Reichman · Journal of the National Cancer Institute 1993 · randomized crossover controlled feeding trial · n=34

Effects of alcohol consumption on plasma and urinary hormone concentrations in premenopausal women.

Cited 399 times in the scientific literature.

Level 2 - randomized trial

Randomized controlled crossover trial

PubMed 8478958 · doi:10.1093/jnci/85.9.722 · record verified 2026-08-29

What was done

In a controlled-diet crossover study lasting six consecutive menstrual cycles, 34 premenopausal women aged 21–40 years with regular menstrual cycles were randomized to consume 30 g of ethanol daily (approximately two drinks) for three cycles and no alcohol for three cycles, in crossover fashion. All food and alcohol were provided to maintain stable baseline body weight. Hormones were measured in pooled plasma or 24-hour urine samples collected during the follicular (days 5–7), peri-ovulatory (days 12–15), and mid-luteal (days 21–23) phases of the third cycle in each diet condition.

What was found

Alcohol intake was associated with significant hormonal increases compared to the alcohol-free period. In the follicular phase, plasma dehydroepiandrosterone sulfate rose 7.0% (P = .05). In the peri-ovulatory phase, plasma estrone increased 21.2% (P = .01), plasma estradiol increased 27.5% (P = .01), and urinary estradiol increased 31.9% (P = .009). In the luteal phase, urinary estrone increased 15.2% (P = .05), urinary estradiol increased 21.6% (P = .02), and urinary estriol increased 29.1% (P = .03). The percentage of bioavailable estradiol did not change, but absolute bioavailable estradiol was elevated due to higher total estradiol.

Why it matters

This controlled trial experimentally demonstrates that moderate alcohol intake increases circulating and urinary estrogens in premenopausal women, providing a plausible biological mechanism for the link between alcohol intake and breast cancer risk.

Limits

The study was limited to 34 healthy premenopausal women and tested only a single daily ethanol dose (30 g) under strictly controlled feeding conditions. The abstract does not evaluate breast tissue changes, long-term disease outcomes, or washout dynamics between phases.

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