Women's Health & Caffeine

Women deal with a unique set of health concerns that all interact with caffeine and coffee differently. Learn how caffeine affects breast health, hormones and menstruation, menopause, and osteoporosis to decide whether drinking coffee or caffeine is the best choice for your health.

The effects of caffeine on breast health

Breast health is influenced by multiple factors. While the jury is still out regarding the effects of caffeine and coffee on breast health, women susceptible to tenderness or fibrocystic changes report relief after giving up these substances. Breast tenderness is also a premenstrual symptom that can be reduced by eliminating caffeine.1

Fibrocystic Breasts

Women with fibrocystic breasts report noticeable breast tenderness, non-cancerous lumps and small nodular cysts. Animal models demonstrate fibrocystic changes in the presence of caffeine intake and many women have found relief and pain reduction with caffeine elimination.2, 3

Epidemiological studies, however, suggest there is no link between caffeine and fibrocystic breasts, but these studies do not take into account the fact that caffeine may affect symptoms only in women who are already susceptible. Caffeine reduction for those women who suffer from fibrocystic breasts continues to be an important recommendation for treating breast pain and lumps.4

The effects of caffeine on menopause

There is a great deal of variation in the severity of symptoms women experience during the natural transition of menopause. Many menopausal symptoms, including hot flashes, difficulty sleeping, vaginal dryness, osteoporosis and increased risk of heart attack, are exacerbated by coffee and caffeine. Coffee drinking is also associated with difficulty emptying the bladder fully.5 Coffee consumption also may one of the factors responsible for accelerating the age at which menopause begins.6

Hot flashes, sleep and caffeine

Poor sleep quality or short sleep duration can increase the severity of menopausal symptoms such as hot flashes and depression. Coffee drinking interrupts sleep and increases the intensity of hot flashes7, and women who drink less coffee report fewer hot flashes.8 Therefore, it is recommended that women who experience hot flashes reduce coffee consumption.9

The effects of caffeine on heart health

Heart-related conditions are the primary cause of death for women, whose risk factors for heart disease and heart attacks increase after menopause. Caffeine and coffee consumption adversely affect cholesterol and other lipid levels, homocysteine, blood pressure, arrhythmias and stress levels, all of which are factors implicated in increasing the risk of heart disease.10

Coffee drinking significantly increases serum levels of the amino acid homocysteine. High homocysteine levels are associated with heart disease. This negative effect occurs within hours of consuming caffeinated, decaffeinated, filtered and unfiltered coffee.11

The effects of caffeine during cancer treatment

Women going through breast cancer treatment may also consider eliminating coffee and caffeine because they increase the body’s stress response, compromise the liver and interfere with deep rest and relaxation.

Multiple drug regimens and/or chemotherapy increase the body’s stress response, impact the liver, and affect rest and recuperation. If someone is in the midst of treatment for cancer, drinking coffee and caffeine can make these side effects worse.

Caffeine interferes with the repair of DNA and interacts with chemotherapeutic agents.12 In cancer treatment regimens, caffeine is used therapeutically (and under supervision) because it enhances the toxicity of these drugs.13 Therefore, caffeine or coffee should not be casually consumed in these situations.

Caffeine elevates the stress hormones cortisol, epinephrine (also known as adrenaline) and norepinephrine, which are responsible for increased heart rate, blood pressure, and the fight or flight response. Additionally, circulation of oxygen to the brain and extremities is decreased, the immune system is suppressed and energy to the body’s repair and restoration mechanisms are deferred after coffee consumption.14 During cancer treatment, a strong immune system with reduced stress is critically important.

The effects of caffeine on hormones and menstruation

Women are more sensitive to caffeine than men and their bodies may take much longer to detoxify it and recover from its stimulating effects.15 Caffeine directly affects women’s hormonal levels by increasing estrones (female hormones), while decreasing available testosterone.16

Premenstrual syndrome & caffeine

Up to 40% of women of childbearing age experience some degree of premenstrual syndrome (PMS), and up to 10% suffer from severe symptoms. PMS symptoms occur between ovulation and menstruation and include breast swelling and tenderness, weight gain, headaches, abdominal cramping and bloating, nausea, joint pain, acne, irritability, lethargy, fatigue, depression, anxiety and even hostility and aggression.

PMS is not adequately explained by vitamin deficiency or hormone imbalance, and most treatments including oral contraceptives, vitamins, diuretics or hormones are ineffective against everything on the list.

Coffee and caffeine consumption during PMS is not advised, because it elevates the stress hormones cortisol, epinephrine and norepinephrine, increasing heart rate, blood pressure, and anxiousness while decreasing the circulation of oxygen to the brain.17 Stress levels account for a significant amount of variation in the symptoms felt throughout a women’s menstrual cycle.18

Lifestyle changes including exercise, stress reduction, and sodium and caffeine restriction can have a positive impact on symptoms. Elimination of coffee can reduce breast tenderness, nervousness and irritability.19

The effects of caffeine on osteoporosis

Our bones are constantly in a state of adding minerals and being broken down. The interaction between the two is necessary for our bones to be healthy. Decreased bone density occurs when the rate of breakdown is faster than the rate of building. The conditions resulting from bones becoming more fragile or vulnerable are known as osteopenia and osteoporosis (osteoporosis is more severe).

High coffee intake is associated with an increased risk of lower bone density in older women.20 Women with high caffeine intakes experience higher rates of bone loss than those with low intakes.21 High homocysteine levels from coffee consumption are also a significant risk factor for developing osteoporotic fractures.22

Osteoporosis has no single cause; it is related to a complex series of hormonal interactions that regulate bone formation and reabsorption. A number of different hormone levels, including estrogen and testosterone, are important in mineral deposition and in the activity of osteoblasts, the cells which create new bone.

Calcium, along with a long list of other minerals and vitamins (including Vitamin D), is important for maintaining healthy bone density. Coffee and caffeine interfere with the absorption of minerals and increase the excretion of several vital minerals, including calcium, potassium, magnesium and iron.23 Bone loss associated with caffeine consumption is especially pronounced in women who do not consume adequate calcium.24 It is difficult for older women to compensate for the calcium loss due to caffeine.25

Consumption of acidic foods, such as coffee, increases the leaching of minerals from the bone due to overall increased metabolic acidity. Minerals appear to have a buffering effect on the bloodstream and are subsequently leached from bone to realkinalize the blood when pH levels are too acidic.26 Excess acidity has been associated with negative calcium balance and increased excretion of calcium.27

When hormones like estrogen decrease (as is the case in the transition of menopause), the risk of osteoporosis can increase. The effects of coffee and caffeine on bone mineral density can have a greater impact on these situations.

Works Cited


  1. Budoof 1983
  2. Wolfrom and Welsch 1990
  3. Russell 1989
  4. Norlock, 2002
  5. Bradley, et al 2005
  6. Biela 2002; Nagata, et al 1998; Nagata, et al 2000
  7. Hollander, et al 2001
  8. Park, et al 2003
  9. Lucero and McCloskey, 1997
  10. Salvaggio, et al 1991; Aro, et al 1989; Green and Harari 1992; Verhoef, et al 2002
  11. Verhoef, et al 2002; Urgert, et al 2000; Grubben, et al 2000
  12. Hayashi, et al 2009; Sabisz and Skladanowski 2008
  13. Kimura, et al 2009; Tsuchiya, et al 1998
  14. Robertson, et al 1978; Lane, et al 1990; Lane 1994; Kerr, et al 1993
  15. Mathias, et al 1985; Cherniske 1998
  16. Ferrini and Barrett-Connor 1996
  17. Robertson, et al 1978; Lane, et al 1990; Lane 1994
  18. Kerr, et al 1993
  19. Ugarriza 1998; Dickerson, et al 2003; Barnhart, et al 1995; Massil, and O’Brien 1987; Budoff 1983
  20. Korpelaninen, et al 2003; Barrett-Connor, et al 1994; Hernandez-Avila, et al 1993
  21. Mikuls, et al 2002; Rapuri, et al 2001
  22. Van Meurs, et al 2004; McLean, et al 2004
  23. Bergman, et al, 1990
  24. Harris and Dawson-Hughes 1994
  25. Massey and Whiting 1993
  26. Kynast-Gales and Massey 1994
  27. Massey and Whiting 1993

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Budoff, P.W. 1983. The use of prostaglandin inhibitors for the premenstrual syndrome. Journal of Reproductive Medicine 28(7): 469-78.

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Ferrini, R.L. and Barrett-Connor, E. 1996. Caffeine intake and endogenous sex steroid levels in postmenopausal women. The Rancho Bernardo Study. American Journal of Epidemiology 144(7): 642-4.

Green MS, Harari G. 1992. Association of serum lipoproteins and health-related habits with coffee and tea consumption in free-living subjects examined in the Israeli CORDIS Study. Preventive Medicine 21(4): 532-45.

Grubben, M.J., et al. Unfiltered coffee increases plasma homocysteine concentrations in healthy volunteers: a randomized trial. American Journal of Clinical Nutrition 71(2): 480-4.

Harris, S.S. and Dawson-Hughes, B. 1994. Caffeine and bone loss in healthy postmenopausal women. American Journal of Clinical Nutrition 60(4): 573-8.

Hayashi, K. Tsuchiya, H., Yamamoto, N., Shirai, T., Yamauchi, K., Takeuchi, A., Kawahara, M., Miyamoto, K., and Tomita, K. 2009. Impact of serum caffeine monitoring on adverse effects and chemotherapeutic responses to caffeine-potentiated chemotherapy for osteosarcoma. Journal of Orthopedic Science 14(3): 253-8.

Hernandez-Avila, M., et al. 1993. Caffeine and other predictors of bone density among pre- and perimenopausal women. Epidemiology 4(2): 128-34.

Hollander, L.E., et al. 2001. Sleep quality, estradiol levels, and behavioral factors in late reproductive age women. Obstetrics and Gynecology 98(3): 391-7.

Kerr, D., et al. 1993. Effect of caffeine on the recognition of and responses to hypoglycemia in humans. Annals of Internal Medicine 119(8): 799-804.

Kimura, H., et al. 2009. Caffeine-potentiated chemotherapy for metastatic osteosarcoma. Journal of Orthopedic Science 14(5): 556-65.

Korpelainen, R., et al. 2003. Lifestyle factors are associated with osteoporosis in lean women but not in normal and overweight women: a population-based cohort study of 1222 women. Osteoporosis International 14(1): 34-43.

Kerr, D., et al. 1993. Effect of caffeine on the recognition of and responses to hypoglycemia in humans. Annals of Internal Medicine 119(8): 799-804.

Kynast-Gales, S.A. and Massey, L.K. 1994. Effect of caffeine on circadian excretion of urinary calcium and magnesium. Journal of the American College of Nutrition 13(5): 467-72.

Lane, J.D. 1994. Neuroendrocine Responses to Caffeine in the Work Environment. Psychosomatic Medicine 546: 267-70.

Lane, J.D., Adcock, R.A., Williams, R.B. and C.M. Kuhn. 1990. Caffeine effects on cardiovascular and neuroendocrine responses to acute psychosocial stress and their relationship to level of habitual caffeine consumption. Psychosomatic Medicine 52(3): 320-36.

Lucero, M.A. and McCloskey, W.W. 1997. Alternatives to estrogen for the treatment of hot flashes. The Annals of Pharmacotherapy 31(7-8): 915-7.

Massey, L.K. and Whiting, S.J. 1993. Caffeine, urinary calcium, calcium metabolism and bone. Journal of Nutrition 123(9): 1611-4.

Massil, H.Y. and O’Brien, P.M. 1987. Approach to the management of premenstrual syndrome. Clinical Obstetrics and Gynecology 30(2): 443-52.

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Mikuls, T.R., et al. 2002. Coffee, tea, and caffeine consumption and risk of rheumatoid arthritis: results from the Iowa Women’s Health Study. Arthritis and Rheumatism 46(1): 83-91.

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Sabisz, M. and Skladanowski, A. 2008. Modulation of cellular response to anticancer treatment by caffeine: inhibition of cell cycle checkpoints, DNA repair and more. Curr Pharm Biotechnol 9(4): 325-36.

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Tsuchiya, H., et al. 1998. Caffeine-assisted chemotherapy and minimized tumor excision for nonmetastatic osteosarcoma. Anticancer Research 18(1B): 657-66.

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