When it comes to cocaine, anytime a user abusing this substance, they are risking not only short-term consequences but long-term physiological changes due to the potency of this drug. Cocaine is highly addictive and can have physiological changes like increased heart rates, raised blood pressures and mood changes in both sexes but an additional factor that women must consider is the detrimental changes that can impact their reproductive cycles. Cocaine has the potential to cause reproductive changes and is it is considered a medical emergency when a pregnant mother abusing cocaine presents with an unborn fetus. Cocaine can be highly teratogenic and there are numerous development and birth defects that can hinder the quality of life of this baby.
Thankfully, in modern society, most cocaine abusers will be male patients, (responsible for about 70% of total cases) and the quantity of their intake is higher than women on average. Men are also more likely to administer this medication intravenously while females tend to prefer the intranasal route (snorting). Even if they only account for a portion of total cases of cocaine abuse, women unfortunately are more likely to develop a dependence on this substance.
Although women abusing cocaine are able to still have children, there is a great potential for menstrual effects the longer a women abusing the substance. Women that smoked cocaine have alterations during their follicular phase of the menstrual cycle. This is the period of time where a uterus alters its environment and becomes more hospitable for implantation of a potential fertilized egg.
In one investigation, it was determined that women who used cocaine had heart rates about 10 beats per minute higher than a normal patient and also had blood pressure values about 6 mmHg higher in both systolic and diastolic parameters in the follicular phase. These same women had increased heart rates by about 14 beats per minute and increases in blood pressure by about 7 unit in both systolic and diastolic parameters during the luteal phase. This indicates that as the heart beats faster, blood is not able to as effectively deliver nutrients and vital factors to prepare the uterus for implantation. Even if a woman is not planning to get pregnant, insufficiencies of these nutrients can decrease the frequency of periods and can even leave women infertile in the event they wish to have future children. 
In another study done to determine what dosage variations can cause, it was determined that women that abused lower amounts of cocaine did not have any noticeable changes in their LH (luteinizing hormone) but had noticeable elevated levels when they were using higher quantities of the drug. Due to the addictive potential of this compound, even minor users are highly likely to develop a dependence to higher doses so it is a risk that all users are at risk for.
LH is a hormone that is highly important to trigger ovulation in females during a menstrual cycle and a "spike" in the hormone is the main reason why the egg is released from the ovaries into the uterus. If there is no longer this physiological LH spike and subsequent depression, women will not release eggs when they abuse cocaine and they will have a very difficult time to become pregnant. Long-term abuse may result in irreversible changes. 
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