A groundbreaking discovery about how the hormone estrogen influences alcohol consumption could lead to new treatments for alcohol use disorder in women. Researchers at Weill Cornell Medicine have found that surges in estrogen can trigger rapid increases in binge drinking behavior, particularly in the crucial first 30 minutes after alcohol becomes available.
The study, published in Nature Communications, reveals for the first time that natural estrogen cycles directly influence drinking patterns – a finding that could explain why women are particularly vulnerable to alcohol’s harmful effects.
“We know a lot less about what drives alcohol drinking behavior in females because most studies of alcohol use have been done in males,” explains Dr. Kristen Pleil, an associate professor of pharmacology at Weill Cornell Medicine and the study’s senior author.
This knowledge gap has become increasingly critical. During the pandemic lockdown, women increased their heavy alcohol consumption more than men did, leading to more alcohol-related hospital visits and complications.
The research team made an unexpected discovery about how estrogen influences drinking behavior. Rather than working through the hormone’s usual slow-acting pathway of affecting gene expression, estrogen appears to work through receptors on the surface of brain cells, triggering changes in drinking behavior within minutes.
This rapid action occurs in a brain region called the bed nucleus of the stria terminalis (BNST), where certain neurons become highly active when females with high estrogen levels first encounter alcohol. This activation leads to what Dr. Pleil calls “front-loading” – consuming large amounts of alcohol in the first 30 minutes of availability.
The findings point to potential new treatment approaches. The researchers identified a specific estrogen receptor that drives this behavior, suggesting that drugs targeting this receptor might help reduce binge drinking during hormonal peaks. One possibility might be adapting existing FDA-approved drugs that inhibit estrogen synthesis, currently used to treat certain cancers.
The implications extend beyond female drinking patterns. The researchers found that the same biological machinery exists in males, though the source of estrogen differs. In males, the hormone is produced locally in the brain from testosterone rather than coming from the ovaries as in females.
The study represents an important step toward understanding why women may be more susceptible to alcohol use disorder and could lead to more targeted treatments that consider hormonal influences on drinking behavior.
“Combining [estrogen-targeting] drugs 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 notes.
As research continues, these findings may help develop more effective, personalized treatments for alcohol use disorder that take into account the crucial role of hormones in drinking behavior.
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