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(297) CIGARETTE SMOKING IS ASSOCIATED WITH REDUCED ESTRADIOL LEVELS IN PERIMENOPAUSAL WOMEN.
Vacca, Domenica1, Whiteman, Maura1, Van Ruiten, Lynn1, Miller, Susan2, Flaws, Jodi1, 1 Department of Epidemiology and Preventive Medicine, Baltimore, MD2 Department of Obstetrics and Gynecology, Baltimore, MD
ABSTRACT- During the menopausal transition, between 40-70% of women report experiencing hot flashes. These hot flashes are defined as transient periods of intense heat, most often occurring in the upper body, neck and head followed by flushing of the skin, profuse sweating and sometimes chills. Hot flashes often vary in frequency and severity, and result in disrupted sleep, anxiety, embarrassment, and decreased daily productivity. Although hot flashes significantly impact the quality of life in perimenopausal women, little is known about the factors that predispose women to hot flashes or the factors that alter the frequency and severity of hot flashes. Some studies have shown an association between hot flashes and a decline in serum estradiol levels. In addition, a few studies suggest that the risk of hot flashes increases with cigarette smoking. However, the reasons for this are unknown. Thus, the purpose of this study was to test the hypothesis that cigarette smoking reduces the levels of estradiol in perimenopausal women. To do this, we recruited 50 perimenopausal women (ages 45-54) from the general population of Maryland. Each participant completed a questionnaire and donated a morning blood sample. The questionnaire ascertained demographic information as well as history of hot flashes, cigarette smoking, and reproduction. The blood samples were subjected to an enzyme linked immunoassay for measurement of total serum estradiol levels. Our results indicate that smokers had significantly lower levels of estradiol compared to nonsmokers (smokers = 88.45 ± 8.56 pg/ml, nonsmokers = 134.80 ± 10.37 pg/ml, n = 25 per group, p ≤ 0.001). This difference in estradiol levels remained significant after adjusting for potential confounders such as age and body mass index (p ≤ 0.001). These results support the hypothesis that cigarette smoking reduces the levels of estradiol in perimenopausal women. Since decreasing estradiol levels are associated with an increased risk of hot flashes, it is possible that cigarette smoking increases the risk of hot flashes via reducing estradiol levels. Supported by NIH AG18400.
KEY WORDS: perimenopause, hot flashes, cigarette smoking, women