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Smoking has a detrimental effect on women’s fertility and could trigger earlier menopause, study suggests

Smoking effect on fertility and menopause

A study investigating the impact of smoking on women’s health has found evidence that suggests women who smoke are more likely to suffer from fertility problems, including early onset menopause.

The observational study, published in the BMJ’s Tobacco Control, analysed information relating to lifetime smoking habits, fertility issues and age at natural menopause using data provided by more than 93,000 women to the Women’s Health Initiative Observational Study in the United States.

Of these women, 79,690 experienced a natural menopause – not induced by hysterectomy or ovary removal – and researchers found that women who were or had previously been regular smokers began the menopause up to two years earlier than those women who had never smoked. A similar effect was also noted among non-smoking women who had been regularly exposed to other people’s cigarette smoke, either in the home or the workplace.

According to researchers, women who smoke or had previously been smokers had a 14% increased risk of infertility and a 26% increased risk of menopause before the age of 50, compared with those women who had never smoked.

Experts say that the findings add to a growing body of evidence to indicate that smoking has a detrimental effect on reproductive health and suggest that toxins in tobacco could be disrupting normal hormone production and activity. The researcher’s data also correlates with other studies that found an established link between smoking and fertility problems.

"Long term effects" of smoking on child health

Dr Roger Marwood, gynaecologist, obstetrician and spokesperson for the Royal College of Obstetricians and Gynaecologists (RCOG) says: “This study adds to the weight of data demonstrating the negative impacts of smoking on a person’s health. Smoking, as well as being exposed to second hand smoke can lead to heart disease, lung cancer and other lung diseases, and smoking during pregnancy can increase the risk of having a low-birth weight baby, preterm birth or stillbirth, and can have long term effects on a child’s health.

Smoking and pregnancy

Dr Marwood adds: “As healthcare professionals, we need to support and help women to lead healthier lives and this must include smoking cessation. Women must be made aware of the risks of smoking on their fertility, in pregnancy, as well as their health later in life. They must also be signposted to the excellent support systems that are available to help them quit.”

Dr Richard Quinton, Consultant Endocrinologist and Senior Lecturer at the Institute of Genetic Medicine, says: “This paper pretty well does what it says on the tin and confirms what we thought we already knew from previous studies, i.e. that exposure to cigarette smoke (active or passive) is associated with advancing menopause onset by 1-2 years.

“However, they have also taken this a step further to show that active cigarette-smoking is also associated with infertility, presumably through the same process of toxic ovarian damage that later results in early menopause. There are well-established basic studies to show putative cellular mechanisms for this effect, so it’s not at all surprising, but nice to have it laid out more convincingly.”

“Worrying” findings

Professor Ashley Grossman, Professor of Endocrinology, at the University of Oxford, says: “This is slightly worrying – there is only a slightly increased risk of infertility in smokers compared to never-smokers, but this new study suggests that so-called passive smokers might be similarly affected. Maybe more convincing is the nearly 2-year earlier menopause in smokers and around one year in passive smokers; this dose-response effect does suggest we are looking at a true phenomenon.

Cigarette and tobacco smoke

“This is one more significant reason not to smoke, especially as the fall-off in tobacco use in male smokers may not be equally paralleled in women.”

“Women need to be protected from active and passive tobacco smoke"

“This is one of the first studies of this size and statistical power to investigate and quantify active and passive smoking and women’s health issues. It strengthens the current evidence that all women need to be protected from active and passive tobacco smoke,” conclude the researchers.

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