Studies have demonstrated significant sex differences in alcohol intoxication effects. In contrast, the majority of studies on the alcohol hangover phase did not investigate sex differences. Therefore, the current study examined possible sex differences in the presence and severity of alcohol hangover symptoms. Data from n
= 2446 Dutch students (male = 50.7%, female = 49.3%) were analyzed. They reported the presence and severity of 22 hangover symptoms experienced after their past month heaviest drinking occasion. Subjects were categorized according to their estimated peak blood alcohol concentration (eBAC) and presence and severity of the hangover symptoms were compared between men and women. In the lowest eBAC group (0% ≤ eBAC < 0.08%), no significant sex differences were found. In the subsequent eBAC group (0.08% ≤ eBAC < 0.11%), severity of nausea was significantly higher in women than in men. In the third eBAC group (0.11% ≤ eBAC < 0.2%), women reported higher severity scores on nausea, tiredness, weakness, and dizziness than men. Men reported the presence of confusion significantly more often than women, and women reported the presence of shivering significantly more often than men. In the fourth eBAC group (0.2% ≤ eBAC < 0.3%), women reported higher severity scores on nausea and tiredness than men. In the highest eBAC group (0.3% ≤ eBAC < 0.4%), no significant sex differences were found. In conclusion, across the eBAC groups, severity scores of nausea and tiredness were higher in women than in men. However, albeit statistically significant, the observed sex differences in presence and severity of hangover symptoms were of small magnitude, and therefore, have little clinical relevance.
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