St. Louis Women's Healthcare Group - Obstetric, Gynecology and Infertility
Smoking and Your Reproductive Health

Most people are aware that smoking cigarettes is bad for your health. Smoking causes heart attacks, other heart disease and lung problems, including lung cancer. In fact, among women, lung cancer deaths now surpass breast cancer deaths each year.

Not everyone realizes, however, that smoking is also harmful to a women's reproductive health. For example, smoking is associated with cervical cancer. Among women over age 35 years who are trying to prevent pregnancy, smoking can cause higher risks of side effects with oral contraceptives (the birth control pill). For women trying to get pregnant, cigarette smoking can cause a delay in how long it takes to become pregnant. And, once a woman gets pregnant, smoking can harm the woman and her fetus.

Cancer of the Cervix

The cervix is the opening of the uterus (womb) into the vagina. Women who smoke are more likely to develop cervical cancer than those who don't. The reason for this relationship is not known; however, some studies have found a chemical byproduct of nicotine (the addictive drug in cigarettes) in the secretions of the cervix. The poisons in cigarette smoke may also get to the cervix through the bloodstream.

Increased Side Effects with the Birth Control Pill

Unfortunately, many women mistakenly believe that taking birth control pills is dangerous. The truth is that smoking cigarettes is much more dangerous to your health.

Most birth control pills used by women today have two hormones: estrogen and progestin. These birth control pills are highly safe and effective. They are 99% effective in preventing pregnancy when used correctly and consistently.

Pills with these two hormones also give women many health benefits. The pill helps to prevent cancer of the ovary and lining of the uterus. It also helps women have regular menstrual periods and reduces painful cramps. In addition, the birth control pill can help prevent iron deficiency anemia and help to reduce the chances of getting benign breast lumps.

Women who take the birth control pill may get a side effect called breakthrough bleeding. Breakthrough bleeding consists of spotting or bleeding in between periods. This side effect is not harmful, but can be inconvenient. It usually disappears within 3 months of starting the pill. Women who smoke cigarettes are more likely to experience this side effect than women who don't smoke.

Unfortunately, women who smoke cigarettes and are over age 35 years should not use pills with these two hormones. Older women who smoke and use these pills have an increased risk of heart attack and stroke. Progestin-only pills can be used by older women who smoke, but these pills don't have all the health benefits of the others. So, if you smoke and you want to use the pill, you should stop smoking.

Delay in Getting Pregnant

Women who smoke cigarettes can take longer to get pregnant than women who don't smoke. Studies have found that women who smoke 16 to 20 cigarettes per day are 20% less likely to have given birth in the first year of trying. In the second and third years of trying, about twice as many women who smoke have not given birth compared to women who don't smoke. So, if you're trying to get pregnant, stopping smoking can help your chances.

Pregnancy Outside the Uterus

Ectopic (tubal) pregnancy happens when an egg is fertilized and becomes implanted outside the uterus. Women who smoke cigarettes have a 2 to 4 times greater risk of having this type of pregnancy. This finding has been shown by studies all over the world. The risk also gets higher the more cigarettes you smoke and the longer you've smoked. An ectopic pregnancy can be life-threatening and requires medical treatment or an operation.

Harm to Your Unborn Baby and Infant

Pregnant women who smoke can harm their fetus by putting poisonous chemicals into the blood. A pregnant woman who smokes is more likely to have a spontaneous abortion or stillbirth.

Smoking can hurt the baby after birth as well. The smoke that comes off the cigarette (environmental smoke) also carries chemicals that affect the health of infants, young children and adults. Children of smokers are more likely to suffer from respiratory infections, bronchitis, pneumonia and ear infections.

Low Birth Weight

Babies born to mothers who smoke weigh less than those born to women who don't smoke. Babies weigh less the more the mother smokes. Low birth weight is also associated with an increased risk of problems after birth.

In addition, smoking women have an increased risk of delivering the baby before the full term of pregnancy. Unfortunately, babies of smoking mothers also have about a 25% increased risk of death just after birth.

Sudden Infant Death Syndrome

Babies born to women who smoke cigarettes also have about 3 times the risk of having sudden infant death syndrome (SIDS). With SIDS, the baby dies suddenly and unexpectedly without being sick. Why this occurs is not known, but it may have something to do with an effect of smoking on the baby's breathing.

SUMMARY
Women who smoke need to stop - for their own health and for the health of their babies. Protect yourself and your developing baby - stop smoking. Ask you clinician to help you. Self-help programs and medications can help you quit. Speak to your clinician about the choices available to you.

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