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Estrogen and Alcohol | Sex PharmD · Pharmacy Podcast Network

• 0:05
  Speaker 1: You are listening to the global network of podcasters dedicated
• 0:09
  Speaker 1: to the pharmacy profession. Welcome to the Pharmacy podcast Network.
• 0:36
  Speaker 2: This is the sex pharm d podcast with your host,
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  Speaker 2: Doctor Nadia Archimbaald, licensed clinical pharmacist and certified sex therapist
• 0:44
  Speaker 2: with a focus on women's sexual health and wellness. Doctor
• 0:47
  Speaker 2: A is here to cover important health topics and answer
• 0:50
  Speaker 2: all of your questions about subjects that can be applied
• 0:53
  Speaker 2: to pharmacy practice. And now here's doctor A.
• 0:57
  Speaker 3: Hello, I welcome to another episode of Sex farm D.
• 1:00
  Speaker 3: I am your host, Doctor.
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  Speaker 4: Nadia Archambau, and today I am talking about a very
• 1:06
  Speaker 4: hot topic I've been reading about, researching about, and listening
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  Speaker 4: to in other podcasts also, and that is estrogen and alcohol.
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  Speaker 3: So this is going to be.
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  Speaker 5: Very good information for those of you on homer and
• 1:20
  Speaker 5: replacement therapy, thinking about homeown replacement therapy, talking to patients
• 1:25
  Speaker 5: or friends about homeown replacement therapy, and this will provide
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  Speaker 5: a little bit more clarity on what the implications are
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  Speaker 5: when you drink and you're on home and replacement therapy.
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  Speaker 5: So we all know as healthcare providers. For those of
• 1:42
  Speaker 5: you who are healthcare providers and listening. When we have
• 1:45
  Speaker 5: patients come to us saying can I drink with this medication?
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  Speaker 5: The answer is always no. It's never a good idea.
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  Speaker 5: It's also a liability for us to say yes, drink
• 1:59
  Speaker 5: with this medication. But I wanted to explain exactly what
• 2:03
  Speaker 5: can happen when you're taking a medication. And this is
• 2:07
  Speaker 5: why we tell you no is healthcare providers, and for
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  Speaker 5: US healthcare providers listening, this will be some good information
• 2:15
  Speaker 5: to pass along to your patients, to your friends, and
• 2:17
  Speaker 5: to have for yourself. So basically, the one thing that
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  Speaker 5: estrogen and alcohol have in common is that the process
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  Speaker 5: in the liver. So our medications that we take in
• 2:27
  Speaker 5: general are processed in the liver. So what does this mean.
• 2:31
  Speaker 5: So when you are.
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  Speaker 3: Drinking alcohol and you're on.
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  Speaker 5: Former replacement therapy like estrogen, the alcohol actually can increase
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  Speaker 5: levels of estrogen in your body.
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  Speaker 3: Because it's reducing the ability of the liver. Really, alcohol
• 2:51
  Speaker 3: is reducing the ability.
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  Speaker 5: To process and clear that estrogen out of your body.
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  Speaker 5: So as a result, you have increased blood levels of natural,
• 3:01
  Speaker 5: naturally occurring estrogen or synthetic estradiol, which is what is in.
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  Speaker 3: Your home and replacement therapy.
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  Speaker 5: So too much estrogen is not a good thing because
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  Speaker 5: it can increase your risk for breast cancer. And there's
• 3:20
  Speaker 5: other things also that I'm going to talk about that
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  Speaker 5: it can do. One of the biggest complaints that I've
• 3:26
  Speaker 5: heard from women are I slept awful, I didn't sleep
• 3:32
  Speaker 5: while I was up all night, I was getting hot flashes.
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  Speaker 5: And sometimes a common denominator can be that they had
• 3:39
  Speaker 5: a few glasses of wine before bed. What's one thing
• 3:42
  Speaker 5: a lot of us do to unwind after a stressful day.
• 3:45
  Speaker 5: We have a drink, and then you don't get a
• 3:50
  Speaker 5: good night's sleep, and then you feel more stressed in
• 3:52
  Speaker 5: the morning and you don't feel well. So it has
• 3:55
  Speaker 5: the opposite effect of what we think it can do.
• 3:58
  Speaker 5: So also, what I've been seeing in research and hearing
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  Speaker 5: about is that the combination of alcohol and estrogen can
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  Speaker 5: lower your alcohol tolerance.
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  Speaker 3: This has been.
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  Speaker 5: Seen more in oral estrogen forms and not topical, so
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  Speaker 5: like topical estrogen like a cream or a transdermal patch,
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  Speaker 5: not as much.
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  Speaker 3: But if you're taking any type of capsule or.
• 4:25
  Speaker 5: Tablet that is directly processed by the liver, so it
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  Speaker 5: can actually lower your alcohol tolerance, and patients have noted
• 4:34
  Speaker 5: that their alcohol tolerance drops and what does that mean.
• 4:39
  Speaker 5: It means that they feel intoxicated a lot faster. This
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  Speaker 5: can also exacerbate or increase symptoms of metapause. So if
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  Speaker 5: you're taking estrogen for the reasons of helping you with
• 4:54
  Speaker 5: your hot flashes, with your sleep, your night sweats, alcohol
• 5:00
  Speaker 5: can actually make it worse, so it's doing the opposite effect.
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  Speaker 5: Another important thing about estrogen is that it helps women
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  Speaker 5: preserve their bone density. However, alcohol consumption can increase bone
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  Speaker 5: loss and therefore lessen the protective effects of estrogen. This
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  Speaker 5: can lead to increased risk of osteoporosis. And there were
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  Speaker 5: actually some studies done where they looked at the hormone
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  Speaker 5: estrogen and how it can regulate binge drinking in women,
• 5:43
  Speaker 5: where they would actually have bigger quantities or larger quantities
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  Speaker 5: of alcohol in the first thirty minutes after its after
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  Speaker 5: its offer to them. There was a study done at
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  Speaker 5: Cornell the School of Medicine, and that was actually very
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  Speaker 5: very very interesting to see how alcohol consumption can increase
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  Speaker 5: your desire to drink more. And there's actually some more
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  Speaker 5: studies being done on this. They were looking at alcohol
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  Speaker 5: behaviors in females. And you know, not only is alcohol
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  Speaker 5: you know, basically as far as long term not good
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  Speaker 5: for effects, but it's interesting that estrogen can actually have
• 6:36
  Speaker 5: an impact on that. There were studies done during that
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  Speaker 5: the pandemic.
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  Speaker 3: When when COVID was.
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  Speaker 5: Was big and people were home, and they noticed that
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  Speaker 5: women were increasing their alcohol consumption more than men. And
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  Speaker 5: so that's what triggered some of these studies to happen.
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  Speaker 5: So I was reading a lot about that particular one,
• 7:03
  Speaker 5: and there are what's called so this was a twenty
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  Speaker 5: twenty one study done. I'll put it in the show notes. Also,
• 7:11
  Speaker 5: there is a group.
• 7:12
  Speaker 3: Of neurons in your brain and it's called the.
• 7:16
  Speaker 5: Bed nucleus of the Stria terminalyis, and I'm probably butchering that,
• 7:21
  Speaker 5: but it's called b NST. So they found that those
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  Speaker 5: neurons were more excitable in female mice than in male mice.
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  Speaker 5: So I hate animal testing, but this was one that
• 7:34
  Speaker 5: was done on that. And then that actually that enhanced
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  Speaker 5: neuron activity was they had a direct correlation with binge drinking.
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  Speaker 5: So they were looking at what makes this these neurons
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  Speaker 5: more excitable in that brain region in females more so
• 7:57
  Speaker 5: than males, so they were contributing that to estrogen. So
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  Speaker 5: that's another thing you know against us, where we're increasing
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  Speaker 5: our estrogen and then it's increasing that desire to drink.
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  Speaker 5: Based on that study, so I thought that was interesting.
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  Speaker 5: I'll put that in the notes. And then they also
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  Speaker 5: looked at monitoring hormone levels, so when the hormone levels
• 8:21
  Speaker 5: were lower, the the need to drink was lower. So
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  Speaker 5: if you're on hormone replacement therapy and your estrogen is
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  Speaker 5: going through a peak, you may be more prone to
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  Speaker 5: wanting or craving that alcohol.
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  Speaker 3: So that was a whole that was.
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  Speaker 5: A whole study, and they are looking at and inhibiting
• 8:44
  Speaker 5: enzyme that synthesizes or creates that estrogen two treat alcohol
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  Speaker 5: consumption when those hormone levels surge.
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  Speaker 3: So I thought that was very interesting. Also back to.
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  Speaker 5: Just alcohol in general, we know that it can be
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  Speaker 5: a trigger for hot flashes and the reason for this
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  Speaker 5: is that it causes your blood vessels to dilate or
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  Speaker 5: get larger.
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  Speaker 3: That increases blood flow and that's what leads to that.
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  Speaker 5: Sudden surge of heat of the flushing and sweating and
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  Speaker 5: hot flashes. So alcohol does this by it interrupts your
• 9:27
  Speaker 5: your body's ability to regulate temperature.
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  Speaker 3: So and it does that directly through the brain.
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  Speaker 5: So for example, if your skin feels hot, your your
• 9:37
  Speaker 5: internal temperature can drop and that confuses your body's temperature
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  Speaker 5: control systems sleep, you know, so this will affect your sleep,
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  Speaker 5: maybe because you're getting hot flashes, maybe because you're you're
• 9:51
  Speaker 5: sweating more at night. And again it's that temperature regulation
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  Speaker 5: that alcohol disrupts, and that can cause more to night
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  Speaker 5: cause more night sweats. There were actually studies done where
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  Speaker 5: specific types.
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  Speaker 3: Of alcohol.
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  Speaker 5: Can create more vasodilation or increased blood flow, because that
• 10:13
  Speaker 5: means your blood vessels are getting bigger, causing those that
• 10:16
  Speaker 5: blood to rush through more.
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  Speaker 3: And that they.
• 10:20
  Speaker 5: Found is mostly found in any type of alcohol that
• 10:25
  Speaker 5: contains histamines and sulfites. Well, what's one of the alcohols
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  Speaker 5: that a lot of women drink and that has that
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  Speaker 5: It would be wine, even more specifically red wine, so
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  Speaker 5: some people, you know, there are a lot of studies
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  Speaker 5: about cardiovascular benefits to red wine. Of course, everything in moderation,
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  Speaker 5: but then it's having the opposite effect for a female
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  Speaker 5: having a glass of red wine at night, watching your
• 10:51
  Speaker 5: favorite show on Netflix, and then you go to.
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  Speaker 3: Bed and you sleep horrible.
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  Speaker 5: So I thought that was very interesting with the alcohol.
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  Speaker 3: And then you know, I've traveled to Europe a lot.
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  Speaker 5: And whenever I go to Europe, I notice that if
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  Speaker 5: I have wine, it doesn't affect me as much. Well,
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  Speaker 5: that's because they're not putting a lot of those histamines
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  Speaker 5: and sul fights. So the sulfites are what really can
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  Speaker 5: cause a lot of problems. Also causing that my the.
• 11:27
  Speaker 3: The hangover feeling.
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  Speaker 5: I get migraines specifically, and I feel that I don't
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  Speaker 5: have that as much if I'm in another country because
• 11:36
  Speaker 5: they're not putting.
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  Speaker 3: That in the wine there.
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  Speaker 5: So that's why some people will say, oh, I go
• 11:41
  Speaker 5: you know, I went to Portugal and I didn't get
• 11:43
  Speaker 5: any hangover drinking the wine. Well that's that's a big
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  Speaker 5: reason why. So I thought that was really interesting. And
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  Speaker 5: you know, there's no easy solution, you know.
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  Speaker 3: I mean, we're all human.
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  Speaker 5: We're going to have alcohol if that's something that you like.
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  Speaker 5: There are a lot of alternatives to alcohol though now,
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  Speaker 5: and you know, there's a lot more trending with the mocktails.
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  Speaker 5: I tell people to be careful with these because oftentimes
• 12:14
  Speaker 5: the mocktails have a lot of sugars in them, so
• 12:16
  Speaker 5: they're making drinks that do not contain alcohol, but they
• 12:21
  Speaker 5: you know, they have simple sayerup in them. They have
• 12:23
  Speaker 5: these sweeteners in them, and that's sugar is not the
• 12:26
  Speaker 5: greatest either, and that can that can cause effects with
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  Speaker 5: your sleep also and have an implication on weight gain.
• 12:34
  Speaker 5: So that's not always the answer either. So you just
• 12:38
  Speaker 5: have to be mindful of what they're putting in these mocktails.
• 12:42
  Speaker 5: One thing that has been an alternative that's been really
• 12:48
  Speaker 5: big now are CBD drinks THHC infuse drinks, And depending
• 12:56
  Speaker 5: on what state you're in, there's certain ones that are
• 12:58
  Speaker 5: legal and not legal.
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  Speaker 3: With the THHC components. But I have had.
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  Speaker 5: Patience and friends and you know, woman that I've talked
• 13:11
  Speaker 5: to talk to me about that and how that hit.
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  Speaker 3: That has been a good.
• 13:16
  Speaker 5: Alternative, and I think this could be a good a
• 13:20
  Speaker 5: good thing to look into. But of course everybody's different
• 13:24
  Speaker 5: because you may not have a good reaction to the
• 13:26
  Speaker 5: CBD or THHC. So I'm not recommending any of these things.
• 13:30
  Speaker 5: I'm just talking about different alternatives. But there are a
• 13:35
  Speaker 5: lot of things you can find online, but just you know,
• 13:39
  Speaker 5: make sure to look at the ingredients in it, because
• 13:41
  Speaker 5: sometimes you think it's better for you, but it's really not.
• 13:45
  Speaker 5: Of course, the best thing you can do a lot
• 13:46
  Speaker 5: of times, what I will do when I'm out is
• 13:49
  Speaker 5: I will have sparkling water or just you know, bottled
• 13:53
  Speaker 5: water with lemon.
• 13:57
  Speaker 3: The sparkling water I like because it has that little fit.
• 14:01
  Speaker 5: You can have them add any natural fruit or lemon
• 14:04
  Speaker 5: or lime. I prefer lemon, so that's a good healthy alternative.
• 14:10
  Speaker 5: Sometimes they have you know, non alcoholic wine and beer
• 14:14
  Speaker 5: out Again, look at what the sugar content is in these.
• 14:19
  Speaker 5: Some people like the like kava. That's another alternative. So
• 14:23
  Speaker 5: there are alternatives in different places you.
• 14:25
  Speaker 3: May go to.
• 14:27
  Speaker 5: We'll have these offered at the bars, again depending on
• 14:30
  Speaker 5: what state you're in.
• 14:31
  Speaker 3: But I am liking that there have been alternatives to this.
• 14:36
  Speaker 5: Again, you know, if you're having if you're out and
• 14:39
  Speaker 5: you're having soda as an alternative, that might not be
• 14:44
  Speaker 5: a good thing because it has sugar in it. Or
• 14:48
  Speaker 5: if you're having uh, like a diet soda, you have
• 14:55
  Speaker 5: the or artificial sweeteners like asparta, may supralost. Those are
• 15:00
  Speaker 5: not always good either for you. Some of them can
• 15:02
  Speaker 5: actually induce migraines, so you have to be very careful also,
• 15:11
  Speaker 5: so you know, when in doubt, water is the best thing.
• 15:14
  Speaker 5: Not everyone wants to have that though if they go
• 15:16
  Speaker 5: to a bar, So just use what works for you, and.
• 15:22
  Speaker 3: As far as you feeling good.
• 15:24
  Speaker 5: The next day, it can be worth It can be
• 15:26
  Speaker 5: worth skipping the alcohol for sure.
• 15:29
  Speaker 3: Also, some people were you know.
• 15:33
  Speaker 5: Let's say they have a vodka cranberry with soda water. Again,
• 15:38
  Speaker 5: that cranberry juice could also have added sugar in it,
• 15:42
  Speaker 5: So even if they're having one cocktail, it's not always
• 15:45
  Speaker 5: a good thing with the sugar content.
• 15:47
  Speaker 3: So just things to be mindful of.
• 15:49
  Speaker 5: But I thought this was really interesting as far as
• 15:53
  Speaker 5: what's become more highly studied in women and specifically on
• 15:58
  Speaker 5: hormone replacement there and the reason why you're not sleeping well,
• 16:03
  Speaker 5: for example, when you are.
• 16:07
  Speaker 3: Drinking alcohol, specifically at night.
• 16:12
  Speaker 5: Another thing that I wanted to talk about was since
• 16:16
  Speaker 5: we were talking about hot flashes, and I wanted to
• 16:19
  Speaker 5: talk about the drug Viosa, So as part of my
• 16:25
  Speaker 5: segment where I'm going to rate this drug, Viosa is
• 16:30
  Speaker 5: a that's an FDA approved hormone free prescription pill used
• 16:37
  Speaker 5: to treat hot flashes and night sweats that are caused
• 16:42
  Speaker 5: by metopause.
• 16:44
  Speaker 3: And so this one.
• 16:46
  Speaker 5: Works where it is and I'll include this in the
• 16:49
  Speaker 5: show notes also, So it is a it's called NK
• 16:54
  Speaker 5: three neurocanain three receptor antagonist. So when your estrogen drops
• 17:01
  Speaker 5: when you're going through metopause, that NK three brain chemical
• 17:06
  Speaker 5: will become overactive and that's what triggers your hot flashes.
• 17:10
  Speaker 5: And again it's that body's ability to self regulate. So
• 17:16
  Speaker 5: when you take this medication, it will block that neurokinin
• 17:22
  Speaker 5: b which helps to restore your body's internal thermostat.
• 17:28
  Speaker 3: As you can call it.
• 17:30
  Speaker 5: It does not contain estrogen or hormones. It is an
• 17:33
  Speaker 5: option for women who cannot be on hormone or placement
• 17:38
  Speaker 5: therapy or choose to not be on it, but they
• 17:41
  Speaker 5: are experiencing or suffering from hot flashes and they want
• 17:45
  Speaker 5: something to help with that. So this can be a
• 17:47
  Speaker 5: good hormone free alternative for that, which I like. And
• 17:53
  Speaker 5: clinical trials showed that sixty percent of women taking the
• 17:58
  Speaker 5: Vioza experienced more than half a reduction, so more than
• 18:04
  Speaker 5: fifty percent reduction in their moderate to severe hot flashes.
• 18:09
  Speaker 5: So you know, you can read this in the study
• 18:11
  Speaker 5: on the drug website also, but there was one clinical
• 18:14
  Speaker 5: trial where women had reported a drop where if they
• 18:18
  Speaker 5: received if they had about twelve daily hot flashes, it
• 18:22
  Speaker 5: dropped down to four point five. So you know, it's
• 18:27
  Speaker 5: not completely getting rid of hot flashes, but it is
• 18:32
  Speaker 5: decreasing the frequency of it, which I think is a
• 18:35
  Speaker 5: great thing. So this can be worth a try. Of course,
• 18:38
  Speaker 5: talk to your doctor about it, but I think this
• 18:42
  Speaker 5: can be a good alternative to hormone therapy if you're
• 18:46
  Speaker 5: just suffering from hot flashes. And again i'll put that
• 18:52
  Speaker 5: website on there so you can take a look. So
• 18:57
  Speaker 5: as far as the speed of how quickly it will work,
• 19:02
  Speaker 5: some patients reported a difference as soon as one week
• 19:07
  Speaker 5: and then with full effects usually established by then, or
• 19:13
  Speaker 5: some people reported up to four weeks, so one month.
• 19:17
  Speaker 5: I usually say give your body a month two for
• 19:22
  Speaker 5: your to get used to UH the UH medication and
• 19:28
  Speaker 5: start seeing effects.
• 19:30
  Speaker 3: So as far as that goes, I think it can
• 19:35
  Speaker 3: be a good thing. UH sleep.
• 19:37
  Speaker 5: It has increased your your quality of sleep by decreasing
• 19:42
  Speaker 5: the hot flashes. There were some side effects reported of course,
• 19:49
  Speaker 5: again your liver which which metabolizes all these drugs. There
• 19:54
  Speaker 5: there was a warning on Bioza for uh liver for
• 20:00
  Speaker 5: anyone with a risk of liver injury, so you want
• 20:04
  Speaker 5: to monitor liver functions.
• 20:05
  Speaker 3: Again, that's why it's always important to.
• 20:07
  Speaker 5: Have your doctor run routine blood work to make sure
• 20:11
  Speaker 5: everything's operating normally, so you can, you know, have ease
• 20:16
  Speaker 5: and knowing that the medication you're taking is not going
• 20:18
  Speaker 5: to cause liver damage if you're prone to that or
• 20:21
  Speaker 5: already have liver damage. And then the other side effects
• 20:27
  Speaker 5: they reported some woman had reported what it actually is
• 20:33
  Speaker 5: supposed to decrease, But there's always two sides to that.
• 20:37
  Speaker 5: Where are they getting a hot flash because they were
• 20:40
  Speaker 5: already getting a hot flash or did the you know,
• 20:42
  Speaker 5: did the medication actually cause that. So there's always pros
• 20:49
  Speaker 5: and cons to everything. But as far as my my
• 20:55
  Speaker 5: rating for this goes on RX meter on a scale
• 20:59
  Speaker 5: of one to ten, and I give this an eight. Again,
• 21:03
  Speaker 5: I'd like to hear more from what everyone else is saying.
• 21:06
  Speaker 3: The only reason why I give it, well, maybe i'd
• 21:09
  Speaker 3: give it a nine, maybe eight point we're going to
• 21:11
  Speaker 3: say eight point five.
• 21:13
  Speaker 5: So and the reason why I say this also is,
• 21:16
  Speaker 5: you know, of course, everybody's different, but I think it
• 21:20
  Speaker 5: is a promising drug for people. The only con to
• 21:24
  Speaker 5: this that I'm seeing is the price. Of course, everything
• 21:27
  Speaker 5: that works has a price. If you don't have insurance,
• 21:30
  Speaker 5: the medication can be can run from seven hundred to
• 21:34
  Speaker 5: I was looking about seven hundred and eighty, so just
• 21:37
  Speaker 5: under eight hundred dollars for a one month supply, which
• 21:39
  Speaker 5: has a big price tag on it.
• 21:41
  Speaker 3: Everyone's insurance is different. I'm not sure.
• 21:46
  Speaker 5: What medication plans cover it. You know, you can look
• 21:49
  Speaker 5: at the drug discount plans, but this is a pricey drug,
• 21:53
  Speaker 5: so that is a.
• 21:54
  Speaker 3: Big con for my RX meter. So I'd also like
• 22:00
  Speaker 3: to hear what everyone else has to say.
• 22:03
  Speaker 5: About it, and love your comments, feedback, anything you'd like
• 22:09
  Speaker 5: to add, anything you'd like to.
• 22:10
  Speaker 3: Learn more about.
• 22:11
  Speaker 5: I'm here for you, and thanks again everyone for listening.
• 22:16
  Speaker 5: And I hope everyone is able to look at all
• 22:23
  Speaker 5: this research and what I've been talking about and just
• 22:27
  Speaker 5: take it into perspective and.
• 22:29
  Speaker 3: Not get really overwhelmed with the information. You know, life
• 22:33
  Speaker 3: is short. We still have to enjoy it.
• 22:36
  Speaker 5: But again, as I always say, everything in moderation, thanks
• 22:39
  Speaker 5: everybody for listening.