Cigarette Smoking Linked to Hot Flashes
Antoaneta Sawyer, PhD
A recent study executed by Laurie Barclay on “Cigarette smoking is associated with hot flashes, higher androstenedione levels, a higher total androgen-to-total estrogen ratio, and lower progesterone levels in women who are not postmenopausal, according to the results of a cross-sectional study” was reported in the November 17, 2008 issue of Obstetrics & Gynecology, 112, 1037-44. "Despite the decades of research that have been performed, few risk factors for hot flushes [flashes] have been identified," write Chrissy J. Cochran, PhD, from Johns Hopkins School of Public Health in Baltimore, Maryland, and colleagues. "One of the most common risk factors studied in association with hot flushes is cigarette smoking."
The cross-sectional study sample consisted of 362 women with hot flashes and 266 without hot flashes, who were not postmenopausal, ages 45 to 54 years. Participants were evaluated with a self-reported questionnaire and a blood sample for hormone measurements. Compared with never-smokers, current smokers had significantly higher androstenedione levels, higher androgen-to-estrogen ratio, and lower progesterone levels. The odds of experiencing hot flashes were greater in former and current cigarette smokers vs. never-smokers (former smokers: odds ratio [OR], 1.41; 95% confidence interval [CI], 0.99 - 2.01; current smokers: OR, 2.43; 95% CI, 1.28 - 4.62). Adding hormones to the smoking and hot-flash model did not attenuate this association. Limitations of this study include smoking obtained by self-report; cross-sectional design, precluding determination of the temporality of the association between smoking and hot flashes; and collection of only 1 blood sample per participant in the study.
The conclusion of the above study is: "Cigarette smoking is associated with hot flushes through a mechanism that may not involve alterations in hormone levels or their ratios, rather, the effect is probably a more direct stimulatory action of nicotine on the nicotinic receptors in the hypothalamus."
