Female reproductive system damage

Smoking can cause problems for virtually all aspects of the reproductive system. Women who smoke are more likely to have difficulty conceiving, may not respond as well to treatment for infertility, experience earlier menopause and have an increased risk of cervical and vulval cancer. 1,2

Some of the effects of tobacco smoke on the female reproductive system include3
  • Reduced fertility;
  • Menstrual cycle irregularities, absence of menstruation and menstrual cramps;
  • Menopause reached one or two years earlier;
  • Increased risk of cancer of the cervix and vulva; and
  • If a smoker is aged over 35 years and taking the oral contraceptive pill, the risk of stroke and heart attack increases.

Reduced fertility

Smoking is associated with an increased risk of infertility, for both women attempting to become pregnant for the first time (primary infertility) and women who have previously been pregnant (secondary infertility). Women who smoke also have a poorer response to in vitro fertilisation (IVF).4,5 Smokers have an increased risk for ectopic pregnancy and miscarriage. Ectopic pregnancy occurs when the fertilised eggs implants and begins to grow outside the uterus, usually in the fallopian tube. The embryo needs to be surgically removed and the damaged tube needs to be repaired or removed.5 Also see the fact sheet ‘Smoking harms unborn babies’ for more information on the effects of smoking during pregnancy.

Menstrual cycle irregularities, absence of menstruation and menstrual cramps

Smokers may experience more menstrual cramps and discomfort than non-smokers. Some studies suggest that smoking may be associated with a greater likelihood of menstrual irregularity. Smokers also tend to have a shorter menstrual cycle than non-smokers.4

Menopause reached one or two years earlier

Women who smoke reach menopause approximately two years earlier than non-smoking women and may experience more menopausal symptoms, including hot flushes, sweats and insomnia.6, 7 Postmenopausal women who smoke also tend to have lower bone density and therefore have a higher risk of getting a hip fracture compared to women who have never smoked.4 The risk of early menopause increases with the more cigarettes your smoke.5 Quitting smoking will reduce the risk of early menopause.7

Increased risk of cancer of the cervix and vulval

Women who smoke are at double the risk of developing cervical cancer compared to women who have never smoked.8 The risk remains after taking into account other risk factors for cervical cancer including infection with the human papilloma virus (HPV), a likely factor in most cases.8,9 Your risk of developing cervical cancer increases the longer you smoke and the more cigarettes you smoke.9 Smoking is also associated with an increased risk of cancer of the vulva.4 While vulval cancer is rare, an estimated 40% of cases in Australia are thought to be caused by smoking.10

If a smoker is aged over 35 years and taking the oral contraceptive pill, the risk of stroke and heart attack increases

Women who smoke and use oral contraceptive are at a higher risk of heart disease. These women have a higher risk of having a heart attack than non-smokers using oral contraceptives.5 This risk increases as you get older. Women who smoke and use oral contraceptives may also have increased risk of having a stroke.11

Sources
1. American Council on Science and Health. Cigarettes: What the warning label doesn’t tell you. Second edition. New York, American Council on Science and Health, 2003.
2. Cancer Research UK, News and Resources, Vulval cancer risk factors. (printed 02/07/07).
3. Better Health Channel, Smoking – Effects on your body. (Printed 09/07/07).
4. U.S Department of Health and Human Services. Women and Smoking. U.S Department of Health and Human Services, Centres for Disease Control and Prevention, National Centre for Chronic Diseases Prevention and Health Promotion, Smoking and Health, 2001.
5. British Medical Association. Smoking and reproductive life: The impact of smoking on sexual, reproductive and child health (This link was active at the time of submission). Board of Science and Education & Tobacco Control Resource Centre, February 2004. .
6. Greenberg G, Thompson SG and Meade TW. Relation between cigarette smoking and use of hormonal replacement therapy for menopausal symptoms. Journal of Epidemiology and Community Health 1987; 41 (1):26-29.
7. Mikkelsen TF, Graff-Iversen S, Sundby J, Bjertness E. Early menopause, association with tobacco smoking, coffee consumption and other lifestyle factors: a cross-sectional study. BMC Public Health (This link was active at the time of submission), 2007, 7:149; doi:10.1186/1471-2458-7-149.
8. Vineis P, Alavanja M, Buffler P, Fontham E, Franceschi S, Gao YT, Gupta PC, Hackshaw A, Matos E, Samet J, Sitas F, Smith J, Stayner L, Straif K, Thun MJ, Wichmann HE, Wu AH, Zaridze D, Peto R, Doll R. Tobacco and Cancer: Recent Epidemiological Evidence. Journal of the National Cancer Institute, 2004, 96(2): 99-106.
9. U.S. Department of Health and Human Services. The health consequences of smoking: a report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centres for Disease Control and Prevention, National Centre for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2004.
10. AIHW (Australian Institute of Health and Welfare) & AACR (Australasian Association of Cancer Registries) 2007. Cancer in Australia: an overview, 2006. Cancer series no. 37. Cat. No. CAN 32. Canberra: AIHW.
11. WHO Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception 1996 Ischaemic stroke and combined oral contraceptives: results of an international, multicentre, case-control study. Lancet 348: 498 - 505.