When you wake up the morning after a heavy night of drinking, the first thing that's likely to run through your mind is, "Ugh, how long will I feel like this?" Typically, hangovers only last in the morning—generally easing off after you've eaten breakfast—and at most should last 24 hours.
But, sometimes, those aftereffects of a night of drinking linger way past their welcome—like the dreaded two-day hangover which makes you realize that you just can't cope with alcohol in quite the same way you could when you were 21.
What exactly is a hangover?
"Hangovers are somewhat poorly understood from a medical standpoint," says Fred Goggans, M.D., the medical director at McLean Hospital in Maine, USA. For the most part, the symptoms are considered a form of short-term withdrawal and tend to be time-limited.
Your liver also has to work overtime to process alcohol. "The liver needs to first break down alcohol into acetaldehyde, which is toxic," says Anne Boris, R.D., L.D.N., of Northwestern Medicine Huntley Hospital. "Then, it breaks down acetaldehyde into acetate, which is nontoxic." If a person drinks too much for their body, or if their liver isn't working efficiently, the body can't turn acetaldehyde into acetate quick enough—that's where a hangover comes into play.
Goggans also says that the strength and length of your hangover goes hand-in-hand with the amount of alcohol you had. Beyond that? "There are also some other factors that are speculated to influence the intensity and duration of a hangover," he says.
But why do some hangovers last an acceptable amount of time and others don't?
You didn't drink enough water.
"Alcohol has a diuretic effect—heavy drinking may maximize that," says Vincent Pedre, M.D., author of Happy Gut. Drinking can dehydrate you—even more if you're vomiting or suffering from diarrhea. And this, on top of mineral imbalances (from the influx of booze and loss of fluids and electrolytes), can slow how fast your body detoxifies itself, he explains.
Ease the pain by staying hydrated—alternating every glass of booze with a glass of water, he says—and make sure to keep drinking water even when you really don't feel like it the next day.
You had a bad night's sleep.
You know how a good sleep can help you feel your best in the morning? Well, you might not realize that while a few glasses of wine could put you to sleep, it certainly won't help you get your deepest rest. "People tend to have interrupted sleep following a drinking episode," says Goggans.
It all comes full circle: the more you drink, the worse you sleep, and then, the worse you feel the day after (and sometimes the day after that).
You drank a darker alcohol.
Meet congeners—they're flavoring agents or byproducts of fermentation in booze, and they are linked to hangovers, says Goggans. "It seems like the congeners in the darker liquors and drinks are associated with a longer hangover," he says.
Liquors linked to worse next-day pain include whiskey, rum, red wine, and brandy, says Goggans. On the other hand, these are the liquors less likely to cause a hangover: white wine, vodka, and gin.Continue reading below ↓
You're getting older.
When you're 21, your ability to detoxify alcohol is different to when you're 40 (or even 28), says Pedre. "As we get older, our cells age, and we might not be able to process toxins as we did when we were younger," he says. So while three drinks might have had minimal effect back in college, that amount may feel like double that 10 years later.
You have a sensitivity, but don't realize it.
Lots of people have sensitivities to certain food or chemicals they don't even know about. Beer, for example, is made with barley and hops (aka, gluten); mixers can be high in sugar; wine can have sulfites—all of these are things you can be intolerant to, says Goggans, which can really amp up your hangover (yes, even if you only have one glass).
You drank on an empty stomach.
Alcohol can irritate the lining of your stomach, which can make any hangover-induced nausea, abdominal pain, or vomiting worse, says Boris.
Booze can also affect your blood sugar, says Chaun Cox, MD, family medicine physician at Mayo Clinic Health Systems. "Alcohol is a big surge of calories and simple sugars, it can spike your blood sugar then make it fall," he says, adding that not having food in your stomach before drinking can make those levels spike even more drastically.
The solution? Eating a little bit of something relatively hearty (opt for a sandwich instead of a garden salad) before drinking to slow alcohol's absorption.
You're on your period.
Your body's already under a little bit of strain during your period (you are bleeding, after all), and since alcohol can dehydrate you, it can deplete your energy even more at that time of the month, says Cox.
You're on medication.
Many medications are metabolized (aka broken down) by the liver and kidneys—the same organs your body uses to metabolize alcohol, which can leave those two organs working overtime, and possibly not performing their best.
"Pain relievers like acetaminophen, antidepressants, cholesterol medication, and blood pressure medications are ones you want to be especially careful with," says Cox.
Antibiotics can also affect how your body processes alcohol, says Cox. While it's not an issue with all antibiotics, some can cause nausea, liver damage, and high blood pressure when combined with alcohol, says Cox—so it's best to check with your doctor to know if your specific medication interacts with booze.
This article originally appeared on WomensHealthMag.com. Minor edits have been made by the Cosmo.ph editors.