rest of her pregnancy and that, in his opinion, she was entitled to this one alcoholic beverage since the baby had gone to full term.
There are a number of "good girls" who feel they ought not to require the permission of Jacobson, his organization, or any other "public interest" group before making their own decisions.