Tobacco, gynecological troublemaker

Actu GP Le tabac, fauteur de troubles gynécologiques

Tobacco consumption modifies both the flora and the metabolites of the vagina. These changes live women open to an increased risk of urogenital infections and of developing unpleasant odors.


Smoking kills… vaginal microbiota diversity. Women who smoke display an imbalance of their intimate flora which is likely to facilitate the development of bacterial and viral sexually transmitted infections (STIs), and even to damage the structure of the cervical epithelium or impair the immune response. The underlying mechanisms behind these risks are still obscure, but the answer may lie in the composition of the local metabolome*. This hypothesis led an American research team to describe and compare the vaginal microbiotas and metabolites of 17 smoking and 19 non-smoking women.

Smoking-related variations

607 different metabolites were identified using high-precision analytical techniques. Metabolic profiles varied depending on microbial composition and on the consumption or non-consumption of tobacco. Significant differences were observed in twelve metabolites according to whether the person was a smoker or non-smoker. The identification of microbiota bacterial populations also revealed large differences depending on smoking habits. In particular, most smokers had lower levels of lactobacilli, bacteria known for their protective action on the vaginal wall. Microbial composition is thought to have the greatest influence on the vaginal metabolome.

Infections and odors on the rise

The researchers cross-checked their data and observed that smokers, particularly those with a lower concentration of lactobacilli, displayed an abundance not only of nicotine and its derivatives, but also of agmatine, cadaverine, putrescine, tryptamine and tyramine. These metabolites are known to alter the infective power of “bad bacteria” responsible for some urogenital infections, and to contribute to bad odor. Thus tobacco consumption is thought to have a negative impact on women’s health, in particular in those whose vaginal flora is already depleted of lactobacilli.


*All metabolites—i.e. small molecules derived from the host, from microorganisms, and from derivatives of foreign products to the host (drug, nicotine…)—contained in a given environment.



T. Nelson, J. Borgogna, R. Michalek, et al. Cigarette smoking is associated with an altered vaginal tract metabolomic profile. Nature, Scientific reports, 2018.