The menstrual cycle appears to have an effect on nicotine cravings,
according to a new study by Adrianna Mendrek of the University of
Montreal and its affiliated Institut universitaire en santé mentale de
Montréal. "Our data reveal that incontrollable urges to smoke are
stronger at the beginning of the follicular phase that begins after
menstruation. Hormonal decreases of estrogen and progesterone possibly
deepen the withdrawal syndrome and increase activity of neural circuits
associated with craving," Mendrek said. She believes that it could
therefore be easier for women to overcome abstinence-related withdrawal
symptoms during the mid-luteal phrase, i.e. after ovulation, when their
levels of estrogen and progesterone are elevated, but psycho-social
factors cannot be excluded, as tested women were explicitly asked in the
study about the phase of their menstrual cycle. "Taking the menstrual
cycle into consideration could help women to stop smoking," Mendrek
said. The findings were published in Psychiatry Journal.
The researchers came to their conclusion by working with 34 men and
women who each smoke more than 15 cigarettes a day. They filled out
questionnaires and had underwent MRI brain scans, which were taken while
they looked at either neutral pictures or pictures designed to make
them want to smoke. The women were scanned twice -- once at the
beginning of the follicular phase of their menstrual cycle and then
again at the mid-luteal phase. Estrogen and progesterone levels were
also measured.
Fewer than one ex-smoker in ten manages to stay that way after a
year, and women who smoke have a harder time quitting than men, even
when they smoke the same amount. In drug studies involving rodents
(nicotine and other substances), scientists have observed sex
differences. "Female rats become addicted more quickly, and are willing
to work harder for the same quantity of dose," Mendrek explained. This
observation led Mendrek's team to conclude that females are perhaps at
higher risk of addiction, and sex hormones could be the reason why.
The situation is much more difficult to unravel when it comes to
humans. Each smoker is unique in terms of his or her tobacco use,
personal history, personality, social situation and environment.
"Stress, anxiety and depression are probably the more important factors
to take into consideration," Mendrek said. "Having said that, amongst
young people, tobacco use by women is unfortunately increasing."
The researchers led their study with two specific objectives in mind.
The first was to check if there are gender differences in the neronal
circuits linked to craving. The second was to determine if the
electrocortical changes associated with nicotine withdrawal fluctuate in
tandem with hormone variations.
No significant differences were found between the men and women
insofar as the neuronal circuits were concerned. However, the activation
patterns for the females varied considerably over their menstrual
cycle. Certain areas of their frontal, temporal and parietal cortex
revealed greater activation during the follicular phase, while limited
activation was recorded in the hippocamp during the luteal phase.
Mendrek hopes her conclusions will encourage researchers to pay
greater attention to biology when designing their research protocols. "A
greater knowledge of the neurobiological mechanisms governing addiction
should enable us to better target treatment according to the smokers
profile," she said.
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