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According to the Cleveland Clinic, low estrogen levels can lead to the following [6]: Dry skin Tender breasts Weak or brittle bones Difficulty concentrating Moodiness or irritability Vaginal dryness (atrophy) Hot flashes or night sweats Irregular periods and/or no periods Weight gain, especially in the stomach Headaches before or during your period Decreased sex drive Painful intercourse (dyspareunia) Fatigue Insomnia Testosterone Smoking is pro-androgenic and increases testosterone levels: High testosterone levels can cause side effects such as hirsutism, skin blemishes, irregular menstrual cycles, and a reduced sex drive