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Female smokers more likely to kick the habit by ‘timing’ their quit date with their menstrual cycle, study shows

Summary:

Women who want to quit smoking may have better success by

carefully timing their quit date with optimal days within their

menstrual cycle, according to a new study.

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Research shows that women have greater difficulty with smoking

cessation than men.

Credit: © Serhiy Kobyakov / Fotolia

Women who want to quit smoking may have better success by carefully

timing their quit date with optimal days within their menstrual cycle,

according to a new study from researchers at the Perelman School of

Medicine at the University of Pennsylvania. The results, published

online this month in Biology of Sex Differences, were also presented

at the annual meeting of the Organization for the Study of Sex

Differences (OSSD), held at Penn.

Cigarette smoking remains the leading cause of preventable death in

the United States, and women experience more severe health

consequences from cigarette smoking than men, including a 25 percent

increased risk of developing coronary heart disease and chronic

obstructive pulmonary disease. Research also shows that women have

greater difficulty with smoking cessation than men.

"Understanding how menstrual cycle phase affects neural processes,

cognition and behavior is a critical step in developing more effective

treatments and in selecting the best, most individualized treatment

options to help each cigarette smoker quit," said the study's lead

author, Reagan Wetherill, PhD, a research assistant professor of

Psychology.

Wetherill and senior author Teresa Franklin, PhD, a research associate

professor of Neuroscience in Psychiatry, have been studying the brains

of premenopausal women who smoke cigarettes for several years in

Penn's Center for the Studies of Addiction. Their work is based on a

significant animal literature showing that the natural sex hormones —

estrogen and progesterone — which fluctuate over the course of the

menstrual cycle modulate addictive behavior. The animal data show that

during the pre-ovulatory, or follicular phase of the menstrual cycle,

when the progesterone-to-estrogen ratio is low, women are more likely

to be spurred toward addictive behaviors. Alternatively, during the

early pre-menstrual or luteal phase of the menstrual cycle, when the

progesterone-to-estrogen ratio is high, addictive behaviors are

thwarted, suggesting that progesterone might protect women from

relapsing to smoking.

In the current study, 38 physically healthy, premenopausal women who

smoke and who were not taking hormonal contraceptives, ranging from 21

to 51 years of age, received a functional MRI scan to examine how

regions of the brain that help control behavior are functionally

connected to regions of the brain that signal reward.

The researchers theorized that the natural fluctuations in ovarian

hormones that occur over the course of the monthly menstrual cycle

affect how women make decisions regarding reward — smoking a

cigarette — and so-called "smoking cues," which are the people,

places and things that they associate with smoking, such as the smell

of a lit cigarette or going on their coffee break. These "appetitive

reminders" to smoke are perceived as pleasant and wanted, and similar

to cigarettes, are also rewarding.

In 2015, the researchers showed that compared to when women are in the

luteal phase of their menstrual cycle, which is the period of time

following ovulation and prior to menstruation, women in the follicular

phase — which begins at menstruation and continues until ovulation —

have enhanced responses to smoking cues in reward-related brain

regions. This finding led them to further test whether groups differed

in the strength of the functional connections that exists between

regions exerting cognitive control and reward-related brain regions.

The weaker the functional connections between cognitive control brain

regions and reward signaling brain regions, the less ability women

have to 'Just Say No' when attempting to quit.

The women in the study were separated into two groups — those in

their follicular phase and those in their luteal phase. Results

revealed that during the follicular phase, there was reduced

functional connectivity between brain regions that helps make good

decisions (cortical control regions) and the brain regions that

contain the reward center (ventral striatum), which could place women

in the follicular phase at greater risk for continued smoking and

relapse. Orienting attention towards smoking cues (pictures of smoking

reminders such as an individual smoking) was also shown to be

associated weaker connections between cognitive control regions in

follicular females.

"These data support existing animal data and an emerging human

literature showing that progesterone may exert protective effects over

addictive behavior and importantly, the findings provide new insights

into sex differences in smoking behavior and relapse," Franklin said.

"Interestingly, the findings may represent a fundamental effect of

menstrual cycle phase on brain connectivity and may be generalizable

to other behaviors, such as responses to other rewarding substances

(i.e., alcohol and foods high in fat and sugar).

"The results from this study become extremely important as we look for

more ways to help the over 40 million individuals in the U.S. alone

addicted to cigarettes," Franklin, continued. "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."

Story Source:

The above post is reprinted from materials provided by Perelman School

of Medicine at the University of Pennsylvania. Note: Materials may be

edited for content and length.

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