Researchers at the Perelman School of Medicine show that women who want to stop smoking may be more successful if the quit date is timed during specific days in their menstrual cycle.

Researchers’ 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 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.

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