Smoking and the menopause: why complaints get worse (and what helps)

Important: Quitting smoking is the most important health step at any age. Help is available through your doctor and Thuisarts.nl — quit smoking. This article does not replace a treatment plan.

Why smoking worsens menopausal symptoms

Tobacco smoke contains thousands of substances that burden blood vessels, lungs and hormone balance. During menopause, estrogen naturally decreases — smoking speeds up that process, according to several epidemiological studies. The result: more hot flashes, drier skin, poorer sleep and higher risk of bone loss.

The Health Council and RIVM classify smoking as the largest preventable cause of illness and premature death in the Netherlands. The risk increases around menopause: cardiovascular disease, COPD and rising blood pressure are more common in smoking women after 45.

Concrete effects on menopausal complaints

Hot flashes and night sweats

Nicotine and other smoking substances stimulate the nervous system and dilate blood vessels — similar to what happens during a hot flash. Smokers report more frequent and severe hot flashes than non-smokers in the same age group. Stopping can lead to a reduction within a few weeks.

Bone density and osteoporosis

Estrogen protects bones; smoking disrupts this protection and reduces calcium absorption. Combine this with increased risk of osteoporosis after menopause and the picture is clear: smoking makes bone fractures more likely.

Skin and mucous membranes

Smoking accelerates skin aging and increases dryness — just like declining estrogen. Also read: weak skin barrier during menopause.

Sleep and energy

Nicotine seems relaxing, but disrupts sleep cycles and increases nighttime awakenings. This significantly increases fatigue during menopause.

Smoking, alcohol and weight: the triangle in menopause

Many smokers also drink more alcohol — both of which put a strain on the liver, sleep and blood pressure. After quitting smoking, some women experience weight gain due to altered metabolism and snacking; that can reinforce menopausal symptoms. A plan that includes exercise, protein-rich meals and realistic expectations works better than strict dieting.

How to stop - practical step-by-step plan

1. Determine your start date

Choose a specific day within two weeks. Tell those around you — support significantly increases the chance of success.

2. Use professional help

Your doctor can prescribe nicotine replacement (patch, lozenges) or medication. In the Netherlands, smoking cessation programs are often reimbursed. See Thuisarts.nl.

3. Replace the ritual

The first coffee, the break moment — these are triggers. Replace them with a walk, herbal tea or breathing exercise. Avoid extra caffeine if it makes you shaky.

4. Restore nutrients

Smokers often have lower vitamin C and B12 status. Have your blood values ​​checked and eat lots of vegetables, legumes and oily fish. Vitamin D is also important for bones and immune function.

5. Four intermediate steps

Cutting less is better than continuing to smoke. Every unsmoked cigarette counts. In case of relapse: analyze the trigger and start again — without feeling guilty.

Long-term health benefits after quitting

Stopping smoking is beneficial at any age — including menopause. Within 20 minutes, heart rate and blood pressure drop; circulation and lung function improve within weeks. In the long term, the risk of heart attack, stroke and lung cancer will decrease significantly, according to RIVM.

For women around the menopause, the combination of quitting plus exercise is extra valuable: muscle retention, better bone density and fewer blood pressure problems. Work with your doctor on a plan that suits your symptoms — hot flashes, weight and mood can all improve when smoking is removed from the picture.

Many women notice that after quitting they have more energy for walking and strength training. Support recovery with protein-rich meals, hydration and a consistent supplement pattern. Xodil morning and evening packs are designed as a daily system without nicotine or caffeine — useful if you're looking for structure after breaking your smoking habit.

Smoking and hormonal therapy: discuss risks

If you are considering hormone therapy for hot flashes, smoking is an important topic of discussion. Smoking increases the risk of thrombosis and cardiovascular complications; combined with systemic estrogen, that risk may increase further. Quitting smoking lowers that threshold and makes treatment safer in the long term.

Your doctor can combine nicotine replacement with coaching — often reimbursed from a prevention fund or on a basic basis. Make a plan before the menopause intake so that your doctor has a complete picture of your lifestyle and risk profile.

Sources

• Thuisarts.nl — quit smoking
• RIVM — smoking and health
• NHG — Menopause
• Xodil — science

Frequently asked questions

Does smoking worsen hot flashes during menopause?

Yes. Research and clinical experience show that women who smoke have more frequent and heavier hot flashes. Stopping reduces that tax.

Is it too late to quit after 50?

No. The body partially recovers at any age. Blood pressure and circulation improve within weeks; in the long term, the risk of cardiovascular disease decreases.

Can I combine smoking and hormone therapy?

Smoking increases the risk of thrombosis and cardiovascular problems — also with hormone therapy. Always discuss this with your doctor. Read: transitional treatment and reimbursement.

How do I prevent weight gain after quitting?

Exercise daily, eat protein and fiber with every meal, and get enough sleep. See overweight and menopause for more context.

Do supplements help quitting?

They replaceand no smoking cessation plan, but can supplement shortages. B vitamins, magnesium and antioxidants support recovery — as in Xodil Daily Packs.

Last updated: June 2026. This article does not replace medical advice. In case of persistent or serious complaints: contact your doctor.