Smoking and Early Menopause

By WV Marshall

Smoking and other lifestyle factors have been linked to the early onset of menopause.

In addition, menopause symptoms can be exacerbated by smoking.

Menopause Worsens Symptoms

When you smoke, your

  • anxiety,
  • mood swings,
  • sleep,
  • skin problems, and
  • hot flashes

all grow worse.

How Smoking Impacts the Body

Cigarette smoking has been shown to influence ovarian aging and follicle reserve through altering gonadotropins and sex hormones, as well as having harmful effects on ovarian germ cells.

Both smoking and menopause lower estrogen levels, raising your chances of experiencing menopause symptoms and other health problems.

If you smoke, it can impact your ability to take hormone replacement therapy (HRT) and achieve hormone balance, and you may need to use greater dosages of hormones, increasing your chances of experiencing side effects.

Nicotine from cigarettes is known to suppress the action of the aromatase enzyme, which catalyzes the conversion of androgens to estrogens.

Smoking and Early Menopause

As a result, smoking lowers estrogen levels in the bloodstream, causing early menopause in women.

In layman’s terms, this indicates that smoking not only lowers estrogen levels faster than a nonsmoker’s menopausal estrogen experience, but it also hastens menopause.

Smoking vs. Nonsmoking

Tobacco users are 43% more likely than non-tobacco users to experience early menopause.

This means less time with estrogen’s beneficial effects, which can lead to increased risk of

  • osteoporosis,
  • heart disease,
  • diabetes,
  • obesity, and
  • Alzheimer’s disease

after menopause.

Bone Loss and Osteoporsis

Women who smoke have a two-fold increased incidence of fractures compared to non-smokers.

Women who smoke lose bone density more quickly, increasing their risk of osteoporosis.

This is because cigarette smoke produces free radicals, which target the organs, hormones, and cells that keep your bones healthy, including the cells that rebuild bone.

Smoking also decreases blood flow throughout the body, causing nerve damage.

You’re more prone to fall if your feet and toes lose feeling.

Vaginal dryness

Production of the vaginal lubricating fluid reduces as estrogen production declines during menopause and is further slowed by smoking.

Vaginal dryness can make activities such as exercise and intercourse extremely uncomfortable, if not outright painful.

Less estrogen production (due to smoking, for example) means less natural lubrication.

Smoking can also make menopausal symptoms more severe.

Benefits of Quitting Smoking

Women who quit smoking before the age of 40 eliminate the majority of their chance of dying young.

When you stop smoking, your risk of stroke and heart disease decreases quickly. (Your cancer risk decreases more slowly.)

Women who stop smoking by the age of 50 reclaim around six years, while those who stop by the age of 60 reclaim about four years of the decade they would have lost if they hadn’t quit.

Smoking, Early Menopause and Bladder Cancer

In several populations, experiencing menopause before age 45 is associated with a higher risk of bladder cancer.

This higher risk was significant if the woman were a smoker.

A study, which looked at health outcomes of more than 220,000 U.S. Nurses, was presented during the European Association of Urology congress in Barcelona.

American and European scientists studied the medical histories of nurses enrolled in Nurses’ Health Study I and II, which followed health outcomes of the nurses since 1976.

The scientists found that women who went into menopause before the age of 45 were 45 percent more likely to have bladder cancer than those who went into menopause after 50.

If these women experiencing early menopause had smoked, the risk of bladder cancer was 53 percent greater than women who had menopause at a later age.

Around one woman in 20 women undergoes early menopause before the age of 45; the average age at menopause is 51 in developed countries.

“We found that smoking women who experienced menopause before they were 45 years old had a greater risk of bladder cancer. Smoking remains the most important risk factor for bladder cancer,” lead researcher Dr. Mohammad Abufaraj said.

“Our data also revealed that it is unlikely that female factors such as age when periods begin, number of pregnancies, oral contraceptive use or the use of hormone replacement therapy are associated with bladder cancer risk.

Smoking is associated with earlier age at menopause thereby further increasing the risk of developing bladder cancer.”

Abufaraj said the study indicated that when menopause begins at an earlier age, the risk of bladder cancer increases.

“Our primary interpretation is that a factor like smoking, which is known to correlate with earlier age at menopause, remains of grave concern as the main cause of in bladder cancer,” he said. “It reinforces the warning that smoking really is harmful in ways that we might not have easily imagined.”

Arnulf Stenzl, chairman EAU scientific congress committee and who was not involved in this research, said this long-term study demonstrated “smoking clearly sticks out as the underlying reason for the increased incidence of bladder cancer.”

Other RIsk Factors

“However, we need to remain open to other factors causing bladder cancer, such as hormonal changes leading to an earlier menopause; this work indicates that these changes may themselves be a result of long term nicotine exposure,” Stenzl said.

The same research team previously found that smoking has “a dose-response relationship” with prognosis in both early and advanced bladder cancer, European Association of Urology said.

Cigarette consumption degrades outcomes, such as response to therapy and mortality.

Once smoking cessation occurs, it takes a decade for the risks return to the same levels as non-smokers.

EAU released information about the study. (

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