BACKGROUND: The relationship between menopausal transition, alcohol use and women's health remains poorly understood despite its relevance in psychiatry and women's health. Alcohol and menopausal symptoms can overlap, which can lead to misattribution and a barrier to access appropriate care. The objectives are to map the existing literature on the relationship between menopause, perimenopause and alcohol use. We also aim to synthesise current evidence and identify knowledge gaps across 3 domains: alcohol and impact on menopausal physiology and symptoms; menopausal transition and impact on alcohol use patterns; and psychosocial context and mental health. METHODS: A scoping review was conducted using the Ovid MEDLINE, PubMed, Embase, Cochrane and PsycINFO databases. Studies were included if they involved perimenopausal, menopausal or postmenopausal women and addressed any kind of alcohol use. Data were synthesised thematically. RESULTS: Fifty-seven studies were included, predominantly prospective cohorts (n = 18) and cross-sectional studies (n = 15). Most focused on postmenopausal populations, with perimenopausal women under-represented. Moderate alcohol consumption was associated with higher oestradiol and lower follicle-stimulating hormone levels, though effects on menopausal timing were inconsistent. Findings on vasomotor symptoms, sleep disturbance and sexual function varied considerably. No consistent evidence demonstrated that the menopausal transition independently increases alcohol consumption. Mental health outcomes were reported in fewer than one-quarter of studies, with moderate drinking showing neutral effects while heavy consumption correlated with worse mood and cognitive complaints. CONCLUSIONS: The literature provides only a partial understanding of the menopause-alcohol relationship, with conflicting results across vasomotor symptoms, sleep, sexual function and psychological outcomes.