Keywords: Alcohol, women, primary care

Background:

Alcohol consumption among women has significantly increased in Bulgaria over the past two decades, posing a serious public health challenge. Female alcohol dependence involves unique physiological, psychological, and social factors that are often underrecognized in primary care. Alcohol misuse is a known risk factor for non-communicable diseases (NCDs), contributing to disease onset and progression. There is a need for updated data on the epidemiology and complications of alcohol abuse among women in general practice.

Research questions:

What are the frequency and patterns of alcohol consumption among adult women in general practice, and what are the associated health and social consequences?

Method:

A cross-sectional study was conducted from October 2023 to August 2024 in a primary care clinic in Razgrad, Bulgaria, following ethical approval. The study included 318 adult women divided into seven age groups. Data collection involved socio-demographic surveys, alcohol consumption questionnaires, liver enzyme measurements (ASAT, ALAT, GGT), and liver ultrasound. Documentary, sociological, laboratory, instrumental, and statistical methods (descriptive statistics, correlation, and factor analysis) were applied. Methodological reliability was confirmed via Cronbach's alpha.

Results:

Risky alcohol consumption was identified in 11.3% of participants, harmful use in 2.2%, and alcohol dependence in 2.5%. Elevated GGT was found in 19.5% of women; hepatic steatosis in 27.4%, and cirrhosis in 0.9%. Frequent alcohol use (≥4 times weekly) was reported by 16.7%. A significant correlation was observed between consumption frequency and age group (35–65 years). Higher questionnaire scores were associated with abnormal GGT and pathological ultrasound findings.

Conclusions:

This study confirms increasing alcohol consumption among women and highlights the associated risks of physical and psychological harm. Screening for alcohol misuse in primary care is essential for NCD prevention. The findings emphasize the key role of GPs in early detection and intervention.

Points for discussion:

The need for screening for alcohol abuse in primary care

Alcohol as a risk factor for socially significant diseases