Uh oh – noticed your body is not coping well with your usual glass of wine? Alcohol intolerance is something that can develop around perimenopause. Let’s have a look at why your body is rejecting alcohol and what you can do about it.

Alcohol intolerance during perimenopause

It’s common for women to experience alcohol intolerance symptoms as they transition through menopause. There are a few mechanisms at play here, which we’ll explore in a moment.

But in case you’re not familiar, the symptoms of alcohol intolerance can include:

  • Hot flushes
  • Palpitations
  • Anxiety
  • Low mood
  • Increased anger, irritability and frustration
  • Tummy upsets and diarrhoea
  • Headaches
  • Weight gain around the middle

Depending on the contributing cause, you might experience a few of these, or the whole kit and caboodle!

Why can’t I drink as much as I used to?

A few primary mechanisms are at play here: liver detoxification, blood glucose, and histamine.

The liver

Alcohol is a priority for the liver to detoxify. In fact, it will put alcohol to the top of the queue, ahead of other processes such as hormone metabolism and nutrient metabolism.

As a result, you’ll have fewer nutrients to access (at a time that you’re needing even more to support you) and you can throw off the balance of hormones (cortisol, testosterone, oestrogen, the list goes on!)

Blood glucose

Alcohol is also treated like a sugar by the body. It will increase your blood glucose level, regardless of what alcohol you drink or mixer you use! This throws off your insulin balance, leading to more body fat and abdominal fat in particular.

This feeds into perimenopause symptoms as well. Your oestrogen influences your insulin sensitivity, leaving you prone to blood sugar fluctuations and increased insulin resistance. All of this adds up to some serious mood swings, low energy, increased fat storage and feeling generally miserable!


This is an incredibly common (but overlooked) cause of alcohol intolerance. Consuming alcohol increases the release of histamine. Now keep in mind, histamine is essential – it’s involved in immunity, inflammation and nervous system function. It’s an excitatory chemical, meaning it amps up activity (compared to more calming chemicals like GABA).

When histamine is released, it causes body-wide symptoms including:

  • Blood vessel dilation and flushing
  • Runny nose
  • Itchy eyes and/or skin
  • Hives
  • Puffy face
  • Headache
  • Diarrhoea

So what does this have to do with alcohol? The body can tolerate a certain amount of histamine before you overfill the bucket, so to speak. So if you already have borderline histamine, a glass of wine can tip you over the edge.

Some of the common contributors to high histamine include:

  • Allergies and intolerances (particularly if unidentified or not managed properly!)
  • Bacterial overgrowth in the gut (SIBO and dysbiosis)
  • Increased intestinal permeability and poor gut function
  • Fermented foods such as cheese, sauerkraut, kombucha, yoghurt
  • Other foods that can trigger histamine release such as MSG, glutamate, lectins and additives
  • Stress
  • Genetics – this can influence how quickly you clear histamine from the body
  • Anything that blocks the enzyme that processes histamine including tea, cola, energy drinks and some medications

So if you already have a couple of these factors, alcohol can overload your body’s histamine capacity. As a result, you trigger alcohol intolerance symptoms caused by too much histamine!

I think I have alcohol intolerance – what can I do?

Well the simple answer is to not drink alcohol. But that’s not an option for everyone, so there are a few other ways you can minimise your symptoms!

Don’t ‘save’ your drinks up – you’re better off drinking one glass a few nights a week vs having an entire bottle on Friday night

Switch your wine out – it’s higher in histamine, so try clear spirits like vodka and gin instead

Stick to low sugar options – ideally you’ll have mixers that use natural sweeteners or use plain soda water

Manage your stress for your oestrogen’s sake, your blood glucose, your liver AND your histamine load!

Stock up on high vitamin C and high quercetin foods – these help to clear histamine. Go for your red, green and purple veg, as well as cruciferous veg like cabbage, kale and cauliflower, along with some fresh fruit

Include B6 and essential fatty acids to support histamine metabolism

Support your detox pathways – the easiest way to do this is with plenty of fresh, filtered water daily!

Increase your fibre-rich foods for additional gut support

Reach for some herbal teas – my favourites include dandelion root, turmeric, ginger, peppermint and nettle tea

Ready to start your year feeling amazing?

The New Year is almost here, and you have the opportunity to make a change!

If you want to dive into the New Year feeling energised, cool as a cucumber and able to tackle anything the world throws at you, I’m here to help. Book in for a free discovery call today, and we can explore how I can help you to support and nourish yourself in 2023 – mind, body and spirit.