Hyperemesis gravidarum, uterine fibroids, and endometriosis: effects of cigarette smoking on risk

Abstract There is substantial evidence that smoking produces an ‘anti-oestrogen’ effect (Baron 1984). This important consequence of smoking appears to be the end result of a number of metabolic pathways: altered hepatic metabolism of endogenously-derived oestrogens (Michnovicz et al. 1986), early ovarian failure (Willett et al. 1983), reduced circulating levels of orally ingested exogenous oestrogens (Jensen et al. 1985), and, possibly, reduced ovarian oestrogen production (MacMahon et al. 1982).