Chronic consumption of alcohol in levels typically consumed by alcoholic women clearly produces adverse health consequences, including a shorter life expectancy. The health consequences of alcohol use appear to depend on the characteristics of the person consuming the alcohol (genetic vulnerability to particular diseases, the particular point in the life span when the majority of the alcohol is consumed, and the pattern of consumption typical for that individual). For adolescence and young adulthood, emphasis is placed on increased rates of accidental and suicidal mortality. For middle age, breast cancer risk and risk for developing osteoporosis is discussed. Finally, use of alcohol alone and in combination with psychoactive drugs presents special problems for older women. Other specific adverse effects of alcohol are reviewed with respect to gender differences in cardiovascular, hepatological, and neuropathological outcome, as well as with respect to HIV/AIDS. Psychiatric comorbidity and domestic violence are also discussed with respect to gender differences.