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Kath Elliott recognises her former self in some of her clients seeking support to change the way they drink. Many are high-performing, aged in their 40s and 50s, with big jobs, families and numerous stress factors.
Elliott describes herself as a former “social binge drinker”, able to spend days off alcohol but then going hard.
“If I look back at it, a lot of it was around relieving stress and the pressure of juggling motherhood, working a corporate job and trying to keep that perfect veneer,” she says.
Elliott quit alcohol in 2019, aged 46, following a fall in front of her family after drinking. She left corporate PR, trained as an alcohol mindset coach and has since worked with people to understand and adjust their relationship with Australia’s favourite drug.
She helps her clients examine what underlies their alcohol use – shifting from “automatically responding to ‘I need a drink’ to … ‘What am I actually feeling?’” – and has noticed women often identify stress and the sense of reward as factors.
Alcohol use has traditionally been researched on males, in part because men have historically been far bigger drinkers and partly because women’s variable hormones were viewed as a complexity, says Dr Leigh Walker, a Florey Institute of Neuroscience and Mental Health researcher.
But in recent decades, men’s drinking has declined in Australia and women’s has increased, especially in mid-life, and Walker and others have begun researching what is driving the change.
Walker’s team has just published a paper on sex differences in brain circuitry showing emotions are a stronger driver of binge-drinking for females than males. The researchers believe this shows stress or distress may be a cause of craving among female binge drinkers.
“There is building evidence to understand the female brain acts differently in response to alcohol and what causes us to drink excessively. You go out to have one drink, but instead you have five – that stop signal is what we’re interested in,” said Walker, who leads the Florey’s hormones and behaviour group.
The brain’s emotional regulation centre was far more strongly activated in females than males while binge-drinking, and when this mechanism was blocked, females consumed less alcohol, the group found.
Though for ethical reasons this research needs to be conducted on mice – which like many mammals enjoy alcohol when freely given access to it – the brain mechanisms are relevant across species.
‘Women will drink at levels that many don’t realise are affecting their body in much worse ways [than men face] because of our physiology.’
Dr Leigh Walker, Florey Institute of Neuroscience and Mental Health
Closing the gender gap in understanding drivers of alcohol consumption is especially important because alcohol causes more severe physical harm to women at lower consumption levels, and women have a higher risk of certain alcohol-related problems than men.
“Women will drink at levels that many don’t realise are affecting their body in much worse ways [than men face] because of our physiology,” Walker said.
“We have much more fat, and alcohol can ‘live’ in that fat in a sense; we drink less and get more drunk, and the amount coursing around in our bodies is also different from men because of their lean mass, and how it’s metabolised.”
Associate Professor Shalini Arunogiri, an addiction and mental health researcher with Monash University and a treating psychiatrist at Turning Point, said the research finding conformed with what clinicians see. Confirming the link between emotions and alcohol in brain mechanisms was valuable in the quest for better treatments, she said.
Dependent drinking and craving for alcohol as a response to stress alone was more clinically common in women than in men, Arunogiri said, while patterns for men included stress and also reward responses.
“For a lot of women, the cues are internal: thinking about stress, pain, trauma; struggling to cope is driving the urge to drink as the way to manage that rather than seeing a bottle shop [and sensing reward],” she said.
Women interviewed as part of the Florey’s gender and behaviour lab work on how sex, hormones, and neural circuits shape vulnerability to alcohol-use disorders have spoken about managing the aftermath of trauma with alcohol.
“Emotional pain is a big part of what I’ve seen and listen to in people’s stories,” said Walker.
“For a lot of people alcohol is a coping mechanism … we are trying to understand comorbid problems like depression and alcohol use, or stress disorders or trauma, why people are drinking, and looking at treatments tailored by sex and gender as well.”
Australian and New Zealand women have among the highest rates of risky and binge-drinking globally, Walker said. Australian Bureau of Statistics data shows up to one in four women (18 to 24 per cent) binge drinks – more than four drinks on a single occasion – at least once a month.
Australia’s first study into the incidence of female drinking at very high-risk levels, by Flinders University in 2024, found more than 300,000 women regularly drink at such levels, and highlighted growing evidence alcohol may interact with women’s natural biological rhythms and its impact worsens with age and menopause.
Arunogiri said the Florey research was important because it provided evidence that might lead to better treatments for alcohol use disorder.
“The work presented here is ground-breaking at a mechanistic level. It raises the possibility of future drug development. It helps us understand the nuance in how we view women’s alcohol use,” she said.
Kath Elliott said women wanting to cut down on alcohol often tell her similar things about why they drink to what the researchers report. But her personal experience has taught her that managing difficult emotions is far easier without alcohol in her system.
“Since I’ve been alcohol-free, I’ve been much more able to cope with stress in a better way,” she said. “You’re able to emotionally regulate so much better using other tools … and by the very nature of taking a toxic substance out of your body, its ability to deal with stress is already increased so much.”
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Wendy Tuohy is a senior writer focusing on social issues and those impacting women and girls.Connect via X or email.From our partners
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