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It is known that women who smoke tend to have an earlier menopause than non-smokers and are more likely to experience hot flushes [1]. A recent paper reports a study to test the hypothesis that cigarette smoking is associated with hot flushes through a mechanism involving levels of androgen, progesterone and sex hormone binding globulin (SHBG) or the ratio of androgens to estrogens [2].

Current smokers had significantly higher androstenedione levels, with a mean of 2.20 ng/ml (95% confidence interval (CI) 1.94-2.51 ng/ml) compared to never smokers at 1.93 ng/ml (95% CI 1.83-2.03 ng/ml; p < 0.01), and lower progesterone levels, but there was no difference in levels of serum estradiol, estrone, testosterone, SHBG or dehydroepiandrosterone sulfate between any of the groups. However, there was no correlation between hormone levels and the incidence of hot flushes.

For women who had ever smoked cigarettes, the greater number of pack-years was associated with greater odds of reporting hot flushes. Current smokers of 1–25 pack-years were 6.2 times more likely to experience any hot flushes compared with never smokers.


  • David Sturdee
    Department of Obstetrics & Gynaecology, Heart of England NHS Foundation Trust, Solihull Hospital, Solihull, UK


  1. Gallicchio L, Miller SR, Visvanathan K, et al. Cigarette smoking, estrogen levels and hot flushes in midlife women. Maturitas 2006;53:133-43. Published January 20, 2006.
  2. Cochran CJ, Gallicchio L, Miller SR, Zacur H, Flaws JA. Cigarette smoking, androgen levels, and hot flushes in midlife women. Obstet Gynecol 2008;112:1037-44. Published November 4, 2008.
  3. Freeman EW, Sherif K. Prevalence of hot flushes and night sweats around the world: a systematic review. Climacteric 2007;10:197-214. Published June, 2007.
  4. Sturdee DW. The menopausal hot flush anything new? Maturitas 2008;60:42-9. Published May 20, 2008.
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