Effects of sex steroids on ethanol pharmacokinetics and autonomic reactivity

Several lines of evidence indicate that female sex steroids, especially estrogen, interact with ethanol pharmacokinetics. Both animal and human studies are consistent in indicating that voluntary intake of alcohol decreases with increasing estrogen concentrations. Such effects are equivocal with progesterone and nonexistent with testosterone. There is some suggestion that estrogen modulates monoamine oxidase activity and via that mechanism alters sympathetic nervous system tone. Alterations in sympathetic nervous system tone, in turn, can alter gastric motility and absorption of alcohol from stomach and intestines. Several types of studies, both animal and human, indicate that high estrogen concentrations also impair ethanol metabolism. At present the exact mechanism of action for this effect is not known. Future studies investigating this aspect are indicated. At present the effect of sex steroids on performance and its interaction with alcohol do not show a clear relationship. There are contrary pieces of information both for and against the view that menstrual cycle, performance and alcohol interact.