POSTMENOPAUSAL WOMEN
AND ESTROGEN LEVELS

Purohit V Moderate alcohol consumption and estrogen levels in postmenopausal women: a review. ALCOHOL CLIN EXPRES 1998;22:994-7.

This report reviewed the English language literature on the association between moderate alcohol consumption and estrogen levels in healthy postmenopausal women who are not exposed to hormone replacement therapy. Of two studies that utilized urine estrogen levels, only one reported a significant positive association between the estrogens, estrone and estradiol, and alcohol consumption. Two out of six blood analysis studies reported a significant effect of alcohol on estradiol levels. However, one of these two positive studies was significant only for Danish and Portuguese women and not for Spanish women. In the other positive blood sample study, American women demonstrated increased estradiol levels only with wine and not beer or whiskey as compared to abstainers. Purohit concluded; "further studies arerequired to ascertain the relationship between moderate alcohol consumption and estrogen levels in postmenopausal women."

The author reviewed two reports that had studied the effect of an acute heavy dose of dilute ethanol on estrogen levels in postmenopausal women taking estrogen replacement. Both demonstrated that transdermal and oral estrogen-exposed patients exhibited a significant rise of serum estradiol after an ethanol drink equivalent to about 3.5 vodka/juice cocktails taken fasting over a short time in a 60 kg woman.

Longnecker M P and Tseng M Alcohol, hormones, and postmenopausal women ALCOHOL HEALTH & RESEARCH WORLD 1998;22:185-9.

Another review indicates the temporary increase in estradiol levels in postmenopausal women receiving hormone replacement therapy after dosing with alcohol equivalent to 3.5 to 4 standard vodka drinks. They note however no effect on hormone levels in women who were not receiving hormone replacement therapy. No effect on estrone levels was seen with acute alcohol ingestion whether the women were taking hormones or not.

After reviewing the nonexperimental data from epidemiological studies, these authors come to a similar conclusion: "the evidence that alcohol affects the levels of those hormones (estradiol and estrone) is inconclusive."

The following two articles concerning hormone levels in postmenopausal women related to alcoholic beverage intake are recent examples of epidemiological survey reports:

Madigan M P et alSerum hormone levels in relation to reproductive and lifestyle factors in postmenopausal women (United States). CANCER CAUSES CONTROL 1998;9:199-207.

Serum estrone levels were significantly higher among postmenopausal women drinking more than 20 grams per week of alcohol compared with abstainers.

Alcohol intake (not separated by type) of 125 postmenopausal women from five regions of the United States, who did not take hormone replacement therapy, was generally low in this cross-sectional study. Median intake of the 22 women who drank twenty or more grams of alcohol per week was 63.5 g/week and "almost all of whom drank less than two drinks (less than 30 g) per day." Association for the 20 or more grams of alcohol per week group was seen for all the hormones studied (direct relationship with estrone, estradiol and androstenedione and inverse for sex-hormone-binding globulin) but only the estrone relationship was statistically significant.

Nagata C et alAssociations of alcohol, height, and reproductive factors with serum hormone concentrations in postmenopausal Japanese women. Steroid hormones in Japanese women. BREAST CANCER RES TREAT 1997;44:235-41.

Serum levels of estradiol, sex hormone-binding globulin and dehydroepiandrosterone sulfate were measured in 61 postmenopausal Japanese women and compared to alcohol intake recorded on a self-administered questionnaire. The authors conclude: "alcohol consumption was positively associated with estradiol level and there was a strong linear trend after controlling for age, height, and body mass index (p for trend = 0.001). Trend for increasing dehydroepiandrosterone with alcohol consumption was also statistically significant after controlling for age and history of hysterectomy (p for trend = 0.01)."

PHYTOESTROGENS

Gavaler J S Alcoholic beverages as a source of estrogens. ALCOHOL HEALTH RESEARCH WORLD 1998;22:220-7.

Fascinating review of the literature that suggests wine may have an in-vivo phytoestrogen effect from non-alcoholic components.

Substances produced by plants that exert estrogen-like effects are called phytoestrogens. These naturally occurring plant sterols have been shown to exhibit affinity for the estrogen receptor in animal models. The estrogenic effects are usually less than that produced by the steroidal estrogens, estrone and estradiol. Reports in the literature have suggested that women with diets rich in phytoestrogens have a low incidence of estrogen-related cancers (Messina J NATL CANCER INSTITUTE 1991;83:541-6), cardiovascular diseases (Anderson N ENGL J MED 1995;333:276-82), and climacteric symptoms (Albertazzi OBSTET GYNECOL 1998;91:6-11).

Researchers have studied the hormonal effect in animals of a diet containing the residue from alcoholic beverages remaining after dealcoholization, which removes all the volatile substances and much of the water. For example, oophorectomized rats were fed in their daily diet concentrates of red wine or bourbon congeners that approximated one or two standard drinks. After four weeks, female rats fed the dealcoholized concentrates of red wine and bourbon demonstrated a dose-dependent estrogen-like effect on uterine weight (increased) and luteinizing hormone levels (decreased) as compared to controls. "The estrogenic effects on both uterus weight and luteinizing hormone levels were more pronounced in the animals exposed to red wine congeners than in the animals exposed to bourbon congeners. In addition, the estrogenic effects reached statistical significance at lower doses of red wine congeners than of bourbon congeners. These findings suggest that red wine contains a higher content and/or biologically more active phytoestrogens than does bourbon."

A human study has been done that appears to confirm that red wine contains biologically active phytoestrogens. For a four-week period the diet of postmenopausal women was supplemented with a dealcoholized red wine concentrate equivalent to one glass of wine daily. Statistically significant lower levels of follicle-stimulating hormone and luteinizing hormone and elevated levels of high-density lipoprotein and sex hormone-binding globulin suggest that the wine residue had estrogenic activity in-vivo.

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