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Menstrual Cycle May Affect Tobacco Withdrawal

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WebMD Health News

April 25, 2000 -- Women, don't try to quit smoking on New Year's Day or your birthday unless it's near the beginning of your menstrual cycle. Women who quit smoking later in their menstrual cycle have significantly more withdrawal symptoms, according to a new report in the Journal of Consulting and Clinical Psychology.

Experts say a quit date within the first 14 days of your monthly cycle may reduce your anxiety, depression, and irritability if you are a smoker of childbearing age.

Because negative mood is a characteristic of both tobacco withdrawal and menstrual discomfort, researchers compared women who quit smoking during the follicular phase (1-14 days after their periods) with women who quit during the later luteal phase (15 days or more after) of the menstrual cycle.

Seventy-eight participants up to 65 years of age selected quit dates within a window of several days. They also rated their general mood, desire to smoke, and menstrual discomfort before and during counseling sessions twice a week. To tell if the women cheated and smoked, researchers tested and analyzed their expired breath.

The two groups had similar ranges of age, education, marital status, and smoking history. And initially, participants reported no difference in mood, smoking desire, or menstrual discomfort. But after one week of not smoking, the late-cycle group reported significantly more anxiety, depression, and irritability.

"The findings suggest a simple strategy to reduce the adverse symptoms of smoking cessation, without any cost or side effects," says study co-author Kenneth Perkins, PhD, a professor of psychiatry at the University of Pittsburgh School of Medicine. "But it's not yet clear if an early follicular quit date reduces relapse."

Women are in particular need of smoking cessation interventions because quitting tends to be more difficult for them, says Perkins. "Women also have more health risks from smoking than men."

And the health risks of smoking continue to grow. "Almost every cancer is associated with tobacco use, and more women now die of lung cancer than breast cancer," says Joyce Doyle, MD, director of the General Medical Clinic at Grady Memorial Hospital and assistant professor of medicine at Emory University, both in Atlanta. "And in developing heart disease, smoking seems to have a more powerful effect in women than men."

Smoking is also a risk factor for osteoporosis and is closely associated with low-birth-weight babies, says Doyle. "Teenage girls are starting to smoke at a faster rate than teenage boys. But to quit, women have to really want it."

You might choose a birthday or a holiday as a quit date, or perhaps respond better to a smoking contract with your physician. "Either way, drug therapy doubles the success rate and is often combined with behavioral therapy," Doyle says.

Doyle says hormones appear to affect drug withdrawal symptoms, and the researchers agree. Perkins. "Future studies should compare women with men and the effect of nicotine replacement during menstrual phases. A key question is whether menstruation affects withdrawal from other drugs," Perkins says.

The study was supported with a grant from the National Institute on Drug Abuse.

Vital Information:

  • Women who quit smoking during the second half of their menstrual cycle tend to experience more anxiety, depression, and irritability than those who quit during the first half.
  • It is unclear whether the quit date affects the chance a woman will relapse.
  • Women who smoke increase their risk of many serious conditions, including most cancers, heart disease, osteoporosis, and their risk of having low-birth-weight babies.

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