Women who were active smokers, or had high exposure to secondhand smoke, had a greater risk of infertility and a higher likelihood of experiencing natural menopause before age 50, according to Medpage Today.

Women who had been active smokers at any time in their lives had overall odds ratios of 1.14 (95% CI 1.03-1.26) for fertility and earlier menopause (OR 1.26, 95% CI 1.16-1.35) compared with women who had never smoked, according to Andrew Hyland, PhD, at the University of Buffalo, NY, and colleagues.

The smoking group reached menopause about 22 months earlier than the mean of 49.4 years for women who’d never smoked and hadn’t been exposed to secondhand smoke, they wrote in Tobacco Control.

Women who had never smoked, but had been exposed to high levels of secondhand smoke, were more likely to be infertile (adjusted OR 1.18, 95% CI 1.02-1.35) and reach earlier menopause (OR 1.18, 95% CI 1.06-1.31) compared with never-smokers with low levels of exposure to secondhand smoke. In addition, high secondhand smoke exposure was associated with reaching menopause 13 months earlier.

“[This] is one of the first studies of this size and statistical power to investigate and quantify active and passive smoking and women’s health issues,” the authors stated. “It strengthens the current evidence that all women need to be protected from active and passive tobacco smoke.”

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