Over the last 20 years, there has been an alarming increase in alcohol use and alcohol use disorder (AUD) prevalence among women, narrowing the historical gender gap. Concurrently, there has also been a significant rise in alcohol-related liver disease (ALD) prevalence, severity, and mortality among women. Despite this, there are no recent reviews that have sought to evaluate both sex and gender differences at the intersection of AUD and ALD. In this narrative review, we address the escalating rates of ALD and AUD in the United States, with a specific focus on the disproportionate impact on women. Sex and gender play an important and well-known role in the pathogenesis and epidemiology of ALD. However, sex and gender also are implicated in the development and prevalence of AUD, as well as in the treatment of AUD, all of which has important consequences on the approach to treatment of ALD patients with AUD. A better understanding of sex and gender differences in AUD, ALD, and the intersection of the two is essential to enhance prevention, diagnosis, and management strategies. These data underscore the urgent need for awareness and preventive efforts to mitigate the potential long-term health consequences.
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