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A woman goes through several phases during her lifetime. Menstruation starts as the woman attains puberty, normally at the age of 12-15 years. Cessation of menstruation is known as menopause. Life after the last menstrual period when the ovaries stop functioning and the woman loses her fertility is quite challenging as the body undergoes several hormonal changes. A woman is said to have entered into the phase of menopause if she has not experienced periods for twelve consecutive months. In the U.S., the average age of menopause is 51 years but it may vary according to the region (northern, southern) where the woman lives, overall health, diet, race and lifestyle of the woman, genetic factors and the biological clock that regulates the bodily functions, etc. Take a look at the following section to explore the relationship between smoking and the onset of early menopause.

Smoking and Menopause: How are they Linked

A woman does not reach menopause suddenly. Several changes, especially hormonal changes take place within her body and the menstrual cycle slows down gradually. The body of a woman in perimenopausal stage and premenopausal stage exhibits several symptoms like irregular menstrual cycle, hot flashes, night sweats, high heart rate, increased irritability, loss of libido, insomnia, etc. Studies show that the percentage of women experiencing menopause at 'premature age' has significantly increased over the last few years. Hysterectomy (surgical removal of the uterus and ovaries), obesity, genetic factors, certain illnesses and treatments like chemotherapy and radiation, bad habits like smoking, drug/alcohol abuse can be the reason behind an early menopause. A number of researchers are busy studying smoking and its effects on menopause.

According to the study reports presented by the researchers of the Massachusetts General Hospital, the specific gene 'Bax' and the genetic receptor 'Ahr' trigger the onset of menopause when activated; and the chemicals that the body receives through smoking activate these genetic factors that destroy the ovarian cells. Thus, smoking affects the average menopause age.

Effects on smoking on menopause may vary from woman to woman depending upon whether the woman belongs to the class of ex-smokers or current smokers and the number of cigarettes smoked per day. Smoking affects the health of the arteries which in turn can affect the blood supply to the ovaries and can trigger an early menopause. Several study reports show that smokers have a higher risk of reaching menopause at an earlier age than non-smokers. Smokers show higher rate of infertility than non-smokers as smoking is responsible for the toxic effects on ovaries. Smoking speeds up the rates of follicular atresia. Several studies have thrown light on the fact that, more the number of cigarettes smoked, higher is the rate of inception of perimenopause.

According to the study reports presented by the 'International Journal of Epidemiology', early menopause increases the risk of osteoporosis and heart diseases. As ovaries stop functioning, the woman loses estrogen that helps control bone loss. Once the woman attains menopause, bones become weak and porous. Loss of bone density increases the risk of fractures. Hormonal changes lead to weight gain after menopause which in turn results in increased blood pressure and increased risk of heart diseases.

As smokers reach menopause earlier, they need hormone replacement therapy (HRT) earlier. Studies show that the severity of the peri- and premenopausal symptoms is higher in smokers than in non-smokers. Smokers may have to face certain side effects of HRT as they opt for it earlier than non-smokers. Since smoking is linked to earlier menopause, quitting smoking as early as possible is the only way of preventing health complications after early menopause.

Effects of Smoking on Menopause

Certain studies were conducted by the Institute of General Practice and Community Medicine, Faculty of Medicine, University of Oslo, Norway and by the Norwegian Institute of Public Health, Oslo. The reports say that:
  • Women who smoke are more likely to enter into the phase of menopause before the age of 45 years.
  • Women who smoke have an increased risk of osteoporosis and heart diseases as they reach menopause at an earlier age.
  • Passive exposure to smoke does not affect the age of menopause.
  • The risk of reaching menopause at an earlier age is almost doubled in case of women who smoke too much.
  • Women who stop smoking 10 years before menopause are less likely to reach menopause before the age of 45 years.
  • Women who start smoking later in life are also likely to reach menopause earlier than non-smokers.
  • The average age of menopause is not affected much, if women quit smoking 10-15 years before menopause. If a woman stops smoking earlier in life, the risk of early menopause is reduced to a great extent.
  • Dr. Thea F. Mikkelsen and her colleagues at the University of Oslo studied a group of 2,123 women belonging to the age group 59 to 60 years. They found that women who currently smoked were 59% more likely to reach menopause earlier than the non-smoking women.
Various studies have shown that smokers are likely to hit menopause between the age 43-50 years. Hence, women should not underestimate the connection between smoking and menopause.

Volodymyr Dvornyk, from the University of Hong Kong has also presented his study reports which confirm the fact that women who smoke reach menopause at an earlier age than non-smokers. Hitting menopause earlier results in several health problems like diabetes mellitus, osteoporosis, obesity, Alzheimer's disease, heart diseases, and others.

A few years before, it was not possible for doctors to determine at what age a woman would reach menopause. But, according to new researches, doctors can now predict approximately when a woman would have her last menstrual period, by keeping a record of the declining levels of anti-müllerian hormone (AMH) secreted by the ovaries.

According to the North American Menopause Society, after menopause, most women experience high levels of self-confidence and energy than they used to have when they were young. They feel more empowered, more focused and more involved, than ever before. But for women who smoke, menopause can be an awful and turbulent process. Remember, it's never too late, you can quit smoking and can definitely stay away from the ill effects of early menopause.