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Combined, these effects disrupt normal cyclic hormone patterns, change feedback to the hypothalamus and pituitary, and can result in irregular cycles, low sperm quality, or anovulation

But biology is complex

For example, they induce the demethylation of endogenous retroviral elements (ERVs), activating a viral mimicry state: the double-stranded RNA produced by ERV transcription is recognized by intracellular pattern recognition receptors, leading to enhanced tumor immunogenicity through activation of the MAVS pathway and increased type I interferon production [23, 230]

Smoking is associated with elevated low-density lipoprotein cholesterol, decreased high-density lipoprotein cholesterol, increased blood catecholamine levels, increased fibrinogen levels, and impaired vascular endothelial function [36,37,38,39,40,41,42,43,44,45,46,47,48]