Smoking and menstruation

Menstrual problems can be difficult to describe and study, and there is no generally accepted definition of menstrual problems. Nevertheless, a limited number of studies have suggested that smoking may affect the  menstrual cycle.
Certain studies suggest that women who smoke seem to be more likely than non-smoking women to have  painful periods (dysmenorrhea). These studies suggest that smokers are 50 per cent more likely to report having painful periods than non-smokers.The more cigarettes smoked, the greater the risk of period pain.

One study found that women who smoked 10 or more cigarettes daily were almost twice  as likely to have painful periods as non-smokers. For women who had smoked for nine years or longer, the risk was almost three and a half (3.4) times greater.25 Smoking has also been reported to affect the duration of painful periods. On average, women who smoke report that they have around a half-day more pain during their period than non-smokers

Any increased risk of painful periods in smokers seems to be partially reversible. Most studies have found that while period pain is less common among ex-smokers than among current smokers, it is more common than among women who have never smoked.Women who smoke appear to be more likely to have irregular periods (menstrual irregularity). Smokers also
seem to have shorter menstrual cycles, on average, than non-smokers.10 Among women who stop smoking,
the risk of irregular periods returns to that seen in non-smokers.

There is also limited evidence to suggest that smoking is associated with missed periods in women who have previously menstruated (secondary amenorrhea). One study found that high-school girls who smoked were twice as likely as non-smokers to miss three or more consecutive menstrual periods.
The pathways through which any impact of smoking on the menstrual cycle might be mediated are unclear.

One possibility is that changes in body weight may be involved. Another is that smoking may lead to
alterations in sex hormone metabolism

Key messages: Smoking and menstruation

• There is limited evidence that women who smoke may be more likely to have painful periods or
• irregular periods.
• here is limited evidence to suggest that smoking is associated with missed periods in women who
• have previously menstruated.
• Stopping smoking appears to reduce any increased risk of menstrual problems.

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