Cigarette smoking and steroid hormones in women

doi:10.1016/0960-0760(91)90247-3

The Journal of Steroid Biochemistry and Molecular Biology

Volume 39, Issue 4, Part 1, October 1991, Pages 529-534

https://doi.org/10.1016/0960-0760(91)90247-3 Get rights and content

Abstract

Epidemiological evidence has suggested that cigarette smoking has an anti-oestrogenic effect in women, but the effects of smoking on steroid hormone metabolism are not fully understood. We compared serum concentrations of oestradiol, progesterone (luteal phase) and dehydroepiandrosterone sulphate (DHEA-S), and urinary excretion rates of six steroids of predominantly adrenal origin, in healthy premenopausal and postmenopausal female smokers and non-smokers. Serum concentrations of oestradiol, progesterone and DHEA-S did not differ between smokers and non-smokers by >5%, and none of these differences was statistically significant. Mean urinary excretion rates of androsterone, aetiocholanolone, DHEA, 11-keto-aetiocholanolone, 11-hydroxyandrosterone and 11-hydroxyaetiocholanolone were very similar in smokers and non-smokers in premenopausal women, but were from 2–44% higher in smokers than non-smokers in postmenopausal women. The difference was statistically significant only for 11-hydroxyandrosterone. These results confirm previous reports that cigarette smoking does not affect serum oestradiol in premenopausal or postmenopausal women, but provide only weak evidence to support previous findings of increased levels of some adrenal steroids in postmenopausal women smokers. The mechanism for the apparent anti-oestrogenic effect of cigarette smoking remains unclear.

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Cited by (70)

Prospective evaluation of luteal phase length and natural fertility
2017, Fertility and Sterility
Citation Excerpt :
Presuming that some of these women with shorter cycle lengths may also have a shorter luteal phase, that finding is consistent with our results. Smoking has been associated with antiestrogenic effects such as a decrease in endometrial cancer, earlier age of natural menopause, and increased risk for osteoporosis (25, 26). Smoking may be associated with abnormal sex steroid synthesis or metabolism, although studies have not been consistent in establishing the exact relationship between smoking and sex steroid hormones (25–30).
To evaluate the impact of a short luteal phase on fecundity.
Prospective time-to-pregnancy cohort study.
Not applicable.
Women trying to conceive, ages 30–44 years, without known infertility.
Daily diaries, ovulation prediction testing, standardized pregnancy testing.
Subsequent cycle fecundity.
Included in the analysis were 1,635 cycles from 284 women. A short luteal phase (≤11 days including the day of ovulation) occurred in 18% of observed cycles. Mean luteal phase length was 14 days. Significantly more women with a short luteal phase were smokers. After adjustment for age, women with a short luteal phase had 0.82 times the odds of pregnancy in the subsequent cycle immediately following the short luteal phase compared with women without a short luteal phase. Women with a short luteal length in the first observed cycle had significantly lower fertility after the first 6 months of pregnancy attempt, but at 12 months there was no significant difference in cumulative probability of pregnancy.
Although an isolated cycle with a short luteal phase may negatively affect short-term fertility, incidence of infertility at 12 months was not significantly higher among these women.
NCT01028365.
The effects of smoking on steroid metabolism and fetal programming
2014, Journal of Steroid Biochemistry and Molecular Biology
Citation Excerpt :
Key also doubts the anti-estrogen effect of smoking. In his study, serum concentrations of estradiol, progesterone and dehydroepiandrosterone (DHEAS) did not differ in pre- or post-menopausal smokers compared to non-smokers by more than 5%, and none of the differences were statistically significant [33]. In our study, we only found lower levels of estradiol in the luteal phase [34].
Tobacco addiction is a serious psychosocial and health problem. A pregnant woman who smokes not only influences the maternal organism, but also passes health risks on to the unborn child. A fetus exposed to maternal smoking is not only directly influenced, but is also endangered by a wide range of diseases up to his or her adult years. The components of tobacco smoke play a significant role in the development of a number of diseases for a large proportion of the smoking population, as well as among those pregnant.
This article summarizes findings regarding the impacts on the production of steroid hormones – first describing the smoking-related changes in steroidogenesis in women, and then focusing on the influence of maternal smoking on the fetus's developing steroidogenesis. We assume that if during prenatal development the fetus has already been exposed to the effect of endocrine disruptors at the time fetal steroidogenesis begins fetal programming, this exposure can have serious pathophysiological effects both in the pregnancy as well as later in life. An example of such effects might be a delay in the creation of kidney adrenal androgens, which could also be evident on the level of steroid neuroactive metabolites that may influence the individual's psychological state and lead to later addictions.
Effects of cigarette smoking on female reproduction: From oocyte to embryo (Part I)
2011, Gynecologie Obstetrique et Fertilite
Le tabagisme est associé à une diminution de la fertilité, un allongement du délai de conception et à des risques d’échec en Fécondation In Vitro (FIV). Depuis quelques années, la prévalence du tabagisme chez les femmes en âge de procréer n’a cessé d’augmenter. L’objectif de ce travail était de mener une revue de la littérature des effets du tabagisme sur la reproduction, la fertilité et sur les différentes étapes de la reproduction depuis l’ovocyte jusqu’à l’embryon. À l’aide d’études cliniques, les conséquences du tabagisme ont été analysées durant chaque étape des fonctions reproductives : de la folliculogenèse, la stéroïdogenèse, le transport de l’ovocyte et de l’embryon au sein de la trompe de Fallope jusqu’au développement embryonnaire précoce. Au travers des études expérimentales, nous avons tenté de formuler des hypothèses sur les mécanismes impliqués dans la toxicité du tabac. L’analyse des études publiées confirme que le tabagisme diminue la réserve ovarienne, interfère avec la synthèse d’hormones stéroïdiennes, favorise l’implantation ectopique et altère le développement embryonnaire précoce, ce qui se traduit par une augmentation du risque d’infertilité. Les métabolites du tabac sont présents au sein des différents organes de l’appareil génital et engendrent une toxicité locale, responsable des anomalies visualisées.
Cigarette smoking is associated with lower fecundity rate, adverse reproductive outcomes and higher risk of IVF failure. Over the last decades, prevalence of smoking among women of reproductive age has increased. The aim of this work was to focus on the knowledge of the effects of cigarette smoking on all reproductive stages, from oocyte to embryo. For each reproductive functions human clinical and experimental studies were analysed in order to find hypothesis and explanations for effects observed. All reproductive functions are targets of smoke compounds and cigarette smoking impairs ovarian reserve, sexual steroids synthesis, Fallopian tubes functions and embryo development, leading to reduced fecundity. Some of smoke compounds were identified in ovarian tissue, in uterine fluid and in the embryo, suggesting direct toxicity.
Smoking and gynecological cancer. Causality and outcomes
2008, Progresos en Obstetricia y Ginecologia
Hace más de 40 años que se viene advirtiendo acerca de las consecuencias del tabaquismo en la salud de la población, pero fue en el año 2002 cuando se publicó una revisión sobre el problema y las consecuencias para la salud de la mujer. Sin embargo, existe controversia en cuanto a la relación que tiene el tabaquismo con los tumores ginecológicos más frecuentes, por lo que se realizó esta revisión.
El tabaquismo, a pesar de su efecto antiestrogénico, no disminuye el riesgo de presentar cáncer de mama. Hay controversia sobre si aumenta, de forma genérica, el riesgo en las fumadoras. Sí se ha establecido la existencia de una mayor mortalidad por cáncer de mama en las mujeres fumadoras.
No se ha podido establecer una asociación con el cáncer de ovario de forma global; sin embargo, sí parece haber una asociación entre el tabaquismo y los tumores de estirpe epitelial de tipo mucinoso. Existe suficiente evidencia epidemiológica para relacionar el consumo de tabaco como un factor de riesgo independiente para el desarrollo de cáncer de cérvix.
El tabaquismo parece tener un efecto protector frente al cáncer de endometrio.
For more than 40 years, people have been warned about the consequences of smoking to health but it was not until 2002 that a review on the issue and its consequences to women’s health was published. However, the connection between smoking and the most common gynaecological tumors is still not clear, which is why this review was carried out.
Despite the antiestrogenic effect of smoking, it does not reduce the risk of female breast cancer. However, it cannot be stated that it always increases the risk for breast cancer. What has been noticed is a higher mortality rate due to breast cancer among smoking women.
A general association could not be established with ovarian cancer; however, there appears to be a connection between smoking and epithelial mucinous tumours.
There is enough epidemiological evidence to identify smoking as an independent risk factor for the development of cervical cancer.
Smoking appears to have a protective effect against endometrial cancer.
Influences on circulating oestrogens in postmenopausal women: Relationship with breast cancer
2007, Journal of Steroid Biochemistry and Molecular Biology
Sex hormones are intrinsically linked to the development and treatment of the majority of breast cancers. High oestradiol levels are associated with elevated breast cancer risk in the postmenopausal setting and are given increasing importance in determining chemoprevention target groups. This review aims to evaluate the impact of various lifestyle factors including body mass index, diet, smoking, and alcohol on normal physiological sex hormone profiles. The role of genetic polymorphisms is also discussed, and all are placed within the context of designing future epidemiological studies and breast cancer risk algorithms.
The relationship between factors affecting endogenous oestradiol levels in postmenopausal women and breast cancer
2006, Journal of Steroid Biochemistry and Molecular Biology
Breast cancer accounts for 1 in 4 of all female cancers worldwide; approaching 13,000 women dying per year in the UK alone. Seventy five per cent of all diagnosed breast cancers are oestrogen receptor (ER) positive. Ovarian synthesis of oestrogens ceases at menopause and as breast cancer is more prevalent in postmenopausal women the non-ovarian sources of oestrogen are important in disease progression. There is now considerable evidence that associates increased breast cancer risk with prolonged exposure to oestrogens hence greater attention is now being given to determining whether the measurement of plasma oestrogen may assist in identifying chemoprevention target groups. Studies suggest that in most postmenopausal patients the intra-tumoural concentrations of oestrogens are up to 20-fold higher than those present in the plasma however, while the extent of biosynthesis of oestrogens within breast tissue is a major determinant of local exposure, plasma levels are a useful indicator of overall metabolism in peripheral tissues. As such it is important to understand factors that influence these measurements. This review summarises the impact of lifestyle such as body mass index, together with the role of genetic polymorphisms placed within the context of designing future epidemiological studies and breast cancer risk algorithms.

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Cigarette smoking and steroid hormones in women

Abstract

Maturitas

Am. J. Obstet. Gynec.

Eur. J. Cancer Clin. Oncol.

Am. J. Obstet. Gynec.

Steroids

Fert. Steril.

Eur. J. Cancer

Contraception

J. Steroid Biochem.

Smoking and estrogen-related disease

Am. J. Epidem.

Cigarette smoking and the risk of endometrial cancer

New Engl. J. Med.

Cigarette smoking in women with cancers of the breast and reproductive organs

J. Natn. Cancer Inst.