Alcohol and men
Get the facts about how alcohol can affect men’s health
Men are more likely to drink more alcohol, more frequently, and are more likely to binge drink than women.1,2
The UK Chief Medical Officers’ low risk drinking guidelines recommend it’s safest, if you choose to drink, for men (and women) to drink no more than 14 units a week, spread over three or more days with several drink-free days, and no bingeing.
Drinking more than the low risk guidelines means a greater risk of a range of health issues – from short-term risks like injuries and accidents, low energy and sexual performance difficulties, to increased risk of heart disease and cancer in the longer-term.
Your gender (whether you identify as a man, a woman, or something else) can influence your risk from alcohol too.3 That’s because people’s perception of themselves, and the way society sees them, can influence their drinking behaviour.
Alcohol does have some effects that are different for men. These happen because of differences in anatomy and physiology between biological males and females,4,5 and because of differences in typical drinking behaviour.6
Research has found that higher levels of body testosterone (the primary male sex hormone) are linked to riskier drinking behaviour, and a greater risk of alcohol dependence.7
Regardless of the causes, alcohol has a huge impact on men’s wellbeing. Twice as many men die from an alcohol-specific condition compared to women.8
The combined risk of harm due to alcohol, smoking and obesity are greater than each on their own. Figures from 2014 show the combined effect of alcohol consumption with smoking and obesity cut male life expectancy in Europe by almost six (5.8) years.9
Heart disease is the leading cause of death for men in the UK10 – and there is strong evidence that long-term regular drinking damages the heart (for both men and women).11
Alcohol can also impact your mental health. Men are disproportionately affected by suicidal thoughts and actions, which can be linked to regular heavy drinking.12 Almost three-quarters (75%) of people who died by suicide in the UK in 2021 were men.13
The male body is more prone to put on more weight around the middle – sometimes known as a ‘beer belly’.14 Despite the name, it isn’t beer in particular that causes this weight gain – but calories. And alcohol contains almost as many calories as pure fat. Calories from alcohol are 'empty calories', meaning they have little nutritional benefit, so consuming extra calories through drinking leads to weight gain.15,16
Fat around the middle of the body is believed to be especially harmful because it is laid down directly in the organs inside the abdomen (belly), including the liver. This type of ‘central obesity’ increases even more your risk of developing heart disease, type 2 diabetes, stroke and some cancers including kidney, prostate and bowel cancers.17
Weight gain from any cause, including drinking, can lead to weight gain around the chest in men, causing the breasts to get bigger – this is often referred to as ‘man boobs’.
For men who are long-term heavy drinkers, there is also some evidence that alcohol can cause breast tissue to grow (‘gynaecomastia’).18
Alcohol depresses the central nervous system and can affect blood flow to the penis which can make it difficult for some men to get, and keep, an erection.19
In the longer-term, persistent heavy drinking can harm the liver, contributing to low levels of testosterone and increased levels of oestrogen - which can contribute to erectile dysfunction and low sex drive (libido).20
Alcohol also affects male fertility, by reducing the quantity and quality of sperm.21 For men, the more you drink the greater the impact on your sperm – one study found that males drinking five units of alcohol per week (about three 330ml bottles of beer or three 125ml glasses of wine) had lower sperm counts and lower sperm quality measures than men who did not drink alcohol.22
If you’re trying for a baby, the NHS recommends for both men and women that cutting or stopping drinking alcohol can help, as well as not smoking and maintaining a healthy weight.23
And the way alcohol impairs your inhibition24 makes unprotected sex far more common when alcohol is involved, which can lead to sexually transmitted diseases and unplanned pregnancy.25
Men tend to drink in a way that puts their health at greater risk than women – being more likely to drink more alcohol, more often.26 For example, men are much more likely to drink alone than women - a pattern associated with hazardous drinking.27,28
In 2020, among UK adults, almost two thirds (64%) of people drinking hazardously were men, compared to 36% women.29
There is some evidence that this could happen partly because of biological reasons - higher testosterone levels found in men could be linked to greater risk taking and impulsiveness.30 Research suggests another factor is a traditional notion of masculinity in our society, and what is perceived to be ‘manly’.31
More research is needed to fully understand the way hormonal differences for transgender people undergoing hormone therapy could affect how their body processes alcohol.32 But there is some evidence that transgender people may be more heavily affected by high risk drinking than the wider population.33,34,35
This tendency towards higher-risk drinking causes a huge impact on the harm men experience because of alcohol.
Drinkaware’s confidential alcohol self-assessment can help you identify if the amount you drink could be putting your health at serious risk, using a tool developed by the World Health Organization (WHO).
Men’s risks of accidental injury is, on average, much greater than women’s even before taking into account any effect from drinking alcohol.36
Once alcohol is taken into account, short-term ‘acute’ harm from alcohol, like accidental injury, is much more common for men than women.37
These risks primarily increase with drinking a lot of alcohol in a single session, and are more common among men, in part because of men’s underlying risk-taking behaviours.38
In 2019/20, men accounted for almost two-thirds (65%) of all hospital admissions in England where the main cause was alcohol.39
How to prevent alcohol-related accidents
Men are much more likely than women to be involved in drink driving and related accidents. In 2020, 180 men were involved in fatal drink-driving accidents in Great Britain, compared to 20 fatal accidents involving women over the drink-drive limit - a trend that has been consistent since records began in 1979.40
Similarly, among drivers, almost twice as many men admit drink driving than women (6.5% vs. 3.3% in 2019/20).41
The naturally-occurring testosterone found in the male body is linked to riskier drinking behaviour.42 If this leads to heavy drinking over a longer period of time, it increases the risk of alcohol dependence.
About seven out of every ten patients in treatment for alcohol dependence in England in 2019/20 were male.43
Many people can be unsure about how much they're drinking and if it’s hazardous or harmful. A good first step is to take our self-assessment questionnaire to help you work out if your relationship with alcohol is causing increasing risk to your health.
Here are some ways you can cut down on the amount you drink:
Use our free MyDrinkaware app to help you track how much you’re drinking and set goals to reduce the amount you drink.
Alcoholic drinks labels will have the abbreviation “ABV” which shows the percentage of your drink that’s pure alcohol. This can vary a lot. For example, some ales are 3.5%, but some stronger lagers can be as much as 6% ABV. This means that just one pint of strong lager can contain more than three units of alcohol, so it’s important to know the strength of what you’re drinking.
Cut down by switching pints for halves of beer, or choosing a smaller glass for your wine. Opting for spritzers or shandies will also help reduce the number of units you’re drinking.
Drinking water or soft drinks and alternating them with your alcoholic drinks can help you cut down on the amount of alcohol you consumer overall.
A good way to cut down on the amount drink is to have several each week. Try to plan something you enjoy, like a game of football or a movie night, for your non-drinking days and it will make you more likely to stick to them.
If you’re looking for a way to cut down on alcohol without cutting it out completely, alcohol-free or low alcohol drinks could be right for you. These days, there are more, better tasting, low alcohol and alcohol-free drinks to choose from than ever before – with Drinkaware research showing that regular drinkers think the taste has improved over recent years.44
Cutting your drinking with alcohol-free or low alcohol drinks
Many people can be unsure about how much they're drinking and if it’s too much. A good first step is to take our self-assessment questionnaire to help you work out if your relationship with alcohol is causing increased risk to your health.
Drinkchat is a free online chat service. Trained advisors are on hand between 10am-2pm, Monday to Friday, to provide confidential advice.
If you can’t contact Drinkchat in those hours, or would prefer to talk to someone on the phone, you can call Drinkline on 0300 123 1110 (weekdays 9am–8pm, weekends 11am–4pm) and speak to a trained adviser.
Arming yourself with strategies and tips can help you or a loved one take small steps towards big results.
[2] See Health Survey for England (https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england), Scottish Health Survey (https://www.gov.scot/collections/scottish-health-survey/), National Survey for Wales (https://www.gov.wales/national-survey-wales), and Health Survey Northern Ireland (https://www.health-ni.gov.uk/topics/doh-statistics-and-research/health-survey-northern-ireland).
[15] Yeomans, M.R. (2010). Alcohol, appetite and energy balance: is alcohol intake a risk factor for obesity? Physiology &Behavior, 100(1), 82-89.
[16] Kwok, A., Dordevic, A.L., Paton, G., Page, M.J. and Truby, H. (2019). Effect of alcohol consumption on food energy intake: a systematic review and meta-analysis. British Journal of Nutrition, 121(5), 481-495.
[19] Yafi, F.A., Jenkins, L., Albersen, M., Corona, G., Isidori, A.M., Goldfarb, S., Maggi, M., Nelson, C.J., Parish, S., Salonia, A. and Tan, R. (2016). Erectile dysfunction. Nature Reviews Disease Primers, 2(1), 1-20.
[20] Yafi, F.A., Jenkins, L., Albersen, M., Corona, G., Isidori, A.M., Goldfarb, S., Maggi, M., Nelson, C.J., Parish, S., Salonia, A. and Tan, R. (2016). Erectile dysfunction. Nature Reviews Disease Primers, 2(1), 1-20.
[21] Ricci, E., Al Beitawi, S., Cipriani, S., Candiani, M., Chiaffarino, F., Viganò, P., Noli, S. and Parazzini, F. (2017). Semen quality and alcohol intake: a systematic review and meta-analysis. Reproductive Biomedicine Online, 34(1), 38-47.
[25] George, W.H., Davis, K.C., Norris, J., Heiman, J.R., Stoner, S.A., Schacht, R.L., Hendershot, C.S. and Kajumulo, K.F. (2009). Indirect effects of acute alcohol intoxication on sexual risk-taking: The roles of subjective and physiological sexual arousal. Archives of Sexual Behavior, 38(4), 498-513.
[36] Holmes J, Angus C, Buykx P, Ally A, Stone T, Meier P, Brennan A (2016) 'Mortality and morbidity risks from alcohol consumption in the UK: Analyses using the Sheffield Alcohol Policy Model (v.2.7) to inform the UK Chief Medical Officers' review of the UK lower risk drinking guidelines', Sheffield: ScHARR, University of Sheffield
Last Reviewed: 14th June 2023
Next Review due: 14th May 2026