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Socialites to soccer moms, more women are drinking today – and drinking more. There’s a sobering price to pay: around 130 people now die in South Africa each day of alcohol-related causes, says Medical Research Council acting vice president Prof Charles Parry, director: Alcohol and Drug Abuse Research Unit.

We have one of the world’s highest average individual consumption rates of alcohol a year among drinkers. South Africa is ranked second highest for harmful patterns of drinking, and highest for binge drinking.Women drink for a cocktail of reasons, from escaping poverty or heartache to masking insecurities, shedding inhibitions and just “feeling good”, says Carol du Toit, director of the South African National Council on Alcoholism and Drug Dependence (SANCA) Durban Alcohol and Drug Centres. While that may be fine in moderation, it can easily tip into abuse.


The drivers

Studies show the social stigma that traditionally gave women a sense of shame about drinking and getting drunk has faded. In addition, advertising and celebrity drinkers have lent alcohol acceptability and allure.

Du Toit attributes the rise of what’s been dubbed the “Scummy Mummy” to women’s radically altered patterns of parenting and work. Before, we settled down and started families in our 20s, stopping work for the preschool years or longer, she says. Today, we’re putting off children until far later and, driven by demanding careers, barely stop for the births. Multiple roles leave us stretched and stressed, ripe for self-indulgence and escape in alcohol. But while some women stop at one, others drift into addiction.

Disruptive or traumatic early life experiences such as divorce, desertion, physical and psychological abuse, alcoholism in the family or psychiatric illness, make you vulnerable to developing a drinking problem, says Parry. So do genetics, although research suggests they are responsible for only half of our risk for alcoholism. Environmental factors account for the rest – peers, family, availability and generally poor social conditions.

The differences

Alcohol affects women differently and more dangerously than men. “Once swallowed, it passes through the digestive tract and is dispersed in the body’s water,” Du Toit explains. “The more water in the body, the more diluted the alcohol. Women generally weigh less than men and have less water in their bodies, so their brain and other organs are exposed to more alcohol. But worse, is the exposure to more of the toxic byproducts produced through the breakdown and elimination process.”

Women also have lower levels of certain enzymes involved in the breakdown of alcohol. Hormone fluctuations influenced by menstruation, oral contraceptives, menopause or hormone replacement therapy (HRT) may also affect alcohol metabolism. The result is that women become intoxicated after drinking less than men. Women are also  are more likely to experience adverse effects after drinking smaller amounts for fewer years.

The dangers

Alcohol raises women’s risk of breast cancer, hypertension, heart disease, ulcers, reproductive problems, osteoporosis, pancreatitis, brain damage and memory loss. It also raises their chances of depression, attempted suicide and abuse of recreational drugs.

Liver damage from alcohol abuse is more severe for women than men. “They develop cirrhosis and hepatitis faster than men. And, more women die from it,” says Du Toit. Even one drink a day can increase the chances of contracting breast cancer by about 20%, says Parry. Post-menopausal women or those with a family history are especially at risk. Drinking also exposes women to accidents, sexual assault, risky sexual behaviour, sexually transmitted infections (STIs) and unwanted pregnancy.

Young women are more vulnerable, says Du Toit. “Drinking before age 15 gives a higher predisposition to alcoholism than starting at 21.” They risk eczema, headaches, sleep disturbance, poor education performance and loss of friendships at a crucial life stage.

Drinking while pregnant can cause foetal alcohol syndrome (FAS). Babies are born with below average birth weight, facial abnormalities, and mental impairment that causes long-term difficulties with learning, memory and problem-solving. FAS also causes behavioural problems.

The denial

Waiting for those with alcohol problems to come to their senses and get help is usually futile, says Du Toit: “Denial is part of the disease.” It’s up to those close to them to ensure they get treatment. “They need to see a clinical psychologist or social worker in private practice. Alternatively, they come for an informal, confidential chat with a SANCA counsellor.”

Ultimately, alcoholism has three outcomes: insanity, death or recovery. “This is a progressive disease and left untreated is always fatal,” say Du Toit.

The good news is that women are equally capable of recovery as men. Psychotherapy, medications and self-help and support groups are all available. “The sooner they are started the better.”

Take care

You could be at risk of a drinking problem if you:

  • gulp drinks at parties
  • insist on drinks at any special event or outing
  • consume drinks at certain regular intervals, however inconvenient to others
  • insist on a drink for your “nerves” because of a stressful day
  • need a drink before you can make a presentation or entertain people
  • drink when depressed to escape
  • lie about drinking or minimise it to others
  • make promises about drinking to others or yourself (“I’ll cut back tomorrow”)
  • use breath-fresheners and perfume to disguise the smell of alcohol
  • miss work because of drinking (especially Mondays or after holidays)
  • act promiscuously as alcohol loosens inhibitions
  • become moody and unpredictable
  • have memory lapses
  • feel generally unwell

These signs in isolation don’t necessarily indicate alcoholism, but a pattern can point to a problem. Get help. If you see them in others, contact SANCA for personalised advice on how to help them.


The World Health Organization advises:

  • two alcoholic drinks a day is the maximum
  • no drinking if you will be driving
  • you should have at least one day a week where you abstain
  • no drinking if pregnant.
  • If you have a history of illness or on medication, consult a doctor or pharmacist before drinking.

Get help

SANCA National 086 147 2622 or (regional) 031 202 2241, 011 892 3829, 021 945 4080 or visit SANCA counsellors are currently undergoing international training in programmes for women.

Alcoholics Anonymous SA has women-specific groups in some cities. Contact: 0861 435 722 or visit

Glynis Horning