The Link between Smoking and Menopause

By Nadine Salmon, BSN, IBCLC, Clinical Content Specialist AMN Healthcare

We all know that cigarette smoking increases the risk of cardiovascular and lung disease, but did you know that it can affect the timing of the onset of menopause, the intensity of the symptoms of menopause, and the incidence of osteoporosis after menopause?

Researchers at the University of Hong Kong found that women who smoke are more likely to go into menopause about a year earlier than those who don’t smoke (Pittman, 2011). This is significant as the age of menopause influences the risk of bone and heart disease, as well as breast cancer.

These findings, recently published in the journal Menopause, come from six studies conducted in the U.S., Poland, Turkey and Iran, which collected data from about 6,000 women. The researchers, led by Volodymyr Dvornyk, found that non-smokers, on average, hit menopause between the ages of 46 and 51. Yet, smokers in the study reached menopause earlier, on average, between the ages of 43 and 50. Dvornyk and his colleagues also analyzed five other studies that used a cut-off age of 50 or 51 to group women into "early" and "late" menopause. Out of more than 43,000 women in that analysis, women who smoked were 43 percent more likely than nonsmokers to have early menopause (Pittman, 2011).

Both early and late menopause have been linked to health risks. Women who hit menopause late, for instance, are thought to be at higher risk of breast cancer because one risk factor for the disease is increased exposure to estrogen. Yet, the medical community generally agrees that earlier menopause is more likely to be associated with postmenopausal health problems, including osteoporosis, cardiovascular disease, diabetes mellitus, obesity, and Alzheimer's disease (Pittman, 2011).

According to Freedman (n.d.), there are two theories for why smoking might mean earlier menopause. When activated, a gene known as Bax and a genetic receptor called Ahr initiate the onset of menopause. Researchers at Massachusetts General Hospital have discovered that the chemicals in smoking directly activate these genetic components, creating a pathway to destroying ovarian cells. Smoking may also affect how a woman's body responds to estrogen.

However, there is still much work to be done in order to fully understand the link between menopause and smoking. Even without full knowledge of how smoking impacts menopause, the benefits to smoking cessation are clear; for a variety of health reasons, women should do their best to quit the habit.


Freedman, L. (n.d.). Smoking and Menopause. Article11, Volume 2. Retrieved from: http://www.lbfmd.com/whs_menopause_211_8051.pdf

Pittman, G. (2011). Smoking Linked to Earlier Menopause. Reuters Health. Retrieved from: http://www.reuters.com/article/2011/10/14/us-smoking-menopause-idUSTRE79D49M20111014