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Surges in oestrogen promote binge drinking in females, shows study

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The hormone oestrogen regulates binge drinking in females, causing them to “pregame” – consume large quantities of alcohol in the first 30 minutes after it’s offered, according to a new preclinical study.

The study establishes–for what is thought to be the first time–that circulating oestrogen increases binge alcohol consumption in females and contributes to known sex differences in this behaviour.

The findings could lead to novel approaches for treating alcohol use disorder.

“We know a lot less about what drives alcohol drinking behaviour in females because most studies of alcohol use have been done in males,” said senior author Dr. Kristen Pleil, an associate professor of pharmacology.

Yet females, too, overindulge and are more susceptible to the negative health effects of alcohol than males.

Recent studies indicate that, during the pandemic lockdown, women increased their heavy alcohol consumption more than men. That behaviour has important consequences for women’s health, said Dr. Pleil, “because many studies show this pattern of drinking enhances alcohol’s harmful effects.”

Indeed, women had many more alcohol-related hospital visits and complications than men during and since the pandemic.

In a 2021 study, Dr. Pleil and her team showed that a specific subpopulation of neurons in a brain region called the bed nucleus of the stria terminalis (BNST) were more excitable in female mice than in males. This enhanced activity correlated with their binge drinking behaviour.

But what makes this neural circuit more excitable in females?

“Oestrogen has such powerful effects on so many behaviours, particularly in females,” Dr. Pleil said. “So, it makes sense that it would also modulate drinking.”

To assess oestrogen’s potential involvement, the researchers, including first author Dr. Lia Zallar, who was a graduate student in the Pleil lab at the time of the research, began by monitoring the hormone levels throughout oestrous cycle of female mice.

Then, they served up the alcohol. They found that when a female has a high level of circulating oestrogen, she drinks much more than on days when her oestrogen is low.

That enhanced bingeing behaviour was reflected in heightened activity in those same neurons in the BNST.

“When a female takes her first sip from the bottle containing alcohol, those neurons go crazy,” Dr. Pleil said. “And if she’s in a high-oestrogen state, they go even crazier.”

That extra boost of neural activity means the mice hit the bottle even harder, particularly within the first 30 minutes after the alcohol was made available, a behaviour Dr. Pleil refers to as “front-loading.”

Cell-surface receptors allow oestrogen to act fast

Although the researchers suspected oestrogen would have an effect on drinking, they were surprised by its mechanism of action.

This steroid hormone typically regulates behaviours by binding to receptors that then travel to the nucleus, where they alter the activity of specific genes—a process that could take hours. However, Dr. Pleil and her team realised that something else must be happening when oestrogen infused directly into the BNST excited the neurons and triggered binge drinking within minutes.

So, the researchers tested oestrogen that had been doctored so it could not enter cells and bind to nuclear receptors—a feat of chemical engineering performed by Dr. Jacob Geri, assistant professor of pharmacology at Weill Cornell Medicine.

They determined that when oestrogen promotes bingeing, the hormone is binding to receptors on the neurons’ surface, where it directly modulates cell-cell communication.

“We believe this is the first time that anybody has shown that during a normal oestrous cycle, endogenous oestrogen made by the ovaries can use such a rapid mechanism to control behaviour,” Dr. Pleil said. That rapid action drives the front-loading of alcohol when oestrogen is high.

The team identified the oestrogen receptor that mediates this effect and determined that it is expressed in the excited BNST neurons and in neurons from other brain regions that excite them. The researchers are now investigating the signalling mechanisms for this effect, and they will also examine whether the same system regulates drinking in males.

“All of the infrastructure is there in males, too: the oestrogen receptors and the basic circuit organization,” Dr. Pleil said. The only difference will be the source of the oestrogen, which in males without an ovarian source relies on local conversion of testosterone to oestrogen in the brain.

Inhibiting the enzyme that synthesises oestrogens could offer a novel treatment for selectively reducing alcohol consumption when hormone levels surge. An FDA-approved version of such an inhibitor is currently used to treat women with oestrogen-sensitive cancers.

“Combining this drug with compounds that modulate the downstream effects of the chemicals produced by the BNST neurons could potentially provide a new, targeted approach for treating alcohol use disorder,” Dr. Pleil said.

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Fertility

Most NHS regions in England limit IVF to single cycle, research finds

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Nearly 70 per cent of NHS regions in England fund only one IVF cycle for women under 40, breaking national guidelines, new research has found.

Twenty-nine of the 42 integrated care boards, which control local NHS budgets, now offer only one round of treatment, after four reduced access in the past year.

National Institute for Health and Care Excellence (Nice) guidelines recommend three full cycles for women under 40 who have been unable to conceive for two years.

Only two of England’s 42 integrated care boards have policies consistent with these guidelines, which they are not legally obliged to follow.

The research was conducted by the Progress Educational Trust, a fertility charity.

Sarah Norcross, the director of PET, said the impact was “devastating” for couples struggling with infertility.

She said: “Infertility is already incredibly stressful for people, and it puts them under even more pressure, because there is so much riding on whether that one NHS-funded cycle is going to work.

“And for some people, that will be their only chance, because private fertility treatment is so expensive.”

The data showed regional variations, with the whole of the north-west offering just one cycle.

“It’s a postcode lottery, and we’re seeing a race to the bottom,” said Norcross.

Of the 29 integrated care boards that offer a single cycle, 19 provide only a partial cycle, where not all viable embryos created are transferred.

There was just one recent example of improved services, from NHS South East London, which in July 2024 went from one partial to two full cycles.

The NHS estimates that about one in seven couples may have difficulty achieving a pregnancy. One cycle of IVF can cost from £5,000 at a private clinic.

Fertility rates in England and Wales have fallen since 2010 to 1.41 children per woman in 2024, the lowest on record and below the replacement level of 2.1 at which a population is stable without immigration.

Health minister Karin Smyth said in a written parliamentary answer last month that it was “unacceptable” that access to NHS-funded fertility services varied across the country.

Revised Nice fertility guidelines are due this spring, but Norcross said changing them seemed pointless.

She said: “Fertility treatment has always been a Cinderella service. It’s always been the one they’ve chosen to cut or to ignore.

“Nice has recommended three full NHS-funded cycles, for women under 40, for more than 20 years. This has never been implemented across England, unlike in Scotland.”

Norcross advocated centralised commissioning and replicating Scotland’s approach, which included financial modelling and a phased implementation starting with two cycles to avoid long waits, moving up to three once capacity was achieved.

“It is a tried and tested plan that England could follow,” Norcross added.

A Department of Health and Social Care spokesperson said: “We recognise access to fertility treatment varies across the country and we are working with the NHS to improve consistency.

“Nice provides clear clinical guidelines, and we expect integrated care boards to commission treatment in line with these.

“Updated Nice fertility guidelines are expected this spring and we will continue to support NHS England to make sure the guidance is fully considered in local commissioning decisions.”

An NHS England spokesperson said: “These clinical services are commissioned by integrated care boards for their area based on the needs of the local population and prioritisation of resources available.

“All ICBs have a responsibility to ensure services are provided fairly and are accessible by different population groups.”

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Mental health

Fear of ageing may age women faster, study suggests

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Ageing anxiety may accelerate biological ageing in women, with fears about worsening health linked to faster epigenetic ageing, according to new research.

The study found that greater anxiety about growing old was associated with accelerated epigenetic ageing, as measured by the DunedinPACE clock, based on biological markers in blood samples.

Epigenetic changes are shifts in how genes are switched on or off without altering DNA itself, which can influence how the body ages and functions.

“Our research suggests that subjective experiences may be driving objective measures of ageing,” said Mariana Rodrigues, a PhD student and the first author of the study.

“Ageing-related anxiety is not merely a psychological concern, but may leave a mark on the body with real health consequences.”

Researchers analysed data from 726 women in the Midlife in the US study.

Participants were asked how much they worried about becoming less attractive with age, having more health issues and being too old to have children.

Blood samples were used to assess ageing with two epigenetic clocks: DunedinPACE, which estimates the pace of biological ageing, and GrimAge2, which estimates cumulative biological damage.

The study was conducted by researchers at NYU School of Global Public Health.

Worrying about declining health showed the strongest links with epigenetic ageing, while anxiety about attractiveness and fertility was not significantly associated with biological markers.

The authors suggest health worries are more common and persist over time, whereas concerns about appearance and reproduction may fade with age.

“Women in midlife may also be multiple in roles, including caring for their ageing parents,” Rodrigues said.

“As they see older family members grow older and become sick, they may worry about whether the same thing will happen to them.”

The authors caution that the study offers a snapshot in time and other factors may influence these biological changes.

When analyses were adjusted for health behaviours such as smoking and alcohol use, the link between ageing anxiety and epigenetic ageing decreased and was no longer significant.

“Our research identifies ageing anxiety as a measurable and modifiable psychological determinant that seems to be shaping ageing biology,” said Adolfo Cuevas, associate professor of social and behavioural sciences and the study’s senior author.

They call for more research to clarify how this anxiety influences ageing over time, to guide support for those experiencing ageing anxiety.

“Ageing is a universal experience.” Rodrigues said.

“We need to start a discourse about how we as a society, through our norms, structural factors and interpersonal relationships, address the challenges of ageing.”

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Insight

WUKA and Royal Yachting Association partner to support women and girls in sailing

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WUKA has announced a groundbreaking partnership with the Royal Yachting Association (RYA), including RYA Scotland and RYA Northern Ireland, supporting women and girls in sailing.

Building on WUKA’s growing #TackleAnything campaign – which has already reached thousands of girls across sports in the UK – this collaboration brings practical period solutions into sailing.

Together, WUKA and the RYA are committed to breaking down barriers so periods never limit confidence, participation, or performance on the water.

Ruby Raut, WUKA founder & CEO, said: “Partnering with the RYA has been incredibly important for us at WUKA.

“Sailing is an amazing way for women and girls to build confidence, and periods shouldn’t hold anyone back from enjoying the water or reaching their full potential.

“Through this partnership and our #TackleAnything campaign, we’re proud to provide practical solutions and innovative products that help female sailors feel comfortable, confident, and free to focus on learning, performing, and having fun.

“Breaking down barriers and supporting women to tackle anything — on land, at sea, and everywhere in between – has never felt more meaningful.”

WUKA, which stands for Wake-Up Kick Ass, shares the RYA’s commitment to inclusivity and empowerment.

In 2023, WUKA launched #TackleAnything, a campaign supporting women, girls and sportspeople with periods. Since its launch, the initiative has reached 3,576 girls across 46 clubs and partnered with a range of sports across the UK – from Scottish Gymnastics to Titans wheelchair basketball – helping young athletes play without limits and stay confident, comfortable, and in the game.

The brand offers period-friendly aquatic apparel and practical solutions that help women train and compete with freedom of movement and total assurance.

Through this partnership, WUKA will provide innovative period swimwear for young sailors across key RYA programmes, including the NI Sailing Team, the RYA Scotland Performance Pathway Programme, and the British Sailing Pathways Talent Academies.

By combining WUKA’s mission to challenge stigma with the RYA’s commitment to inclusion, the partnership ensures young sailors can focus on what matters most – learning, performing, and enjoying their time on the water – with confidence and comfort. RYA members will also receive a 10 per cent discount on WUKA products.

Sailing offers incredible benefits for women and girls, but time on the water can present unique challenges -particularly during menstruation.

Together, WUKA and the RYA are providing practical solutions that remove these barriers, helping young sailors participate fully and confidently in the sport.

Sara Sutcliffe, RYA CEO, said: “At the RYA, we have been making strides to break down barriers for women of all ages to help ensure they can experience the water in a supportive and positive environment.

“From education workshops and practical sessions, we want to make sure our female sailors are empowered and this partnership is another great example of how we can demonstrate possible tools to equip them to succeed”.

This partnership is part of the RYA’s wider commitment to making sailing a sport where women and girls can thrive. Alongside initiatives such as the Female Futures Group, the Women’s Race Officials Programme and all new Talent Academy Female Future’s Camps; it demonstrates a continued focus on removing barriers and creating meaningful opportunities across every stage of the sailing.

WUKA’s involvement ensures that practical solutions are available on the water, from innovative period swimwear to support resources, helping young sailors feel fully equipped and confident during training and competition.

By integrating these tools into RYA programmes, WUKA brings a new level of comfort and assurance to female athletes, allowing them to focus entirely on performance, enjoyment, and growth in the sport.

For any women and girls looking to learn more about sailing, visit www.rya.org.uk.

For more information on WUKA visit www.wuka.co.uk.

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