Tobacco, Menstruation, and Menopause

Cigarettes cause irregular menstruation and menopause.Footnote 1

Key facts about tobacco use, menstruation, and menopause

View health-related messages for all tobacco product packaging.

What is irregular menstruation and menopause?

Menstruation, or a "period", is the regular bleeding that occurs from the vagina when the uterus (womb) sheds its lining. Menstruation is part of the menstrual cycle, a monthly hormonal cycle that prepares a body for pregnancy. A regular menstrual cycle and regular menstrual bleeding are important indicators of a healthy reproductive system.Footnote 9

An irregular or painful menstrual cycle or heavy and abnormal bleeding can be an indicator of a serious health problem.Footnote 10Footnote 11

Menopause occurs when a body permanently stops menstruating. After menopause, pregnancy is no longer possible. Most people start menopause between 45 and 55 years of age. The average age of menopause in Canada is 51.Footnote 12Footnote 13

Symptoms of menopause include irregular periods, vaginal dryness, hot flashes, and mood changes. Hot flashes are sudden feelings of warmth, flushing and sweating.Footnote 14

How does tobacco use increase the risk of irregular menstruation and early menopause?

The release of chemicals in the body called hormones regulates menstruation and the onset of menopause.Footnote 2

The chemicals in tobacco smoke, such as nicotine, can cause imbalances in hormone production. Changes in the hormones that control the period cycle may cause shorter cycles and more frequent ovulation (release of the egg from the ovary), leading to early menopause.Footnote 2

How does quitting reduce the risk of early menopause?

Quitting smoking may reduce the risk of early menopause.Footnote 16Footnote 17 If someone smokes, their risk for early menopause increases with how much they smoke and how long they have smoked.Footnote 6Footnote 7 This means the earlier someone quits, the better.

Health benefits of quitting tobacco use at any age

Quitting tobacco use reduces the risk of premature death, improves health, and enhances quality of life.Footnote 17 Quitting at any age is beneficial to one's health.Footnote 17 Even people who have smoked or used tobacco heavily for many years benefit from it.Footnote 17Footnote 18 Quitting is the most important thing someone who smokes can do to improve their health.

Read more about the benefits of quitting smoking.

Call for free help to quit

Call the toll-free pan-Canadian quit line at 1-866-366-3667. Quit line counselling, alone or in combination with cessation medication, increases success in quitting.Footnote 17

Footnotes

Footnote 1

U.S. Department of Health and Human Services. Women and Smoking: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2001.

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Footnote 2

U.S. Department of Health and Human Services. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.

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Footnote 3

Qin LL, Hu Z, Kaminga AC, Luo BA, Xu HL, Feng XL, Liu JH. Association between cigarette smoking and the risk of dysmenorrhea: A meta-analysis of observational studies. PloS one. 2020 Apr 15;15(4):e0231201.

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Footnote 4

Rowland AS, Baird DD, Long S, et al. Influence of medical conditions and lifestyle factors on the menstrual cycle. Epidemiology. 2002;13(6):668-674. https://doi.org/10.1097/00001648-200211000-00011

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Footnote 5

Sakai H, Ohashi K. Effects of past environmental tobacco smoke exposure on the menstrual cycle and menstrual phase‐related symptoms: A cross‐sectional study. Journal of Obstetrics and Gynaecology Research. 2021 Jan;47(1):243-53.

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Footnote 6

Zhu D, Chung HF, Pandeya N, et al. Relationships between intensity, duration, cumulative dose, and timing of smoking with age at menopause: A pooled analysis of individual data from 17 observational studies. PLoS Med. 2018;15(11):e1002704. doi:10.1371/journal.pmed.1002704.

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Footnote 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. 2007;7:149. doi:10.1186/1471-2458-7-149.

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Footnote 8

Shuster LT, Rhodes DJ, Gostout BS, Grossardt BR, Rocca WA. Premature menopause or early menopause: long-term health consequences. Maturitas. 2010;65(2):161-6. doi: 10.1016/j.maturitas.2009.08.003.

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Footnote 9

Office on Women's Health. Your menstrual cycle. Updated February 22, 2021. Accessed May 2, 2022. https://www.womenshealth.gov/menstrual-cycle/your-menstrual-cycle

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Footnote 10

Office on Women's Health. Period Problems. Updated February 22, 2021. Accessed May 2, 2022. https://www.womenshealth.gov/menstrual-cycle/period-problems

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Footnote 11

The Society of Obstetricians and Gynaecologists of Canada. Abnormal Pain and Menstrual Bleeding. Accessed June 24, 2022. https://www.yourperiod.ca/abnormal-pain-and-menstrual-bleeding/is-my-bleeding-normal/

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Footnote 12

Canadian Cancer Society. Menopause. Accessed June 24, 2022. https://cancer.ca/en/cancer-information/resources/glossary/m/menopause

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Footnote 13

Costanian C, McCague H, Tamim H. Age at natural menopause and its associated factors in Canada: cross-sectional analyses from the Canadian Longitudinal Study on Aging. Menopause. 2018 Mar 1;25(3):265-72.

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Footnote 14

Office on Women's Health. Menopause symptoms and relief. Updated February 22, 2021. Accessed May 2, 2022. https://www.womenshealth.gov/menopause/menopause-symptoms-and-relief

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Footnote 15

U.S. Department of Health and Human Services. Smoking and Reproduction. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. https://www.cdc.gov/tobacco/sgr/50th-anniversary/pdfs/fs_smoking_reproduction_508.pdf

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Footnote 16

Hayatbakhsh MR, Clavarino A, Williams GM, Sina M, Najman JM. Cigarette smoking and age of menopause: a large prospective study. Maturitas. 2012 Aug 1;72(4):346-52.

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Footnote 17

U.S. Department of Health and Human Services. Smoking Cessation. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2020.

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Footnote 18

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, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2004.

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