Behind the “I’m Fine”: Women, Alcohol, and Coping in Midlife
The day is finally over. You have answered the messages, handled the responsibilities, checked on everyone else, and somehow made it through another exhausting afternoon.
You pour a drink.
It might feel like your reward, or maybe it is the signal that you can finally stop doing things for other people. Maybe you are hoping it will quiet your mind. But what happens when that drink starts feeling less like a choice and more like something you need?
When we talk about women and alcohol in midlife, we need to look beyond what’s in the glass. Stress, sleepless nights, caregiving demands, and feeling disconnected from yourself can all be part of the story, and deserve a conversation rooted in compassion rather than shame.
Women and Alcohol in Midlife, What Are We Seeking Relief From?
Perimenopause and menopause can arrive during an already demanding season of life. Disrupted sleep, emotional changes, caregiving, relationship stress, loneliness, and the unsettling feeling of being unlike yourself can overlap.
You might be caring for aging parents while supporting children. You may even feel overwhelmed at work or disconnected in a house full of people. Perhaps you are exhausted but cannot sleep, or more anxious than you used to be. Alcohol can become a way to seek relief.
A 2025 study of 936 women ages 40–65 found associations between menopausal symptoms, drinking to cope, and hazardous drinking. [1] Some women also reported avoiding alcohol because it worsened how they felt. These findings describe connections; however,
they do not prove that menopause causes addiction.
In fact, a 2026 review found no consistent evidence that the menopause transition itself independently increases alcohol consumption. [2] The relationship is much more complicated than a simple hormonal explanation.
The “I deserve a drink” Message
Women are surrounded by messages linking alcohol with relaxation, friendship, and getting through a hard day. The wine-themed gifts. The jokes about motherhood. The idea that a stressful week earns you a bottle.
These messages can make it easy to overlook an important question: Is this helping me care for myself?
You deserve rest, connection, pleasure, and relief. There is no doubt about that. But, it is worth noticing whether alcohol has become your main way to access those things. This is a key in figuring out if substance use is becoming a pattern.
When a Pattern Deserves Attention
Consider speaking with a healthcare professional if you notice that you:
Regularly drink more than you intended.
Have tried to cut back but find it difficult.
Continue drinking despite effects on your health, mood, responsibilities, or relationships.
These are recognized reasons to seek an assessment. You do not have to wait for a crisis.
Also, pay attention if drinking feels like your only reliable way to unwind, or if you feel increasingly preoccupied with keeping it private.
The Shame and the Hiding
For some women, the hardest part is admitting they are worried about their substance use.
I should know better.
What would my family think?
I am still handling everything, so surely it cannot be that serious.
Shame can make honesty feel risky. Someone might minimize how much they drink, avoid the topic at appointments, or drink privately because they fear judgment. Hiding is not, by itself, a diagnosis. But feeling that you must conceal your drinking is worth approaching with kindness and honesty.
You can take responsibility for a pattern without attacking yourself. Your concern deserves attention, even if your life looks fine from the outside.
Support Can Begin With One Conversation
In example, you might tell your healthcare provider:
“I have been using alcohol to cope, and I am concerned about my drinking. Can you help me figure out what support I need?”
Professional care may include counseling, medication, and peer support. Treatment can be tailored to your needs.
In the United States, call SAMHSA’s National Helpline at 1-800-662-HELP (4357) for free, confidential treatment referral and information, available 24/7 in English and Spanish. You can also visit FindTreatment.gov to search for care.
If you drink heavily or regularly, especially if you develop shaking, sweating, nausea, or anxiety when alcohol wears off, seek medical guidance before stopping or sharply reducing your drinking. With prolonged heavy drinking, your brain and body can become physically dependent on alcohol. Suddenly reducing or stopping can trigger withdrawal, which may include seizures, hallucinations, or severe confusion and can become life-threatening. A healthcare professional can assess your risk and provide monitoring and medication when needed to help you stop safely. If you are already experiencing seizures, hallucinations, or severe confusion, call 911 or seek emergency care immediately.
How I Can Support You
As a board certified health coach, I can support you as you work toward changing your relationship with alcohol. I have completed multiple courses on this subject, and my lived experience with alcohol-related struggles within my family makes this conversation personally meaningful to me.
Together, we can explore everyday patterns, build supportive routines, practice stress-management habits, and create realistic goals and accountability. When treatment is needed, coaching can provide an additional layer of support alongside your healthcare team.
My role does not include diagnosing or treating alcohol use disorder or managing withdrawal. My role is to help you build supportive habits and navigate everyday challenges without judgement. Your diagnosis, treatment, and withdrawal management belong with qualified healthcare professionals. When those services are needed, coaching can offer additional support alongside your care.
If this feels familiar, reach out privately to schedule a Health Jumpstart Call. We can talk about your goals and whether coaching would be a helpful part of your support system. You do not have to share your story publicly to ask for help.
If you are interested in learning more about this subject, check out my Substack article "When Coping Becomes a Concern: The Conversation About Women, Alcohol, and Midlife"
References
Davies et al. (2025). “Women’s alcohol use in mid-life: Identifying associations between menopause symptoms, drinking behaviour, and mental health.”The study of 936 women examining menopausal symptoms, drinking to cope, and mental health. It found associations, rather than proving that menopause causes problematic drinking. Read the study
Teixeira, Picior, & Ajewole (2026). “The Relationship Between Menopause, Perimenopause and Alcohol Use: A Scoping Review.” Substance Use & Addiction Journal.This review of 57 studies supports the distinction that menopause itself has not consistently been shown to independently increase alcohol DOI: 0.1177/29767342261467588 Read the abstract
National Institute on Alcohol Abuse and Alcoholism (NIAAA). “Understanding Alcohol Use Disorder.”Used for warning signs, treatment options, and the risks of alcohol withdrawal. Read the resource
NIAAA. “Treatment for Alcohol Problems: Finding and Getting Help.”Used for information about professional assessment, counseling, medications, and peer support. Read the treatment guide
Substance Abuse and Mental Health Services Administration (SAMHSA). “National Helpline.”The source for 1-800-662-HELP (4357) and information about its confidential treatment referral service. Visit the National Helpline page
SAMHSA. FindTreatment.gov. The treatment search resource included in both articles. Find treatment services
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