Episode 6: This One’s for the Girls
Sam Hampson:
This is Champagne Problems, where we come together to explore the gray areas of drinking. This is a judgment free zone where we can all take a look at how we make decisions about our relationship with alcohol.
Robbie Shaw:
This episode is called This One's for the Girls. We're going to focus on the differences between the male and the female relationship with alcohol. We have already covered the male relationship, so today we're going to dive into the female relationship. We're going to cover cultural influences, societal influences, and expectations inside the household, as well as biological differences, how our brains and bodies react to alcohol differently. Today, we have got a very special guest in the studio. She is an anesthesiologist with a specialty in pediatrics. She also lives in a household where her spouse is in recovery. So I feel like she's got a lot to bring to the table and... Oh, you know what? She's also my wife and her name is Dr. Ashley McDonald.
Dr. Ashley McDonald:
Thanks for having me.
Robbie Shaw:
We're very happy to have you in here. You and I, obviously we're entrenched in this topic. We talk about it all the time. I also forgot to mention that Ashley is a moderate drinker. She has never really had any addiction issues, dependence issues. So she would fall into that category of a gray area drinker, one who is very controlled. First and foremost, I'd love to talk about some of the things you and I talk about on the regular, and what it’s like living in a household with someone in recovery?
Dr. Ashley McDonald:
Well, I probably think about it more than a typical person would in that I think about every time I take a drink and how it's affecting me, how it's affecting you and what our daughter sees. And so I know that had I not married you, I probably would've been a heavier drinker.
I don't drink typically when it's just us in the house. If it's just me by myself, I'll have a glass of wine when we're at dinner because it's a special occasion for me going out, and of course I'm with friends. But had I not married you, I think I probably would have a glass of wine more often than I do now. And I'm grateful for the fact that I pay attention to it. I'm aware of the health consequences with alcohol and what it means to be raising a daughter with and without alcohol, and leading by example.
Robbie Shaw:
On the other side, I have to be very cognizant of how enforcing I am. I can't put too much pressure on you just because of my past experiences. I would never want to make you feel guilty based on having a glass of wine every now and then, even though sometimes I'm like, "Oh, all alcohol is bad." But I've learned to step back on that as I should.
Dr. Ashley McDonald:
Well, we've been on this wellness path now. My mother passed away a little over a year ago, and since that happened, I've changed a lot of things in my life, including my diet, how much I exercise. And the more we talk about wellness, the more alcohol is definitely something that you have to put in that picture. And once you decided to do this, it made me realize how important that is for me to think about in terms of being healthy. And it's not to say that I'm taking it outta my life completely, but it's something that I think about in terms of what it's doing to my body.
Robbie Shaw:
That's where we're lacking. The topic of alcohol is a sensitive topic. It is a normal structure in our society and culture... It's part of our identities. And to talk about it in a way that might go against the grain is not always welcome.
So I think an interesting topic in this whole arena is how you and I have, and we're still constructing it, decided how we're going to parent our daughter when it comes to alcohol. Obviously I am in the recovery world and there's zero alcohol in my life. And my daughter has never seen me take a sip of alcohol. And I pride myself on that, from a parenting perspective. But at the same time, that's not the reality of our world. It's not the reality inside of our household. There are glasses of wine, there are occasions where there is alcohol and that is perfectly fine.
Dr. Ashley McDonald:
It's interesting because she looks at me as an example. And I think about this a lot, because she thinks, and she has a couple of friends whose dads are recovering alcoholics, the moms drink. And she thinks that moms can handle a glass of wine and dads can't. And she has made that comment to me before. That said, she also said she's never going to drink. But I do worry that she looks at the moms and it's like, well, mommy can have her glass of wine, but the daddys can't handle it.
And I'm trying to reconcile that right now and figure out the best way to talk to her about it and the risks with alcohol, especially drinking too early. And she's going to come into peer pressure, and how we're going to discuss that. Because right now it's so easy, because she's like, “never going to drink, done.” She has equated it with allergies and badness and what's happened to you and she has no desire. She thinks it's bad, but at some point that will change. And I worry that she'll think, well, mom did, and mom does, and so I'm okay too.
Robbie Shaw:
It’s so normalized and everybody's doing it. It's just an interesting conflict there, especially when it comes to parenting. Let's go back to male vs female, and the differences, because that is what is going to be the bulk of this interview. And we are bringing in Sam Hampson, my beloved co-host, who is now coming in from Charleston and not Charlotte. So she is not in the studio today, but she will be coming in via Zoom and conducting an interview with my wife, Dr. Ashley McDonald.
Effects of Alcohol Culture on Women
Robbie Shaw:
I appreciate you two doing this interview in the category of females and females’ relationships with alcohol. I think I'm probably gonna take a step back and allow you all to dig into this.
Sam Hampson:
Thanks. It's super exciting to have you. Well, I'm really excited about this episode in particular. I feel like I've referenced it several times even in some of our other episodes, I was just saying, oh, I can't wait to get to this. There's so much that we can dig into when we talk about women's specific issues around alcohol.
And I think the biggest thing is just starting to have conversations about what information we've never talked about, and why we don't share it. And what's so taboo about sharing it?
I'm just going to jump right in because I'm so pumped to get into this topic. Just broadly, what are some of the unique impacts of alcohol on women that you see either professionally or personally?
Dr. Ashley McDonald:
That's an interesting question. I'm an anesthesiologist, so I don't deal with patients so much in terms of their relationship with alcohol in a patient context that often. There are lots of comments made when we put a patient to sleep that's male or female, where we will notice that it takes them a lot to get them to sleep, like, “oh, they must be heavy drinkers,” but we never really ask them if they are. The more research I do on alcohol's relationship to women, and from a medical standpoint is, the risk of certain health problems that are associated with alcohol and women in terms of we're smaller, we have less body mass, we have less body water, and so it affects us more quickly.
It's harder for us to metabolize it. And so we are more likely to have health problems from a lot less alcohol. The health problems that are related are, breast cancer, digestive issues. The list goes on and on and on. And then from a society standpoint, like you talked about, I think it is so taboo now to judge alcohol. You probably know just as well as I do, when you decide not to drink for a night. I'll get together with my friends and I won't drink because I have to work. I get up at 4:30 in the morning to work. And I always feel like I have to come in and be like, oh, this is the reason I'm not drinking.
Sam Hampson:
It's so interesting even to hear you say you've got the most valid reason, and then even still saying it, and kind of hoping that that's taken as like, “oh, okay, we'll back off.”
Like we can find pretty much any excuse, any event, any emotion, any change in wind to find a reason to drink, but actually finding a reason not to drink or living an alcohol free journey is the big question, right?
For what am I not drinking? Rather than what am I drinking for? And that's a lot tougher for us to come up with, because it doesn't feel as immediate. But it always takes me back to this idea of, I think it would feel more immediate if more people knew the information that we know about alcohol. That's the really tricky place of being uniquely informed about all of these health risks and all of the impact that it's actually having, then you feel like, this is important information that people should know, and yet it feels super taboo to bring up.
Dr. Ashley McDonald:
When I started doing the research on this, Holly Whitaker's book, Quit Like a Woman, was recommended to me. And that book has just been amazing for me in terms of her reflections and talking about its effect and alcohol's relationship with women.
Sam Hampson:
It's this uniquely informed place to be. I know these things, I've started to read about these things. And I would say for anyone who is on this journey, starting this journey, willing to take a look at this journey, I think it's a phenomenal place to start. It's got some really great questions to ask yourself, really easy absorbable takeaways and also some real life, “Hey, this isn't always gonna look perfect in sunshine and rainbows, just give it a stab see what happens.”
Dr. Ashley McDonald:
Especially during these times, anxiety is at an all time high. You have women who have been sending their kids off to school, now they are working from home with kids from home, they are being told, “there's not enough wine.”
These are all things that are on social media, and they're jokes and it's cute and it's funny, however, they don't realize how when you drink a couple glasses of wine, you're actually going to have more anxiety. It's going to actually escalate things and make things worse if you continue to do it an unhealthy amount.
And like you said, it's this delicate balance of getting that information out there. I am trained in how to talk about smoking cessation. I talk about it every single day with patients, and they expect it. They're ready to hear it. They will either give me the finger or maybe listen to me, who knows. But the only time I talk to them about alcohol cessation is the people that already have liver damage, that are coming in for a procedure because of what the alcohol has done to their bodies. That's the only time I bring it up, rarely do I talk to someone that just tells me they're a social drinker. I just nod my head and move on. Because we're just not trained. Even as a medical professional, I'm not trained on how to talk about this stuff because it is so taboo.
Sam Hampson:
And then compounding all of that with the fact that women are going to experience those physical ramifications a lot sooner or quicker. If you look at a woman in her 50s, who's been diagnosed with a substance use disorder versus a man, you're going to see typically much more physical impact on the female.
The Impact of Alcohol on the Female Body
Sam Hampson:
Talking about the dance around this topic, what do you think makes alcohol such a unique topic that it has to even be tiptoed around unlike maybe some of the other things. Like my girlfriends, there's nothing that's off topic, there's nothing that's too taboo to talk about, and still alcohol is somewhere else. What do you think is happening?
Dr. Ashley McDonald:
Well, I think for one, it was the first available way we could self-medicate for our anxiety and depression. And it's always been there for every celebration. When you think about any shower, even a baby shower, there's alcohol, a wedding, alcohol, I mean, everything involving celebration. And so to take that away, you're taking away the celebration. That's the way I think people feel about it.
There's no question that it's here to stay. The question is, how are we going to talk about it? And how can we change the subject? So that it doesn't scare people away from talking about it.
Sam Hampson:
Some of the really in depth scientific stuff is what really gets me. And I always reflect on some of the information that I read and go back to, how come me and the girls don't talk about this? How come my mom and I don't talk about this? Some of the things that come to mind specifically for me, and whichever one jumps out at you that you want to dive into, let's do it, because things like birth control, fertility. What alcohol impact is like around the time of your menstrual cycle, menopause, just female hormones in general, and that interaction with alcohol, what is happening with the amount of information that we know there? And what do you feel like is really not being uncovered or talked about or dug into around some of the hormonal stuff with women?
Dr. Ashley McDonald:
I'm not in reproductive health, so I don't know how much they talk about a lot of these things. I know we always talk about fetal alcohol syndrome, and we tell women not to drink when pregnant. If you're dealing with infertility, I honestly can't say what infertility doctors tell their patients. There is no question that your ovulation will change if you're a moderate to heavy drinker. There have not been a lot of studies. And that's another thing, there's just a paucity of studies on this stuff.
We're clearly not going to give teenagers alcohol and study the effects on puberty. So really the only models that you have to look at are rat models. And though you can compare those to humans, I think that it's always easy to say, well, there's just not enough studies to really tell us.
My dad was a Navy GYN and both my parents drink every night, except for when my dad was on call. And he always tells the stories about back in his day, when women would go into preterm labor, they would feed them alcohol. And he always laughs and tells the story about my mom going into preterm labor with me at Disney, and so he bought her a six pack of beer and fed it to her. I mean, that's just like where? Here's my dad, who's a physician who loves to tell this story all the time and getting my mom drunk while she was pregnant with me.
I'm sure he would die that I'm telling this story right now, but it was a different time. That's just surrounding pregnancy, but I think everything else sort of remains the same. We'll get on a patient about drinking too much, but rarely do we talk about moderate drinking, whether it's fertility, whether it's puberty, whether it's menopause, like I said, I don't see patients for that, but... Based on my medical school training and when I did rotate through the clinic, I don't remember really talking about it.
Sam Hampson:
It's so interesting when you start to open up that door that actually a lot of folks struggle with the same thing. I remember recognizing after a couple of years of not consuming alcohol, that the only medication that had changed for me in all those years was birth control. All the attempts of finding the right birth control, which we're told we just have to do.
And the combination of alcohol, and not high amounts of alcohol, but just alcohol, plus my birth control made me violently ill. And when I started sharing that, it turns out there's a lot of commonality there and there's a lot of conversation that just belongs around it so that we don't feel so lonely and crazy and weird about some of it.
Dr. Ashley McDonald:
Was it a physician that figured out that combination or was it you?
Sam Hampson:
It was me. I don't think it ever got brought up. It was like, it just makes me sick. I'm just going to stop taking it.
And then the conversation around, it makes my cramps way worse. It makes my flow way heavier. It makes everything more painful, and then I get migraines.
Dr. Ashley McDonald:
Right. I mean, medically, there's no question that there's a relationship between alcohol and an increase in estrogen. And you think about dehydration and how that's going to affect your body and how that's going to change your periods, and increase bloating, increase headaches. I mean, all those things are directly correlated, but you're right, we don't talk about it, unless you're hopefully with a group of women that are happy to talk about it.
Sam Hampson:
I hear the same thing later in life. I've worked with a lot of women who experienced very similar things during menopause, and struggle with that journey and changing effects of alcohol going through menopause. I don't know if that's something that you're willing to dig into or know anything about professionally.
Dr. Ashley McDonald:
Actually, when I knew that we were doing this talk, I did look into menopause and alcohol. And once again, there's not a lot of good data, and it's very conflicting in terms of how it affects menopause in general. There are some things that say that it worsens hot flashes, there some things that say that it makes them better. I can't speak to the scientific literature on it, because there's just not a lot of it.
No question, as we go through menopause, we lose more body water. And so the effects of alcohol are way heavier in terms of you can't drink as much once you are going through menopause, and also, alcohol increases your risk of osteoporosis and bone degeneration. And so you’re at a higher risk of having fractures and kyphosis.
Another thing that's interesting is that alcohol and the perimenopausal and post-menopausal women has increased a lot over the past 10 years. And I think that speaks to society and social media and the fact that mommy juice and carrying on to older women and our social circles and the way we get together is always alcohol. And I think it's increased the consumption in older women.
Sam Hampson:
Gosh, there's so much there. Like you said, there's also not enough there in terms of research.
Dr. Ashley McDonald:
What's interesting is, even in the medical literature, a lot of it has caveats, it's like we think if you're drinking just a couple of glasses of wine that you're probably okay, but there's no good scientific literature audit. I do think that literature is probably coming. It's just a hard thing to study. And a lot of people don't want to study it. People don't want to hear it.
Sam Hampson:
Sure. There are some really concrete things that we do know about the interaction between alcohol and our physical bodies. And you had mentioned cancer prior, can you speak a little bit, some of the dots that you've connected in terms of knowing this is a neurotoxin carcinogen and the link with cancer?
Dr. Ashley McDonald:
Yeah. I think that alcohol is related to 6% of all cancers, and 4% of mortality from cancers. Breast cancer being a huge one.
And the relationship of alcohol and an increase in estrogen is probably one of the most important modifiable risk factors that you can change if you have a risk of breast cancer, you should be thinking about your alcohol intake. Of course there's no question of genetic linkages to breast cancer. And those are probably the most important things to be looking at. But if you have a history of it, there is a clear link to alcohol and breast cancer. I don't think they know how much, when you look at it in terms of how many drinks a day puts you at higher risk for breast cancer, I can't say. But there's no question on the link.
And then all the other cancers, like we talked about, it's a toxin. So all organs that you're passing it through, whether it's your esophagus, your stomach, your rectum. I mean, all of those things are at a higher risk of developing cancer.
How to have a Healthy Relationship With Alcohol
Sam Hampson:
What are some of the questions you've asked yourself about your alcohol use? Being someone who's not in recovery, in a marriage with someone who is in recovery comes with its own pieces. And I'm curious for you what questions that have been raised about your own alcohol use.
Dr. Ashley McDonald:
I touched on this earlier, but I think because I'm married to someone that is in recovery, I think about every time I take a drink, I think about how much I'm drinking, what it's doing to me, how my daughter is watching me drink. Am I going to be affected the next day? And will my husband judge me? The last thing I want is for him to look twice at my drinking. I'm very aware of what I drink. That said, I still drink probably more than I would like, over the past year, I've really questioned how much I drink. Especially during COVID, I saw so many of my friends increase their consumption.
And I went the opposite direction, mainly because I was in this whole mindset of, I'm going to be as fit and healthy as ever in my life. I have so much to deal with from the stress standpoint of dealing with COVID and everything else, I need to meditate, I need to exercise.
Sam Hampson:
I think that both a blessing and a curse, but I think once you know the scientific information, once the lifestyle of recovery, once you really have that back door to the negative impact that alcohol can have in a lot of different ways, it really has you. Because I definitely relate on the same level of, I still drink more than I probably would choose to. If you asked me ideally how much I would drink, it would be less than I do.
It's not about cutting it all out at once. It's just about knowing more the next day and exploring and continuing that journey to evaluate what's really best for us, because I really think that there's something so empowering about, I love the word that you used, the modifiability. If that's a word. Of this factor in our physical health and our wellbeing, in our overall empowerment as women to really take a look at the unique effects that has on the female body and make decisions based on that.
Robbie Shaw:
So one thing I'd like to do for our listeners is, have you come up with just two or three things that are takeaways, things to think about, maybe challenges, things to question in the realm of the female relationship with alcohol.
Dr. Ashley McDonald:
Clearly I come from the medical standpoint. So I think that there's a lot of things that we don't talk about from the medical side and the relationship of alcohol to women's bodies, and whether it will be worsening your PMS symptoms, etc. I think these are things that we should be talking about together as women, because we do talk about things all the time, and perhaps bringing up even to your doctor, I would wonder how often that has ever even been brought up. How about you, Sam, anything?
Sam Hampson:
The things that come to mind for me, maybe more challenges than they are takeaways, piggybacking on what you said, Ashley, of just having that space with your girlfriends or with the women in your life. And whatever shift I need to make to be able to talk about this with other women, I have always found that there's common ground when I bring it up. And so I just have to be willing to do that.
The other piece will just be thinking, how empowering this can be as a woman to trailblaze and to do something that may be a bit of a newer concept that may be unpopular. I think a lot of these conversations are starting to happen and I've experienced more and more friends, especially in the wellness or in the athletic realm, starting to talk about the impact of alcohol, but just be willing to really make your own path and your own journey. And if that means taking a look at alcohol, removing alcohol, changing your patterns with alcohol, be brave, go do it, girl.
Robbie Shaw:
The information and opinions shared on this podcast are solely those of the hosts and guests and not a substitute for medical advice. If you feel like you may need professional help, here are some resources. For the substance abuse and mental health services administration hotline. Call 1-800-662-4357 or visit samsa.gov. For listeners in the Charlotte North Carolina community, visit dilworthcenter.org, or call 7043726969. Or visit theblanchardinstitute.com or call 7042881097.