More people are becoming sober, or sober-curious these days, and for good reason. Alcohol has been linked to an increased risk of seven different types of cancer, according to the U.S. Surgeon General’s 2025 warning. But if all of your other habits are in tip-top shape—you work out most days of the week, consistently get seven or more hours of sleep, and eat healthily—how much can drinking really tank your health?
Unfortunately, alcohol can do a lot of damage. The moment ethanol, the type of alcohol found in alcoholic beverages, “enters the body, it crosses every membrane it touches, including the blood-brain barrier and the gut lining,” says Dawn Mussallem, DO, the former integrative oncology leader at Mayo Clinic and current chief medical officer at the longevity clinic Fountain Life. Within minutes, your liver starts breaking ethanol down into acetaldehyde, a toxic byproduct that can damage your DNA.
Ahead, experts share exactly how those run club happy hour margaritas impact your health, even when your lifestyle habits are dialed in.
How Alcohol Affects Your Body Short-Term
Sleep and Recovery
Alcohol induces oxidative stress, an imbalance of free radicals and antioxidants in the body which can negatively impact your cells. Oxidative stress then leads to increased cortisol, gut inflammation, and poor sleep, Dr. Mussallem says. Even a low dose of alcohol (about two standard drinks) before going to bed can reduce your REM sleep, per a 2025 review of articles on the effect of alcohol on subsequent sleep in healthy adults in Sleep Medicine Reviews.
Alcohol can also negatively impact your fitness and recovery since it can disrupt sleep, tank your energy, and lower your heart rate variability (a stress metric which usually drops when you’re sick or tired). This is also why chugging a beer after running a half-marathon is probably a bad idea, says Elizabeth J. Kovacs, PhD, the director of the Alcohol Research Program in the Department of Surgery at the University of Colorado’s Anschutz Medical Campus.
Immune Health
Even in the short-term, alcohol can hinder your body’s ability to fight infection, says Kovacs. “In terms of immunity, alcohol makes the cells lethargic,” she adds.
She references an older study in Alcohol in which participants consumed 100-proof ethanol (50 percent alcohol by volume) mixed with chilled sugar-free seltzer water. Researchers conducted blood tests and examined participants’ white blood cell activity (the cells that defend your body against infection) before and after consuming the drink. “At first, the white blood cells were like rockstars, going to fight in a war against germs,” Kovacs says. In other words, they were active and functional. “But later, in the next blood draw, they were tanking and unable to respond.”
Mental Health
At first, alcohol increases dopamine and serotonin in the brain, says Jasleen Salwan, MD, a board-certified addiction medicine and internal medicine physician at Montgomery Family and Internal Medicine Associates. This creates a feeling of reward and makes you want to socialize more—but alcohol is a depressant, and as you continue drinking, you’ll start to notice those “downer” effects kick in, both during a night of drinking and the next day. (Hello, hangxiety!)
Cancer Risk
Alcohol also leads to greater absorption of carcinogens—especially particles of tobacco smoke, which can dissolve in alcohol—making it easier for them to be absorbed by the body, per the U.S. Department of Health and Human Services (HHS). This also increases your risk for mouth and throat cancers.
Additionally, drinking alters hormone levels like estrogen in the short-term, potentially increasing breast cancer risk, per HHS. Consuming alcohol may also increase risk of ovarian cancer, although the exact connection between estrogen and ovarian cancer is still being studied, according to a 2024 review of articles on alcohol consumption and breast and ovarian cancer development in Current Issues in Molecular Biology.
Lastly, drinking impairs your memory, reaction time, mood, and judgment. There’s also an increased risk of injury, alcohol poisoning, violence, and more, per the Centers for Disease Control and Prevention. Plus, it’s common to experience bloating, puffiness, or a headache the day after drinking, Dr. Mussallem adds.
How much does drinking detract from your overall health, even when your lifestyle habits are good?
Quite a lot, experts say. Exercise, sleep, and a plant-forward diet are great for your health, but “healthy habits do not erase alcohol’s biological footprint,” Dr. Mussallem says. Any alcohol exposure is still exposure.
Even if you drink once in a while and have a great tolerance, alcohol still isn’t great for your health. In fact, in some cases, your body’s reaction to alcohol may be even worse when you do choose to drink. “If you don’t typically drink alcohol and suddenly you have three drinks, your body doesn’t know how to deal with that—so inflammation will be potentially out of control,” Kovacs says.
However, some people’s health may be more affected by alcohol than others, based on genetics, medical history, lifestyle, and of course, how much and how often you drink. Biology is also a factor: Women generally absorb more alcohol and take longer to process it than men, according to the CDC.
Women will also have higher blood alcohol levels, even after drinking the same amount as men, and might feel the effects of alcohol more quickly and for longer. Additionally, women who drink are at a higher risk of cirrhosis (scarring of the liver) and other alcohol-related diseases, per the CDC.
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Here are some important long-term effects of drinking alcohol, especially frequently, according to the experts:
- Cancer risk (mouth, throat, esophagus, breast, liver, and colorectum)
- Mental health issues and alcohol use disorder
- Insomnia
- High blood pressure
- Heart disease
- Weight gain
- Sleep apnea
- Irregular heart rhythms
- Liver and kidney damage
- Systemic inflammation
- Increased LDL cholesterol
- Weakened immune function
- Accelerated biological aging (which is based on your cellular health instead of chronological age)
Who Should Drink Less
While everyone can benefit from consuming less alcohol, there are a few groups who should drastically reduce the amount of alcohol they drink—or stop altogether.
Those in Perimenopause and Beyond
“The perimenopausal and postmenopausal body is more hormonally vulnerable to alcohol’s effects,” says Dr. Mussallem. Estrogen levels decline during menopause and alcohol increases the body’s estrogen production, but it doesn’t do so in a healthy or balanced way.
“Alcohol increases circulating estrogen primarily by interfering with how your liver processes and clears it,” she adds. “This creates unhealthy hormonal spikes, worsening menopausal symptoms, and significantly increasing long-term health risks.”
During this time, alcohol’s costs compound the quickest and can disrupt the areas of your health that you want to protect, like sleep, bone density, cognitive sharpness, and metabolic health, Dr. Mussallem adds.
Those With Increased Cancer Risk
If you have elevated risk for any cancers (like with breast cancer, if you have dense breasts, breast cancer genes, or other moderate- to high-risk genetic findings), you should avoid drinking as much as you can.
Those Using Hormone Therapy
Women on hormone replacement therapy for menopause who drink “are combining two estrogen-elevating inputs, and the data suggests this combination raises breast cancer risk beyond either one alone,” Dr. Mussallem says. Additionally, hormonal cancer therapy lowers estrogen levels, while alcohol raises them—which could make your breast cancer harder to fight.
Those With a Family History of Alcohol Addiction
“If you notice signs of alcohol use disorder in yourself—including cravings, negative consequences, or loss of control—seek medical consultation to safely achieve and maintain abstinence,” Dr. Salwan recommends.
What to Keep in Mind if You Do Want to Drink
For those who don’t fall under the categories above, follow this rule: “Everything in moderation,” says Noelle LoConte, MD, a medical oncologist at the UW Health Carbone Cancer Center and associate professor at the University of Wisconsin School of Medicine and Public Health. “A single glass every few days is not going to be very harmful, but your alcohol choices should be balanced with your medical history.”
Chat with your primary care doctor about what’s best for you, but remember, when it comes to cancer risk, “there is no safe amount of alcohol consumption,” Dr. LoConte says.
- Women: No more than 1 drink in a single day and more than 7 drinks per week
- Adults 65 and older: No more than 1 drink a day and no more than 7 per week
- Pregnant people (or those who might become pregnant): No alcohol
At the end of the day, it’s up to you whether you want to drink alcohol or not—but knowing the risks, it’s probably best to opt for as little as possible. This advice from Dr. Mussallem says it all: “The reframe I offer my patients is this: Every choice is a vote for or against the woman you want to be in 10, 20, 30 years. Your body is always listening.”
Meet the experts: Dawn Mussallem, DO, is a physician, former integrative oncology leader at Mayo Clinic, and chief medical officer at the longevity clinic Fountain Life. Elizabeth J. Kovacs, PhD, is the director of the Alcohol Research Program, Department of Surgery, at the University of Colorado’s Anschutz Medical Campus. Jasleen Salwan, MD, is a board-certified addiction medicine and internal medicine physician at Montgomery Family and Internal Medicine Associates and addiction medicine consultant at the public health platform Start Your Recovery. Noelle LoConte, MD, is an associate professor at the University of Wisconsin School of Medicine and Public Health and a medical oncologist at the UW Health Carbone Cancer Center.
Tianna is the former associate health and wellness editor at Women’s Health. Her writing on wellness and relationships has been featured in Cosmopolitan, Elite Daily, Glamour, mindbodygreen, and more. She holds a M.A. in clinical psychology in education from Columbia University and is a certified yoga instructor. When she’s not writing, you can find her traveling, trying new workout classes, and speaking with audiences about mental health.
