Harmful Effects Of Smoking On Fertility And Reproductive Health

According to the statistics presented by the World Health Organization, the rate of primary reproductive infertility in Indian women stands at 11.8%. In hindsight, the number might not seem like a lot, but given the 1.48 billion population in the country, it accounts for a lot.

Besides lifestyle factors, health complications, drinking alcohol, obesity, etc., smoking is also a major factor contributing to the ever-growing fertility rate and reproductive concerns among women in India.

This article will explore everything you need to know about the effects of smoking on fertility and reproductive health in women.

Is Smoking Before Pregnancy Unsafe?

Smoking, at any point in life, is considered unsafe. Studies have found that excessive maternal smoking increases the risks of congenital birth defects in the child.

Conditions like cleft lip, cleft palate, hypospadias, etc., are common issues that are often heightened in children born to mothers who smoked cigarettes heavily before getting pregnant.

What’s even more fascinating to understand is that the impacts of smoking are lingering. This means that even if a woman quits smoking to get pregnant eventually, the impacts from the history of smoking can prevail through a few trimesters of the pregnancy.

Hence, smoking cessation must happen months before a woman tries to conceive a child to reduce any potential post-birth complications in the baby.

What are the Harmful Effects of Smoking on Fertility?

When discussing fertility concerns, congenital birth defects, etc., in children, there is a misconception that only maternal smoking habits are harmful. Instead, both the intended mother and father need to stop smoking to be able to conceive a healthy baby.

There are several research conducted that showcase the long-term effects of smoking on the fertility and reproductive health of both men and women.

Following are some of the harmful effects of smoking pertaining to fertility concerns:

1. Damage Ovarian Reserve and Quality

We are aware of the fact that men produce sperm pretty much throughout their entire life. However, the same isn’t the case with women.

The female reproductive anatomy is such that every woman is born with limited numbers of oocytes, which keeps them fertile throughout their reproductive period. Smoking adversely affects these oocytes, leading to irreversible damage and quality destruction over time.

Studies have found that the chemicals commonly found in cigarettes, including nicotine, carbon monoxide, and cyanide, lead to the death of the oocytes inside the ovaries. Since the chemicals cause irreparable damage, it eventually depletes the ovarian reserve, leading to fertility concerns.

2. Enhanced Risks of Cancer

The correlation between smoking and its cancer-causing risks doesn’t require an introduction. However, you need to understand that studies showcase that excessive smoking might enhance the risks of causing cervical cancer in women.

While human papillomavirus (HPV) infection is the primary cause of cervical cancer, smoking can increase the risk of developing this type of cancer. It can also worsen the outcomes for those who already have the disease.

According to research, the chemicals in cigarettes and tobacco smoke lead to DNA damage in the cervical cells, leading to genetic mutations and elevated risks of cervical cancer. Furthermore, smoking also alters the immunity of an individual, making it difficult for their body to fight off the HPV infection (the primary trigger behind cervical cancer).

3. Alterations in the Fallopian Tubes

One of the leading causes of infertility and reproductive health issues in women is caused by the onset of Pelvic Inflammatory Disease (PID). Studies indicate a connection between smoking and the onset of PID.

The research indicates that the risk of PID, a type of severe infection in the fallopian tubes, is 2x in women who smoke compared to the ones that don’t.

This is again due to the altered immunity and the presence of white blood cells in the cervical lining of the individual. The lesser the number of white blood cells, the elevated the risks of developing an infection in the fallopian tubes, leading to risks of infertility and associated complications.

4. Increased Chances of Contracting HPV

We discussed how smoking in women elevates the risks of cervical cancer. However, many don’t realize that smoking also makes a woman vulnerable to contracting the Human papillomavirus.

Let’s understand why.

Smoking impairs the standard functions of the immune system; weakening it in the process. When one has a compromised immune system, it becomes more susceptible to contracting infections, including HPV.

Not only does it elevate the risks of cervical cancer, but it can also cause issues like precancerous lesions, genital warts, etc.

5. Increased Risks of Miscarriage

Smoking’s impacts can relay even after a woman gets pregnant. For example, studies showcase that the harmful substances in tobacco smoke can damage the DNA in eggs, leading to genetic abnormalities and failed pregnancies.

This is one of the reasons why women who smoke quite frequently are advised to quit smoking for at least six months before trying to conceive a baby.

At Queen’s Gynecology, we often encounter patients that are heavy smokers and want advice on how to quit so they can expand their family. Since the smoking side effects linger even after one has quit, we often advise our patients to quit it for at least a few months, undergoing thorough testing before trying to conceive a baby.

6. Higher Rate of Ectopic Pregnancy

An ectopic pregnancy occurs when the fertilized eggs implant themselves outside the uterus. Around 90% of such pregnancies aren’t viable and lead to miscarriage or might need an abortion to ensure the mother’s good health.

If not handled adequately and on time, ectopic pregnancy can lead to rupture of the fallopian tubes, followed by internal bleeding.

Smoking increases the risk of ectopic pregnancies due to its impact on the fallopian tubes. The toxic chemicals in cigarette smoke can impair the function of the cilia that line the tubes, hindering the movement of the fertilized egg toward the uterus.

This, in turn, forces the fertilized eggs to implant themselves outside the uterus, leading to an ectopic pregnancy.

7. Impacts on the Estrogen Levels

We have heard that even woman has testosterone reserve in their body. While that is true, it is also a fact that the aromatase enzyme is responsible for turning testosterone into estrogen in the bloodstream.

The nicotine in tobacco inhibits the standard function of the aromatase enzyme, leading to a decreased estrogen level in the bloodstream.

Reduced estrogen levels in women contribute to elevated risks of infertility concerns, ovulation issues, and other influences on reproductive health.

8. Enhanced risks of Endometrial Hyperplasia

Endometrial hyperplasia is a condition that contributes to the abnormal thickening of the uterus. What this does is lead to heavy bleeding during menstruation.

Studies have found that women who smoke have heightened risks of developing endometrial hyperplasia. The treatment related to this condition often leads to future conception issues.

9. Affects Implantation

We discussed how smoking leads to risks of ectopic pregnancy and miscarriages. More studies indicate that women who smoke have an elevated issue concerning the correct fertilized egg implantation.

One of the biggest tobacco side effects is inhibiting myometrial relaxation, a key regulator in the implantation process. The lack of this regulation contributes to elevated risks of implantation failure in the individual.

10. Delayed Menopause

Smoking has been associated with delayed onset of menopause in women. While this may initially appear beneficial, it prolongs the reproductive period during which individuals are exposed to the risks associated with smoking.

This delay further exacerbates the adverse effects on fertility and reproductive health, increasing the overall reproductive risks associated with smoking.

11. Altered Male Infertility

Not just in women, the tobacco effects are equally bad for men’s reproductive health. Smoking can decrease sperm count, reduce sperm motility (the ability of sperm to move effectively), and increase the number of abnormal sperm. These factors decrease the likelihood of successful fertilization and increase the risk of infertility.

Furthermore, the toxic chemicals present in tobacco are also correlated with the onset of erectile dysfunction. It often causes damage to the blood vessels, leading to impaired blood flow to the penis.


The harmful effects of smoking on fertility and reproductive health are evident in both men and women. Quitting smoking is essential to mitigate these risks and improve overall fertility outcomes. Seeking professional assistance and support for smoking cessation is highly recommended, as it can lead to better reproductive health and increased chances of successful conception and pregnancy.

If you are struggling with fertility-related concerns caused by smoking, our team of specialists at Queen’s Gynecology is here to help you navigate those problems. Our holistic diagnosis and tailored treatment approach prioritize treating the root cause of the issue for potent results in the long run.


How does smoking affect male and female fertility?

Men who smoke often enhance the risks of abnormal sperm anatomy and motility. At the same time, maternal smoking leads to issues with the cervix, fallopian tubes, and even uterine complications, which enhance the risks of infertility, miscarriages, etc.

Does smoking affect the normality of periods?

Smoking can alter a woman’s menstrual cycle, shortening the length of the period. Furthermore, smoking also leads to the onset of endometrial hyperplasia, which contributes to heavy bleeding during the period.

Is it safe to smoke once a week?

Regardless of the frequency or number of cigarettes, smoking is terrible for one’s health. So, when it comes to justifying “smoking once a week,” there is none. Even one cigarette can potentially alter one’s fertility and overall well-being.

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