Long-term heavy alcohol intake is associated with endocrinological abnormalities the mechanisms of which are still unclear. The objective of the present study was to investigate the effect of alcohol intake on plasma and urine glucocorticoid and androgen steroid levels in healthy premenopausal women using oral contraceptives. In a placebo-controlled interventional study with a cross-over design including nine premenopausal women using oral contraceptives no effect of tolerance was observed with regard to the magnitude of the acute transient alcohol-induced testosterone elevation after a 1-week alcohol drinking period (0.8 g/kg per day). At non-intoxicated time points elevated plasma testosterone and androstenedione levels were found in the afternoon but not in the morning during the alcohol drinking period compared with placebo. An increase in plasma cortisol levels was observed after the discontinuation of alcohol drinking. No effects were observed in total glucocorticoid conjugates in morning urine spot samples. An increase during the alcohol period relative to placebo was, however, observed in the urine etiocholanolone/androsterone, tetrahydrocortisol/allotetrahydrocortisol as well as the 20-hydroxy-/20-ketosteroid ratios. No consistent effect was observed in the urine (tetrahydrocortisol+allotetrahydrocortisol)/tetrahydrocortisone ratio. It is suggested that the alcohol-induced alterations in plasma glucocorticoid and androgen levels during non-intoxicated conditions are due to a change in the hypothalamic-pituitary-adrenal function. The effects observed in the conjugated urine glucocorticoid and androgen ratios are likely to be mediated by a change in the metabolism of these steroids in the liver. The present results may be of relevance in the development of disturbances in the glucocorticoid as well as sex steroid balance among heavy female drinkers.