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Nicotine and Estrogen - The Interplay

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Nicotine blocks the estrogen hormone in a woman's brain, which is why it is harder to stop smoking, which contains nicotine. Read this article to learn more.

Written by

Dr. Swathi. R

Medically reviewed by

Dr. Sanap Sneha Umrao

Published At May 25, 2023
Reviewed AtJanuary 18, 2024

Introduction

New research shows that nicotine blocks the production of estrogen in the brain of females, creating difficulties while trying to quit cigarette smoking. Studies show that women have a harder time quitting smoking than men. New research indicates that nicotine may block the estrogen hormone production in women's brains, which can explain why it is more difficult to quit smoking. Since more research is needed to understand completely the underlying mechanisms and findings suggesting that nicotine may also impact other aspects of female biology, the gender and sex differences in cessation of smoking have been explored in research studies, with evidence showing women may stop smoking compared to men.

Some findings show that the amount of nicotine present in a single cigarette is sufficient to block estrogen production. According to the researchers, the result could explain several behavioral differences. First, women who smoked were less likely to quit. Second, though estrogen is widespread, receptors in the brain can influence neurotransmission. Nicotine binds to the enzyme responsible for the production of estrogen in the thalamus, the brain region with the highest expression of the enzyme and receptors for nicotine.

How Does the Synthesis of Estrogen Happen in the Brain?

Studies show that those females who were given commercially available nicotine doses intranasally were also given a commercially available radioactive tracer attached to a molecule that binds to the enzyme aromatase, also known as estrogen synthase. It is the enzyme responsible for estrogen production. MRI (magnetic resonance imaging) and PET (positron emission tomography) scans allow the researchers to see how much aromatase is present and where it is found in the brain. As a result, women may resist nicotine replacement therapy and have a greater tendency to relapse when trying to quit smoking. Again, this is because nicotine may influence the brain.

How Does Smoking Affect Estrogen Levels?

These effects are not age-related, and smoking is one of the worst decisions. Around 250 chemicals are present in cigarette smoke, which cause all forms of cancer, not only lung cancer but also diabetes and heart disease, and include a host of other issues in both smokers and those who are exposed to secondhand smoke. There are additional concerns for perimenopausal, premenopausal, and menopausal smokers. The national center of biotechnology information shows that nicotine is known to inhibit aromatase enzyme activity, which catalyzes the conversion of androgens into estrogens. Nicotine reduces estrogen levels and may lead to the early onset of menopause in women. Smoking not only makes one's estrogen levels fall faster than nonsmokers’ menopausal estrogen but also brings about menopause sooner. Decreasing estrogen is the key to many menopausal symptoms. In smokers, it increases the risk of cardiovascular disease. So, it is recommended to combine hormone replacement and smoking. Smoking may cause the following factors such as,

  • Earlier Menopause- Women who smoke can go into menopause earlier than other people. Early menopause is also caused in women when compared to those who do not smoke. The protective benefits of estrogen lead to higher incidences of bone issues, osteoporosis, bone tissues, obesity, diabetes, and Alzheimer's disease post-menopause.

  • More Frequent and Severe Hot Flashes - One's face may turn red, and one may want to rip off one's sweat-drenched clothes. In addition, smoking can make the hot flashes worse and more severe during menopause than in women who do not smoke.

  • Bone Loss and Osteoporosis - Those who smoke are two times more at risk for fractures than nonsmokers. Bone density may decrease in women who smoke and they have a faster chance of getting risk of osteoporosis. Smoking also reduces the blood flow throughout the body, which may also damage the nerves, which may cause their toes and feet to lose feeling with weakened bones.

  • Vaginal Dryness - Estrogen production in females starts decreasing during the menopause and decreases production of lubricating fluid in the vagina. Vaginal dryness may make the activities such as sex and exercise very uncomfortable.

  • Dry Eye Disease - The vagina and eyes need moisture, and when the sex hormones decrease due to menopause and smoking, it can lead to gritty, itchy, painful, stinging, and blurry dry eyes.

  • Secondhand Smoking - Secondhand smoking and the severity of menopause are well-linked. Therefore, if one is a nonsmoker but frequently exposed to smoking, all the above applies to them.

What Are the Effects of Nicotine on the Female Body?

Nicotine's effect on estrogen would also affect other areas of female biology. For example, it is known that nicotine has peripheral effects on the reproductive system in women who smoke and that they may enter menopause significantly earlier. Women may also show a greater risk of developing primary smoking-related illnesses such as heart attacks and lung cancer. The action of nicotine on the hormonal system was involved in any of these reactions.

What Are the Implications of Smoking?

Adding estrogen can help women quit smoking. Nicotine has a strong effect on estrogen production in healthy women. Addiction specialists and the clinical professor said the study might show connections between nicotine and fatigue, energy, and overall wellness. However, nicotine's impact on estrogen production may cause side effects such as increased cardiac diseases and osteoporosis related to estrogen loss and smoking. Therefore, one should screen more for estrogen deficiency and potentially use estrogen replacement. However, this may have additional concerns by causing an increase in deep vein thrombosis when combined with smoking.

What Are the Tips That Help One to Quit Smoking?

Smoking cessation is not easy. There are several methods one can try to help one cut back and quit.

  • Combination of medication and cognitive behavioral therapy.

  • Several medications and patches are also available to help one quit smoking slowly. The most effective medication is Varenicline.

  • Other effective medications are nicotine replacements (pills, gum, spray) and Nortriptyline.

Quitting smoking is based on the individual. Some people may take medications, some may take medications to support them, and others may do better with nicotine replacement therapy such as sprays, gums, patches, or a combination of short and long-acting replacements.

Conclusion

Quitting smoking can be difficult, regardless of gender or biological sex. But some researchers say that women may find it more difficult to quit smoking than men, resulting in several differences between women and men. Effects may be observed in the thalamus, a part of the brain system involved in emotional and behavioral responses. More studies are still needed to better understand the clinical implications of cessation among females. Findings may present a need for specialized medication and care for women trying to quit.

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Dr. Sanap Sneha Umrao
Dr. Sanap Sneha Umrao

Obstetrics and Gynecology

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