Cigarettes Can Sabotage Hormone Balance

The list of negatives attached to smoking cigarettes is long, but most women don’t realize that along with increased risk of heart disease, lung disease, breast cancer, and osteoporosis, as well as accelerated aging, poor skin color and wrinkles, fatigue and nutrient depletion, cigarettes also have profound effects on hormones. It’s well established that premenopausal women who smoke have a significantly higher risk of infertility, difficult menstrual cycles and early menopause, but research over the past few years has established that cigarette smoking also affects menopausal hormones.

After a few tries, middle-aged women tend to give up on quitting smoking because nicotine withdrawal—even with patches and gum—causes emotional instability and weight gain. The challenge of battling nicotine cravings alone is daunting, but the emotional fragility that comes with the first few months of nicotine withdrawal can wreak havoc on relationships with loved ones and co-workers. Those who quit can count on gaining at least ten pounds, as metabolism slows and food becomes a substitute for nicotine. During the years of the menopausal transition, adding nicotine withdrawal to fluctuating hormones can turn a pussycat into a snarling tiger.

Although the overall number of people in the U.S. who smoke cigarettes is steadily declining, the number of women who smoke is rising. If this puzzles you because you don’t smoke and none of your friends do, it’s probably because so many women have become closet smokers, sneaking outside for a few puffs at opportune moments. What was once cool is now shameful.

If you smoke, you probably don’t need yet another reason to quit—the evidence of how bad it is for your health is already overwhelming, and that morning cough is a daily reminder of what it’s doing to your lungs. Every cigarette steals a packet of energy from your body’s daily allotment.

So what’s the good news here? Hormone balance will be easier to achieve and maintain when you quit smoking. In quitting, more can be gained than lost towards mood stability and weight loss, thanks to better hormone balance. It’s a great trade-off. Even using nicotine patches and gum instead of smoking will help, because the chemicals added to cigarette tobacco and created by burning tobacco are thought to be those responsible for most of the negative side effects. In other words, it’s not the nicotine itself that’s so very harmful, it’s the delivery system.

In menopausal women, cigarette smoking raises adrenal hormones such as cortisol (a stress hormone), and androgens (male hormones) such as androstenedione and dehydroepiandrosterone (DHEA). Chronically high cortisol levels create unstable blood sugar, which in turn causes high blood glucose and insulin, which in turn stimulates the ovaries to produce androgens.

In a menopausal woman, the ovaries have slowed their production of estrogen and progesterone, but can continue to produce androgens well into her eighties. Androgens without the balance of estrogen and progesterone are the source of much-dreaded hair loss and whiskers in older women. Cigarette smoking magnifies these effects.

A study of perimenopausal (the years just before and after menopause) women smokers done at the Johns Hopkins School of Public Health found that current smokers had significantly higher androstenedione levels, androgen-to-estrogen ratios and lower progesterone levels, compared with never smokers, and that cigarette smokers had significantly more, and more severe, hot flashes.

Quitting smoking, combined with strategies to balance hormones such as bioidentical hormone replacement therapy (BHRT), stress management, exercise, and reduction of sugar and refined carbohydrates, has dramatic potential to improve overall health, stabilize mood, increase energy, increase weight loss and improve sleep. Not a bad trade-off!


Baron JA, Comi RJ, Cryns V et al, “The Effect of Cigarette Smoking on Adrenal Cortical
Hormones,” Journal of Pharmacology and Experimental Therapeutics, Vol 272, Issue 1, pp. 151-155, 01/01/1995.

Gallicchio L, Miller SR, Visvanathan K et al, “Cigarette smoking, estrogen levels, and hot flashes in midlife women,” Mauritas. 2006 Jan 20;53(2):133-43.

Windham GC, Mitchell P, Anderson M, Lasley BL, “Cigarette Smoking and Effects on Hormone Function in Premenopausal Women,” Environ Health Perspect. 2005 October; 113(10): 1285–1290.