Smoking- and menstrual-related symptomatology during short-term smoking abstinence by menstrual phase and depressive symptoms

Abstract

Menstrual phase and depressive symptoms are known to minimize quit attempts in women. Therefore, the influence of these factors on smoking- and menstrual-related symptomatology during acute smoking cessation was investigated in a controlled cross-over lab-study. Participants (n=147) completed two six-day testing weeks during their menstrual cycle with testing order randomly assigned (follicular vs. luteal). The testing week consisted of two days of ad libitum smoking followed by four days of biochemically verified smoking abstinence. Daily symptomatology measures were collected. Out of the 11 total symptoms investigated, six were significantly associated with menstrual phase and nine were significantly associated with level of depressive symptoms. Two significant interactions were noted indicating that there may be a stronger association between depressive symptoms with negative affect and premenstrual pain during follicular phase compared to luteal phase. Overall, these observations suggest that during acute smoking abstinence in premenopausal smokers, there is an association between depressive symptoms and symptomatology whereas menstrual phase appears to have less of an effect. Further study is needed to determine the effect of these observations on smoking cessation outcomes, as well as to define the mechanism of menstrual phase and depressive symptoms on smoking-related symptomatology.

Systematic and Meta-Analytic Review of Research Examining the Impact of Menstrual Cycle Phase and Ovarian Hormones on Smoking and Cessation

“…32 While five studies assessed premenstrual symptoms; 31,37,44,49,60 there were insufficient data to determine what impact premenstrual symptomatology may have on the relationship between menstrual cycle phase and withdrawal symptoms.…”

“…The statistical estimates were extracted from published papers or obtained directly from the authors for two publications. 31,32 These relatively broad criteria resulted in the identification of studies using multiple methodologies (see Results section for details). For example, some studies randomly assigned participants to either follicular or luteal phase, and compared outcomes between phases (e.g., likelihood of successful cessation, withdrawal, ad lib smoking).…”

“…The remaining eight studies were included in the meta-analysis. 31,32,37,38,44,49,60,66 Estimates from nicotine deprivation study conditions were used when available. Outcomes were examined by measurement of ovarian hormone levels.…”

Genetic Variation of the Mu Opioid Receptor (OPRM1) and Dopamine D2 Receptor (DRD2) is Related to Smoking Differences in Patients with Schizophrenia but not Bipolar Disorder

“…Especially in the group of subjects with bipolar disorder, females were majority. Many studies have been reported the influence of menstrual cycle phases on female's smoking behavior [52][53][54][55][56]. Unfortunately there were no menstrual phase controls in this study.…”

The magnitude, long-term trend and lifestyle risk factors of dysmenorrhea and premenstrual syndrome

“…Dysmenorrhea is defined as a severe, painful, cramping sensation in the lower abdomen occurring just before or during the menses [198]. It is a common gynaecological complaint, affecting the majority of women of reproductive age with 2% to 29% having severe pain [6].…”