In modern times hops are added in the brewing process for bittering, preservation, and aroma in beer, but this is a relatively recent innovation. Historically mixtures of herbs and other plants would have been used in the flavouring of ales and these mixtures were often referred to as gruit. The addition of hops also allowed beers to be brewed weaker than un-hopped ale.
The boiling stage in the production of beer as compared to ale also had a significant consequence on the preservation, taste and nutritional value. For a beer the wort, which is the liquid containing the sugars and protein extracted from the grain was boiled before the fermentation stage. For an ale the wort was cooled and mixed directly with the yeast and not boiled.
Ale was also often served fresh, only just finished the fermentation stage or possibly even still fermenting, as opposed to beer which would be served stale, where it has finished fermenting and cleared. Contrary to popular myth, ales would not necessarily have been any sweeter than beer. As yeast is able to ferment cider and wine to dryness so it can with ale. Combined with the effects of wild yeasts it may have actually been quite sour and added sweetness may be needed.
The brewing of ale largely remained a home activity in medieval times often performed by women ‘brewsters’, and virtually everyone in England would have drunk ale. By the 15th century, ale making was gradually changing to an artisan activity from a family-oriented one, with pubs and monasteries brewing their own ale and beer for mass consumption. Gradually beer took over as the drink of choice and the distinction between ale and beer became lost in time.