Research promises to improve smoking cessation strategies for women.
Based on the findings from a new study that focused on women smokers, researchers suggest that carefully timing a smoking quit date with certain days in a menstrual cycle may lead to greater success.
"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," lead author, Reagan Wetherill, research assistant professor of Psychology, said in a press release.
The idea for the study came from significant animal literature that shows how the natural sex hormones, estrogen and progesterone, modulate addictive behavior as they fluctuate over the course of a menstrual cycle.
When the progesterone-to-estrogen ratio is low in the follicular phase of the menstrual cycle, women are more likely to be driven towards addictive behaviors, the press release explains. Conversely, when the ratio is high during the luteal phase of the cycle, addictive behaviors are reduced. This suggests that progesterone may play a role in protecting women from relapsing.
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To test the idea out, the researchers, from the Perelman School of Medicine at the University of Pennsylvania, recruited 38 physically healthy, premenopausal women ranging from 21 to 51 years of age, all of whom smoked and weren’t taking hormonal contraceptives at the time.
The volunteers received a functional MRI scan, allowing the researchers to investigate how the regions of the brain that help control behaviors are connected to those that signal reward. They were also split into two separate groups — the first were in their follicular phase, and the second in their luteal phase.
The results, which appear in the journal Biology of Sex Differences, showed that, in the women who were in the follicular phase, there was reduced functional connectivity between the brain regions that help us make good decisions (the cortical control regions) and those that regulate reward (the ventral striatum).
Further, by showing the women smoking cues, like pictures that contain individuals smoking, the researchers were able to measure their cravings. In follicular women, the researchers observed a decline in connections between the control and reward regions that correlated with how much attention they paid to the smokers in the images.
Accordingly, the researchers suspect that women in the follicular phase could be at greater risk for continued smoking and relapse due to the weaker connections between the control and reward brain regions.
“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,” like alcohol, high-fat foods, and sugar, said senior author Teresa Franklin.
"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,” she concluded.
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