If you’re a woman and you want to quit smoking, here’s a tip: time it with your menstrual cycle.
A new study from the University of Pennsylvania has concluded that women could see better success if they try to quit during the early pre-menstrual phase of their cycle.
A woman’s menstrual cycle runs an entire month, with three phases:
- The menstrual period (day one of a cycle).
- The follicular phase (as the egg gets ready to release right up until ovulation day).
- The luteal phase (beginning on ovulation day).
Scientists have known for some time that the smoking habit is experienced differently by men and women. A 2015 study by researchers at the Université de Montréal found that when it came to cravings, the brain activity in women varied during different periods in a menstrual cycle.
In that study, 34 smokers consisting of 15 men and 19 women had functional magnetic resonance imaging (fMRI) scans of their brains. The women went through the scans twice, at different times in their cycle and had their levels of progesterone and estrogen measured. They concluded that it may be easier for women to overcome their cravings during the luteal phase.
The new research studied 38 women from the ages of 21 to 51. They also received fMRI scans of their brains to study the connections between the two regions.
The women in the study were separated into two groups: those in their follicular phase and those in their luteal phase. As well, when the women in the follicular phase were shown smoking-cue photos (such as someone smoking a cigarette), there was a weaker connection in the cognitive control regions.
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Scientists concluded that during the follicular phase there was less connectivity between the regions in the brain that helps us make good decisions (called the cortical control regions) and those in the reward centre (called the ventral striatum). This suggests that women in the follicular phase (as the egg is ready to release, typically about seven days after the last day of your menstrual cycle) might have a harder time quitting or could relapse if they’ve recently quit.
The key to the craving lies with the connections between the cognitive control brain regions and the reward-signalling brain regions. Essentially, the weaker the connections, the more difficult it was to make oneself quit.
The hormones progesterone and estrogen play an important role: when the progesterone-to-estrogen ratio is high — as it is during the luteal phase when the egg is released — addictive behaviours are reduced. This suggests that progesterone may help protect women from smoking. Women might have an easier time quitting if they did it two weeks before the start of their period.
“Interestingly, the findings may represent a fundamental effect of menstrual cycle phase on brain connectivity and may be generalizable to other behaviours, such as responses to other rewarding substances (i.e., alcohol and foods high in fat and sugar),” said the paper’s senior author Teresa Franklin in a statement.
“When we learn that something as simple as timing a quit date may impact a woman’s cessation success, it helps us to provide more individualized treatment strategies for individuals who are struggling with addiction.”
However, Adrianna Mendrek, lead author of the 2015 study, said that the answers behind helping women quit smoking may not be so cut and dry.
“When quitting smoking, it might be easier for the initial few days, but it doesn’t last,” she said.
The problem is the “cycle” in menstrual cycle: once the luteal phase is over, women are heading back toward the follicular phase.
“Yes, hormonal influences play a role for sure, but there’s so much more,” Mendrek said. “In terms of practicality, is it going to make a difference in the long-term? I don’t know.”