Quitting Smoking During Perimenopause: Why It Matters and How to Do It
Quitting smoking during perimenopause can reduce hot flashes, protect bone density, and lower cardiovascular risk. Here is a practical guide to stopping for good.
Why Smoking and Perimenopause Are a Particularly Bad Combination
Smoking affects perimenopause in several significant ways. It is linked to an earlier onset of menopause, sometimes by one to two years, meaning women who smoke may experience perimenopause symptoms sooner. It worsens hot flashes and increases their frequency. It accelerates bone density loss, raising the risk of osteoporosis at a time when declining oestrogen already puts bones under pressure. Smoking also increases cardiovascular risk, which rises naturally during the menopause transition. The case for stopping has never been stronger.
The Benefits Come Quickly
One of the most motivating things about quitting is how fast some benefits appear. Within 20 minutes of stopping, blood pressure and pulse rate begin to fall. Within 24 hours, carbon monoxide levels normalise. Within a few weeks, circulation improves and lung function increases. For hot flashes specifically, many women notice a reduction in frequency and severity within weeks of stopping. The longer-term benefits, reduced cancer risk, better bone density, lower cardiovascular risk, build steadily over months and years.
NHS Support That Actually Helps
The NHS Stop Smoking Service has one of the best success rates of any smoking cessation programme. It is free, and it combines behavioural support with approved medications. Nicotine replacement therapy (patches, gum, lozenges, inhalers) is available on prescription. Varenicline and bupropion are prescription medications that can significantly improve quit rates. Speak to your GP or pharmacist about what combination might work best for you. Being honest about previous quit attempts and what helped or did not will allow them to tailor advice.
Dealing with Cravings and Withdrawal
Nicotine cravings typically peak within the first three days and usually pass within a few minutes. Having a strategy for each common craving trigger helps enormously. Identify your patterns: after meals, with coffee, when stressed, at specific times of day. For each trigger, plan a substitute: a short walk, a glass of water, a few deep breaths, or calling someone. The STOP technique (take a step back, think, options, proceed) is a simple way to create a pause between the craving and acting on it.
Managing Weight Concerns
Fear of weight gain stops many women from trying to quit, and this concern is worth addressing directly. Some people do gain a small amount of weight after stopping, partly because nicotine suppresses appetite. However, the health risks of smoking are far greater than any modest weight change. Regular exercise, which also helps with withdrawal symptoms and mood, can help manage weight during the quit process. It is also worth noting that perimenopause-related weight changes are hormonal and largely independent of smoking.
If You Have Tried Before and Relapsed
Most people who quit successfully have made several attempts first. Relapse is part of the process, not a sign of failure. Each attempt teaches you something about what works for you and what does not. If you smoked again after a previous quit attempt, think about what the trigger was and how you would handle it differently. Quitting with support consistently doubles the success rate compared to trying alone. This time, reach out.
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