Cigarette smoking and other correlates of cytologic estrogen effect in postmenopausal women

Cigarette smoking and other factors associated with estrogen-related diseases may influence risk through hormonal mechanisms. To investigate the sex hormone associations of these risk factors, vaginal scrape cytology specimens and questionnaire data were obtained on 215 postmenopausal women at the time of routine pelvic examination. All specimens were read blindly by one cytologist, and the relationships between the indices of maturation and risk factors were assessed with regression techniques. Current cigarette smoking and obesity were associated with increased maturation. In contrast, years past menopause, parity, and coffee and tea consumption were all unrelated to vaginal epithelial maturation. These results elucidate the mechanisms underlying the antiestrogenic effect of cigarette smoking and support the concept that obesity is associated with an estrogenic effect.