In adults with alcohol use disorder (AUD), high progesterone-to-estradiol ratios appear protective against problematic alcohol consumption, as shown in a study. Additionally, women with AUD may derive benefits from treatments tailored to their menstrual cycle phase.
This sex-separated multicentre longitudinal study included 74 naturally cycling females and 278 males with AUD between 2020 and 2022. The authors used generalized and general linear mixed modeling to analyse 12-month data on real-life alcohol use from 21,460 smartphone entries, menstrual cycle, and serum progesterone-to-estradiol ratios from 667 blood samples at four individual study visits.
Menstrual cycle phases showed a significant correlation with binge drinking and progesterone-to-estradiol ratio.
Women demonstrated a lower predicted binge drinking probability of 13 percent and a higher predicted marginal mean of progesterone-to-estradiol ratio of 95 during the late luteal phase relative to during the menstrual, follicular, and ovulatory phases (binge drinking probability and odds ratios [ORs] vs late luteal phase, respectively: 17 percent, OR, 1.340, 95 percent confidence interval [CI], 1.031‒1.742; 19 percent, OR, 1.523, 95 percent CI, 1.190‒1.949; and 20 percent, OR, 1.683, 95 percent CI, 1.285‒2.206; difference in progesterone-to-estradiol ratios, respectively: −61, 95 percent CI, −105.492 to −16.095; −78, 95 percent CI, −119.322 to −37.039; and −71, 95 percent CI, −114.568 to −27.534).
“These ecologically valid findings suggest that high progesterone-to-estradiol ratios can have a protective effect against problematic alcohol use in females and males with AUD, highlighting the progesterone-to-estradiol ratio as a promising treatment target,” the authors said.