Women with PCOS should think twice before lighting up a cigarette | Doctor explains why

For women living with Polycystic Ovary Syndrome (PCOS) (now called PMOS- Polyendocrine Metabolic Ovarian Syndrome), managing symptoms often involves a combination of medication, dietary changes, exercise and lifestyle modifications. However, one factor that frequently receives less attention is smoking, a habit that experts say can worsen many of the metabolic and hormonal issues already associated with the condition.

While smoking is commonly linked to lung disease and heart problems, research suggests that it may also aggravate insulin resistance, disrupt hormonal balance and increase cardiovascular risks in women with PMOS. According to experts, quitting smoking may not cure the condition, but it can significantly improve the body's response to treatment and long-term management strategies.

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Understanding the link between smoking and PMOS

PMOS is one of the most common hormonal disorders affecting women of reproductive age. The condition is characterised by a combination of symptoms that may include irregular menstrual cycles, elevated androgen (male hormone) levels, weight gain, acne, excessive hair growth and fertility-related challenges.

According to WebMD, insulin resistance is one of the key underlying factors in many cases of PMOS. When the body's cells become less responsive to insulin, the pancreas produces more of the hormone, which can contribute to weight gain, hormonal imbalance and worsening symptoms.

Several studies have shown that women with PMOS who smoke tend to have higher levels of insulin resistance and increased androgen concentrations compared to non-smokers.

How smoking may worsen hormonal imbalance

One of the defining features of PMOS is elevated androgen levels, which can trigger symptoms such as acne, thinning hair and unwanted facial or body hair growth.

Studies published in peer-reviewed medical journals have suggested that cigarette smoking may influence hormone metabolism and increase circulating androgen levels. This can potentially intensify some of the symptoms women with PMOS are already trying to manage.

Experts note that smoking can also contribute to chronic inflammation and oxidative stress within the body, both of which have been linked to the progression of metabolic disorders.

Why quitting smoking can make a difference

According to Dr Akshat Chadha, Lifestyle Medicine Specialist, General Physician and Digital Health Influencer, smoking is one of the most controllable risk factors affecting women with the condition.

"Smoking is one of the more actionable variables in the equation. Quitting won't resolve PMOS, but it can create a more responsive foundation for every other intervention a woman is already committed to," says Dr Chadha.

Experts explain that because PCOS affects multiple systems within the body, even modest improvements in metabolic health can have a positive ripple effect.

"When a woman with PMOS quits smoking, the shift isn't just respiratory. Insulin resistance eases, hormonal balance improves, cardiovascular risk drops. The whole management picture starts responding better," Dr Chadha adds.

Lifestyle changes remain central to PMOS management

Health experts continue to emphasise that lifestyle interventions remain among the most effective ways to manage PMOS symptoms. Regular physical activity, balanced nutrition, stress management and maintaining a healthy weight can help improve insulin sensitivity and hormonal health. Quitting smoking can strengthen the impact of these efforts by reducing additional strain on the body's metabolic and cardiovascular systems.

While there is no single cure for PMOS, addressing modifiable risk factors can play a significant role in improving quality of life and long-term health outcomes.