Does Smoking Affect PCOS & How? All You Need To Know

It is well known that PCOS (Polycystic Ovary Syndrome) is a complex condition that is largely affected by multiple different lifestyle factors. But what about smoking? Can smoking actually make PCOS worse? And how?

That’s what you’ll find out in this evidence-based article discussing the effects of nicotine, cigarettes and vaping on PCOS. I’ll also share some practical tips on how to quit smoking and create new habits so you can improve your overall health and restore hormonal balance.

You can also find more information about how to fully reverse PCOS through lifestyle changes here: ‘How To Treat PCOS Naturally (Science-Based Guidelines)‘’

Is smoking bad for PCOS?

Smoking is considered extremely bad for PCOS as it’s associated with multiple health risks that may negatively impact this condition. According to research, smoking may contribute to hyperandrogenism, insulin resistance, inflammation and hormone imbalances responsible for most PCOS-related symptoms.

How does smoking affect PCOS:

Insulin resistance
Hyperandrogenism
Inflammation
Cardiovascular disease
Infertility

✕ Insulin resistance

According to research, smoking is a major risk factor for developing diabetes, metabolic syndrome and impaired glucose tolerance. That’s because smoking and nicotine have been shown to directly decrease insulin sensitivity and therefore increase the risk of insulin resistance.

If you suffer from PCOS you may already know that insulin resistance (your body’s inability to process insulin effectively) is now considered to be one of the root causes of this condition. I’ve discussed this in more detail in my previous article ‘PCOS Insulin Resistance Explained & How To Reverse It’.

Since hyperinsulinemia (high levels of insulin) can make your ovaries produce androgens (the ‘male’ hormones) in excessive amounts, you can easily end up with erratic hormone fluctuations responsible for the majority of PCOS symptoms.

That’s why keeping your blood sugar and insulin levels in check is one of the key strategies for managing PCOS. Several studies involving women with PCOS have demonstrated that cigarette smoking and nicotine indeed increased blood insulin levels and decreased insulin sensitivity in those individuals.

✕ Hyperandrogenism

Hyperandrogenism (high levels of androgens) is one of the three official Rotterdam criteria to be diagnosed with PCOS (polycystic ovaries and irregular periods are the other two). Having abnormal levels of androgens is also the reason why women with PCOS experience a variety of male-feature symptoms (eg. facial hair, acne, hair loss).

While there are many different factors that can contribute to excessive levels of androgens in the blood, smoking appears to be one of them. Cigarette smoking and nicotine have been shown to increase androgenic activity and testosterone levels in women with PCOS.

According to other studies, smokers are also associated with increased levels of adrenal androgens (androstenedione and DHEAS) and decreased levels of progesterone and estrogen. For this reason, women with PCOS who smoke may experience even greater hormone imbalances and aggravated PCOS symptoms.

✕ Inflammation

Chronic inflammation and increased levels of oxidative stress are recognized as other key drivers of PCOS. According to research, low-grade inflammation can stimulate ovaries to produce excessive levels of androgens and therefore cause hormone imbalances.

Women with PCOS have been shown to have elevated levels of several inflammatory markers such as CRP, IL-18, MCP-1, white blood count and oxidative stress. Unsurprisingly, smoking is also associated with increased levels of those inflammatory markers as it triggers an immunologic response in the body and increases the production of free radicals (ROS).

Cigarette smoking and nicotine are therefore major contributors to chronic inflammation and increased levels of oxidative stress in the body. Additionally, smoking is also associated with an increased risk of inflammatory skin diseases and post-adolescent acne which is one of the most common symptoms of PCOS.

✕ Cardiovascular disease

It is clear that smoking is one of the primary risk factors for developing cardiovascular disease (CVD) as it promotes inflammation, atherosclerosis and clot formation. Smoking is also associated with increased blood pressure and impaired blood cholesterol levels (high LDL the ‘bad’ and low HDL the ‘good’ cholesterol).

Unfortunately, women with PCOS are already at increased risk of CVD due to their hormonal and metabolic dysfunctions. Because most of them suffer from poor blood lipid profiles and high blood pressure, smoking could be a serious danger to their cardiovascular health.

In fact, some studies suggest that women with PCOS are twice as likely to develop cardiovascular complications which is why they’re strongly encouraged to implement effective CVD prevention strategies including smoking cessation.

✕ Infertility

PCOS is currently considered the leading cause of female infertility as a result of hormonal disturbances, irregular periods and anovulation associated with this condition. Women with PCOS are therefore likely to experience difficulties getting pregnant as well as during pregnancy.

According to research, smoking and nicotine are huge risk factors when it comes to both male and female fertility. It’s been shown that women who smoke are twice as likely to experience fertility problems as it has a negative impact on hormone production, reproductive system and the eggs’ DNA.

Smoking can also reduce the IVF success rate and increase the risk of miscarriage. It is therefore crucial for women with PCOS to avoid smoking and other nicotine products completely in order to maximize their chances of falling pregnant and experiencing a healthy pregnancy.

Things to consider:

Secondhand smoke
Nicotine products
Weight management

• Secondhand smoke

If you’re not an active smoker but you’re frequently exposed to secondhand smoke in your environment, you can still experience similar health complications that can negatively affect your PCOS. That’s because secondhand smoke contains a variety of harmful toxins, irritants and carcinogenic substances that can easily enter your body.

Secondhand smoke is also associated with an increased risk of infertility, miscarriage, pregnancy complications and low birth weight. One study has shown that women with PCOS exposed to secondhand smoke had significantly lower conception rates, increased hyperandrogenism and a higher incidence of metabolic syndrome.

Therefore, if you’re trying to reverse PCOS and improve your overall health, it is equally important to live in a smoke-free environment as is to not actively smoke.

Does secondhand smoke affect PCOS?

According to research, secondhand smoke may negatively affect PCOS as it’s associated with similar health risks as active smoking. Secondhand smoke also appears to increase androgen levels, decrease fertility rates and contribute to metabolic syndrome in women with this syndrome.

• Nicotine products

Another thing to consider is that the negative effects of smoking are not strictly related to cigarettes only. There are many other tobacco and nicotine products that can affect your health and PCOS in a similar way (including hookahs, pipes, e-cigarettes)

That’s because nicotine itself appears to be responsible for many of the health consequences of smoking (especially fertility problems) and such products are also typically filled with artificial flavorings and other potentially harmful chemicals.

For this reason, it’s important to reconsider using any type of nicotine or tobacco-containing products if you suffer from an endocrine disorder such as PCOS.

Does nicotine affect PCOS?

The evidence suggests that nicotine can negatively affect PCOS as it may contribute to hyperandrogenism, insulin resistance, fertility problems and inflammation. Women with PCOS are therefore strongly encouraged to avoid any nicotine-containing products in order to improve their symptoms.

Is vaping bad for PCOS?

Vaping and e-cigarettes are generally not considered good for PCOS due to their content of nicotine, flavorings and artificial chemicals associated with negative effects on health and fertility. However, vaping may be beneficial for some women with PCOS when used as a tool for smoking cessation.

• Weight management

While quitting smoking is a crucial step for restoring hormonal balance and reversing PCOS you should bear in mind that it may also cause some temporary withdrawal symptoms. One of the most common side effects of smoking cessation is weight gain and changes in body composition.

That’s because smoking acts as an appetite suppressant and once you stop you may experience increased hunger and food cravings that can lead to overeating and weight gain. Since body weight plays a huge role in the management of PCOS, it is important to implement effective strategies to minimize those risks.

Following a healthy balanced diet is key in this process and you can find my best nutrition tips on how to do it here: ‘The Best PCOS Diet (Ultimate Guide)’.

You can also check out my previous article ‘PCOS Cravings: How To Reduce Appetite & Excessive Hunger’ for more information and practical tips on hunger control.

Will quitting smoking help my PCOS?

Quitting smoking can significantly help improve PCOS due to its effects on hormone regulation, insulin resistance and inflammation. However, there are other important lifestyle factors that also need to be considered in order to restore hormonal balance and fully reverse PCOS.

Pro tips:

Know your triggers – identifying your smoking triggers (eg. alcohol, work stress, parties) is key if you want to make some permanent changes in your behavior as it makes it much easier to implement relevant strategies
Find alternatives – replacing your smoking habit with a healthier alternative (eg. chewing gum, e-cigarettes) is one of the most effective methods you can use as it makes the process of habit change much easier
Track your progress – get tested, make measurements and keep a track of your progress, with enough data you’re more likely to trust the strategy and stay motivated, you can find some useful tools here ‘TOP 5 Smart Devices To Monitor & Manage PCOS‘
Plan ahead – being prepared makes it easier to stick to new habits, make sure you’re also prepared for a failure and that you know how to get back on track
Manage stress – if you smoke for the purpose of relieving stress or boredom, it’s crucial you find or develop new effective stress management strategies that will work for you
Exercise & eat healthy- sticking to a healthy diet and regular exercise not only helps manage PCOS but it also makes it easier to identify yourself as a ‘healthy person’ and motivates you to stop smoking

Read more: ‘What Is The Best Exercise For PCOS & Why?‘

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