Treatments
Quit Smoking Tobacco
SMOKING AND MENOPAUSE
You may wonder, what does smoking have to do with menopause?
Well, women who smoke cigarettes are more likely to have hot flashes, to have more of them and to have more severe hot flashes during menopause. Smokers are more likely to have painful periods. They also tend to begin menopause at an earlier age. Unfortunately, women who start menopause earlier tend have a longer menopause transition. Longer time in menopause, more and worse hot flashes, more painful periods.
Yet another set of reasons why you should quit as soon as possible.
Be happy for your choices if you never smoked. Non-smokers have the fewest and least severe hot flashes, compared to current and former smokers. Never smokers are also less likely to have painful periods than current smokers.
Other forms of nicotine, such as vaping, have not been studied for their effect on menopause symptoms.
QUITTING TOBACCO
There are a few main strategies people use to quit. Here’s what we recommend, in order.
- Try quitting cold turkey, in case it works for you. Setting a quit date and then never have another cigarette. That seems to work best if you are less addicted. Also, the younger you were when you started smoking, the harder it may be to quit.
- Decrease your nicotine over time on a schedule. If you haven’t quit in 2 weeks of trying cold turkey, or if you have a track record of failing to quit, you may need to slowly decrease your tobacco on a schedule. Some people cut it in half each week. Some people switch to the nicotine patch or vaping, decreasing the dosage regularly. The patch may be covered by your insurance. Be careful with vaping that you don’t end up accidentally increasing the amount of nicotine you get. Slip-ups are common; just get back on track immediately.
- Talk to a counselor if you have not been able to quit within a month or two of trying on your own. People who talk with a tobacco counselor are twice as likely to quit smoking than people who try it on their own. Also talk to a counselor if you have tried and failed to quit multiple times already. Your addiction may be very strong and hard to break on your own if you smoke or vape a lot, have been using tobacco for a long time, or were exposed to tobacco prenatally. The counselor may suggest prescription drugs that make it much more likely you can succeed. Hypnosis may help you quit, too.
Two great free science based sets of resources are:
- https://smokefree.gov/ They even have advice just for women, https://women.smokefree.gov/ The site is sponsored by the National Institutes of Health, so it’s paid for by your tax dollars. Take advantage of it! You can make a quit plan, get advice, and get text message support.
- https://www.becomeanex.org/. This science-based program is run by the Mayo Clinic and the Legacy Foundation. (The latter also runs national campaigns to keep kids from starting smoking and vaping.)
OUR BOTTOM LINE: DOES IT HELP?
YES. There are lots of reasons to quit smoking. Add hot flashes to the list. The positive effects of quitting smoking don’t happen until 5 years after quitting. However, quitting smoking before menopause is associated with fewer hot flashes and less severe hot flashes. The earlier you quit before menopause the greater the impact on hot flashes.
Smokers are also more likely to have painful periods during their reproductive years. It is not known whether quitting just before or during perimenopause decreases the chance of period pain during the final years of menstruation.
Quitting helps you keep your looks longer, since smoking is bad for your skin and hair. It’s great to know that your hair will improve within 8-10 weeks of quitting.
Quitting may also have a good, long-term impact on your brain fog, dry eye, mood, sleep, and bladder control.
HOT FLASHES AND NIGHT SWEATS
DRY SKIN & HAIR
The longer you smoke and the more tobacco you have, the worse your skin will suffer from premature aging. Wrinkles, sagging skin, greyish complexion. Check out the photos of twins here – one who smoked, and one who didn’t. And it’s even worse if you smoke AND get a lot of direct sun. Nicotine use also hampers wound healing, and increases acne and psoriasis.
The toxic chemicals in cigarette smoke shrink the blood vessels supporting your hair follicles, so that smokers and those exposed to second-hand smoke have fewer hairs and they are more brittle. In fact, scientists can examine the chemicals in your hair to see how much tobacco exposure you have had. After you quit, your hair will start to grow back and be better quality in 2-3 months.
BRAIN FOG / COGNITION
When you first quit smoking, brain fog may increase. This is the addiction fighting you. But stick with it. Research suggests brain fog will clear up by 3 months after quitting, or sooner. And then you may think clearer than when you were smoking.
MOOD, ANXIETY, AND DEPRESSION
Smoking takes a toll on your mental well-being. It’s part of the mechanism of addiction. A tobacco addiction makes you feel worse the longer it has been since your last cigarette or vape. Then you feel a release when you light up. Although the first few weeks of no tobacco can be really rough on your mood, the effects are temporary. Quitters report that they feel even better than when they were still smoking.
Research is needed into how smoking and vaping affect menopause-related mood problems.
BLADDER CONTROL PROBLEMS & INCONTINENCE
Smoking is a risk factor for bladder control problems. Furthermore, a smoker’s cough and weak bladder control means more leaks. Another reason to quit, even if you do not yet have bladder control problems.
DRY EYE
Smoke, whether from your own cigarette or someone else’s, is an environmental contaminant that hurts your eyes. However, we need better research into the relationship between tobacco use, quitting, and dry eye disease. Preliminary studies are showing how bad vaping may be for your eyes, too. The nicotine, aldehydes, free radicals, and flavorings in vapes may affect your eye’s surface.
SLEEP PROBLEMS & INSOMNIA
Nicotine is a stimulant. Smoking close to bedtime may interfere with sleep. Research suggests that smokers may be more likely to have problems sleeping than non-smokers. During quitting, sleep problems are commonly reported. It is not known how long it takes after quitting to have better sleep. More research is needed on quitting during menopause and perimenopause.
ACHES AND PAINS
Smoking may sometimes feels like it brings relief from pain, but it’s the addiction’s short-term trick. Smokers are more likely to have pain, report greater intensity of pain, and take longer to recover than non-smokers. Their chronic pain is less likely to heal. Vaping may be the same – promising short-term pain relief, but more likely to have the person in pain more often. Research is needed on menopause-related pain, smoking, vaping, and quitting.
WEIGHT GAIN
People who quit smoking often gain weight, no matter their stage of life. Several large studies of women who quit after in the 10 years after menopause found that new quitters gained more weight after menopause than women who continued to smoke – about 6 pounds more in 3 years, on average. The good news was that weight gain was smaller among quitters who exercised. Walking seemed to be as good as other forms of exercise. More research is needed on weight gain and quitting just before and during menopause.
POTENTIAL RISKS & SIDE EFFECTS
There are many reasons to quit smoking, and no risks from doing so. The side effects – such as intense cravings if you are heavily addicted to tobacco, sadness, anxiety, irritability, fatigue, and brain fog – are temporary.
Note that post-quitting weight gain appears to be controllable through increasing exercise.
QUALITY OF LIFE EXPECTATIONS
Your quality of life should improve in the long run. People who quit nicotine later report that they are much happier than before.
IF I WANT TO TRY THIS TREATMENT WHAT ARE MY NEXT STEPS?
There are great free resources to help you quit. Two of our favorites are:
https://women.smokefree.gov/
https://www.becomeanex.org/
Your insurance may pay for the nicotine patch or for you to see a quitting counselor. Both have been shown to help people quit more successfully.
Smoking is associated with premature and early menopause. Women who smoked more cigarettes per day had greater likelihood of early menopause than women who smoked less. The risk for women who had quit smoking ten years or more prior to menopause was equal to those who never smoked.
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Zhu D, Chung H-F, Pandeya N, Dobson, AJ, Cade JE, Greenwood DC, Crawford SL, Avis NE, Gold EB, Mitchell ES, Woods NF, Anderson D, Brown DE, Sievert LL, Brunner EJ, Kuh D, Hardy R, Hayashi K, Lee JS, Mizunuma H, Giles GG, Bruinsma F, Tillin T, Simonsen MK, Adami HO, Weiderpass E, Canonico M, Ancelin ML, Demakakos P, Mishra GD. 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. Published 2018 Nov 27. doi:10.1371/journal.pmed.1002704. PMID: 30481189
Authors: Dr. Leslie Snyder & Dr. Katherine Newton. Last reviewed April 22, 2021.
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