Cigarette against a blue background that can affect women's hormones

Does Smoking Affect Women's Hormones?

Written on December 22, 2023 by Gillian (Gigi) Singer, MPH. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

The delicate and complex hormonal systems within a woman’s body (and those of someone assigned female at birth) can be influenced by external factors like certain health behaviors — such as smoking. Smoking harms nearly all bodily systems, and the endocrine system is not immune.

Smokers face a higher likelihood of experiencing specific health concerns and developing various diseases compared to non-smokers. While some health issues manifest immediately, others evolve gradually over time. The following are detrimental health effects of smoking that hold particular sign.[1]

The Dangers Of Smoking

Cigarette smoking is responsible for killing over 200,000 women annually in the United States – in fact, women bear a significantly greater portion of smoking-related diseases and fatalities.[2]

Women smokers are at an increased risk for cancers of the mouth, pharynx, larynx, esophagus, pancreas, kidney, bladder, and cervix. Additionally, between 1959 and 2010, the likelihood of women developing lung cancer surged tenfold. [3]

These risks are well-known — but the effects on reproductive health are lesser known.

Asked And Answered: Does Smoking Affect Women's Hormones?

Decisively: yes.

Women who are smokers are more likely to have low estrogen levels than women who are not smokers, which can lead to mood swings, fatigue, and vaginal dryness.[1]

Research shows that among postmenopausal women, the number of cigarettes consumed daily was associated with increased levels of testosterone, free testosterone, 17-hydroxprogesterone, androstenedione, sex hormone-binding globulin, and estradiol.[4]

Another study suggests that for premenopausal women, smoking, especially at moderate to heavy levels, may influence hormonal levels in women, potentially affecting menstrual cycle length and the levels of key hormones like estrogen and progesterone.[5]

In summary, smoking can cause:

  • Low estrogen levels
  • Increased testosterone, free testosterone, 17-hydroxprogesterone, androstenedione, sex hormone-binding globulin, and estradiol

How might these hormones affect a woman’s health? Keep reading to find out.

Effects Of Hormonal Changes On A Woman’s Health

The human body is a delicate balance of hormones. Thus, changes in the hormonal ecosystem can have notable impacts on the body, its function, and its appearance.

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Changes vary depending on the hormone that is being affected.


Smoking can lead to low estrogen levels. According to the Cleveland Clinic, low estrogen levels can lead to the following [6]:

  • Dry skin
  • Tender breasts
  • Weak or brittle bones
  • Difficulty concentrating
  • Moodiness or irritability
  • Vaginal dryness (atrophy)
  • Hot flashes or night sweats
  • Irregular periods and/or no periods
  • Weight gain, especially in the stomach
  • Headaches before or during your period
  • Decreased sex drive
  • Painful intercourse (dyspareunia)
  • Fatigue
  • Insomnia


Smoking is pro-androgenic and increases testosterone levels: High testosterone levels can cause side effects such as hirsutism, skin blemishes, irregular menstrual cycles, and a reduced sex drive. [7]

Gonadotropin Hormones

Gonadotropin hormones include follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — both of which regulate and contribute to ovulation and the menstrual cycle. This may cause irregular periods and impact fertility.[7]

For those who are trying to become pregnant, smoking can decrease the odds of conceiving.[8]

Anti-Müllerian Hormone

Research has demonstrated that smokers’ anti-Müllerian hormone (AMH) levels are 44% lower than non-smokers, indicating that smoking is toxic to eggs that are in the ovaries.[9]

Thyroid Hormones

Studies show that smoking might alter results in thyroid function tests, like lowering TSH and increasing thyroid hormones.[10]


Research has demonstrated that smoking five or more cigarettes drastically lowers prolactin at the end of pregnancy.[11] Prolactin affects lactation.


In a study of both men and women, smokers exhibited notably higher cortisol levels even after accounting for age, gender, and job title.[12]

Effect of Smoking On Pregnancy

Nicotine and smoking can harm a fetus or baby. Risks of smoking during pregnancy include [1]:

  • Increased risk of premature birth and birth defects
  • Decreased likelihood of healthy birth weight
  • Negative impact on brain development into childhood
  • Increased risk of sudden infant death syndrome (SIDS)

Testing Your Hormone Levels With Everlywell

When it comes to chlamydia testing with Everlywell, you have options! You can use either Everlywell’s At-Home Women's Hormone Level Test or At-Home Men's Health Test.

How It Works

  1. Order your Everlywell at-home testing kit here. Once your test kit arrives, you register it at using the unique ID number included in your box.
  2. You collect your sample in the comfort of your home and mail it to a certified lab with prepaid shipping.
  3. Mail in your sample per the instructions.
  4. Within days, you'll receive physician-reviewed digital results and useful insights on our secure platform.

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  1. Smoking’s impact on women’s health. Smokefree Women. Accessed December 18, 2023.
  2. The Health Consequences of Smoking—50 Years of Progress. A Report of A Report of the Surgeon General. Published online 2014. doi:10.1037/e510072014-001
  3. Women and tobacco use. American Lung Association. Accessed December 18, 2023.
  4. Brand JS, Chan M-F, Dowsett M, et al. Cigarette smoking and endogenous sex hormones in postmenopausal women. The Journal of Clinical Endocrinology & Metabolism. 2011;96(10):3184-3192. doi:10.1210/jc.2011-1165
  5. Windham GC, Mitchell P, Anderson M, Lasley BL. Cigarette smoking and effects on hormone function in premenopausal women. Environ Health Perspect. 2005;113(10):1285-1290. doi:10.1289/ehp.7899
  6. Low estrogen: Causes, symptoms, diagnosis & treatment. Cleveland Clinic. Published February 8, 2022. Accessed December 18, 2023. URL.
  7. Relton R. Does smoking affect testosterone and other hormones? Hertility Health. Published November 24, 2023. Accessed December 18, 2023.
  8. Jandíková H, Dušková M, Stárka L. The influence of smoking and cessation on the human reproductive hormonal balance. Physiol Res. 2017;66(Suppl 3):S323-S331. doi:10.33549/physiolres.933724
  9. Plante BJ, Cooper GS, Baird DD, Steiner AZ. The impact of smoking on antimüllerian hormone levels in women aged 38 to 50 years. Menopause. 2010;17(3):571-576. doi:10.1097/gme.0b013e3181c7deba.
  10. Sawicka-Gutaj N, Gutaj P, Sowiński J, et al. Influence of cigarette smoking on thyroid gland--an update. Endokrynol Pol. 2014;65(1):54-62. doi:10.5603/EP.2014.0008 URL.
  11. Salazar G, Albala C, Yáñez M, Serón-Ferré M, Vio F. Smoking effects on prolactin at the end of pregnancy. Nutrition Research. 1995;15(11):1599-1604. doi:10.1016/0271-5317(95)02030-6.
  12. Steptoe A, Ussher M. Smoking, cortisol and nicotine. Int J Psychophysiol. 2006;59(3):228-235. doi:10.1016/j.ijpsycho.2005.10.011.
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