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Abstract
Cigarette smoking is less common in menopausal women than in younger women, or in men of their age, but is a significant health risk to those who smoke. Smoking is also more common among women who are more socially and economically disadvantaged, with the attendant higher health risks of those groups. The mean age of menopause is earlier in smokers who also have been found to have higher circulating levels of androgens. Smoking increases the risk for heart disease and of osteoporotic fractures. Estrogen replacement may reduce somewhat the risk of cardiovascular disease, but smokers do not derive the same benefit as non-smokers, and continue to show greater all cause mortality. Smokers of menopausal age have accelerated skin aging and an increased risk of mucocutaneous cancers. Vulvar intra-epithelial neoplasia and invasive cancer are both increased in smokers. The of ten expressed concern that smoking cessation may lead to weight gain is borne out in the literature. Smoking cessation needs to be approached with attention to the specific issues of the individual patient. Women of menopausal age attempt cessation with a lower frequency than younger women, and may have more complex needs. Specific efforts to identify menopausal smokers may be necessary, as they may be under-represented in the women who present seeking health information at the time of the menopause.
Resume
Les femmes ménopausées fument moins fréquemment la cigarette que les jeunes femmes ou les hommes de leur âge, mais cela constitue un risque significatif pour la santé de celles qui fument. Le tabagisme est aussi plus fréquent chez les femmes désavantagées sur les plans sociaux et économiques, et il s’ajoute aux risques concomitants pour la santé, qui sont plus élevés dans ces groupes. L’âge moyen de la ménopause est hâtif chez les fumeuses, dont on a constaté que les taux circulatoires d’androgènes sont également plus élevés. Le tabagisme accroît le risque de cardiopathie et de fracture ostéoporotique. La substitution des oestrogènes peut réduire légèrement le risque de cardiopathie, mais les fumeuses n’en tireront pas les mêmes avantages que les non-fumeuses et leur mortalité reste supérieure, toutes causes confondues. Les fumeuses d’âge ménopausique présentent un vieillissement accéléré de la peau et un risque aceru de cancers cutanéomuqueux. La néoplasie intraépithéliale vulvaire et le cancer envahissant sont tous deux plus fréquents chez les fumeuses. La préoccupation souvent exprimée selon laquelle l’abandon du tabac peut se traduire par une augmentation du poids est corroborée dans la littérature. L’approche de l’abandon du tabac doit être caractérisée par l’attention aux questions qui intéressent spécifiquement chaque patiente. Les femmes d’âge ménopausique essaient de cesser de fumer moins fréquemment que les jeunes femmes, et leurs besoins peuvent être plus complexes. Il faudra peut-être déployer des efforts spécifiques pour identifier les fumeuses ménopausiques puisqu’elles sont sous-représentées parmi les femmes qui consultent pour obtenir de l’information en matière de santé au moment de la ménopause.
Key Words
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Article info
Publication history
Accepted:
June 6,
1996
Received:
June 3,
1996
Identification
Copyright
© 1997 Published by Elsevier Inc.
