Add this to the list of reasons why you shouldn’t smoke: Smoking can speed up when menopause starts, worsen symptoms, and cause fragile bones.
Smoking’s effect on menopause has been the subject of numerous studies, and the general conclusion is that women who smoke can go into menopause about a year earlier than nonsmokers—as much as two years earlier for heavy smokers.
While some women may think “I can’t wait to get through menopause and be done with these pesky periods!” it’s important to think about what this really means.
Experiencing menopause sooner means coping with symptoms (hot flashes, night sweats, etc.) earlier than you normally would. Smokers are more likely to have an unpleasant menopausal experience. We know that smokers have more hot flashes as they go through menopause. Smoking can also intensify the symptoms of menopause, including hot flashes and difficulty sleeping. And smoking’s effects linger long after hot flashes stop.
Experiencing menopause sooner also means coping with the serious health concerns that may come with early menopause and the loss of estrogen that results. Prior to menopause, estrogen protects women against events such as heart attacks and bone loss. Early menopause has been linked to heart disease, strokes, and osteoporosis.
Although menopause is a natural part of the aging process, smoking makes what can be expected even worse. Smokers are 35 percent more likely to break a hip after menopause than nonsmokers. Former smokers have a 15 percent greater risk of hip fracture. How long you smoked will affect your risk of fracture more than how much you smoked.
The medical literature discussing smoking’s effects on menopause goes back to 1962, when a study found an “early menopause” in 20 percent of 650 smokers, compared with 1.7 percent of 5,000 nonsmokers. Since then, study after study has added to the body of evidence that smoking can make menopause miserable.
Researchers have multiple theories about why smoking leads to earlier menopause. One thought is that smoking may affect how estrogen is made or removed from the body; others think certain chemicals in cigarette smoke may kill a woman’s eggs. In the end, there isn’t just one way that smoking affects menopause, so the only way to avoid these negative effects is to remove the cause—smoking.
The lesson for women is clear: If you smoke, quit; if you don’t smoke now, don’t start. The negative health effects of smoking are well known—lung cancer, heart disease, stroke. But still, nearly 20 percent of women smoke cigarettes, a habit that’s difficult to break. Knowing that menopause could be more difficult because of smoking might be the incentive women smokers need to become smoke-free.
Cherise Hamblin, M.D., is a physician with Family and Maternity Medicine specializing in obstetrics and gynecology. She is a graduate of Franklin & Marshall College, Northwestern University Medical School, and completed her residency at Maricopa Integrated Health System.