A complex interaction of hormones cause many women of childbearing years to experience physical, psychological, and emotional symptoms related to their menstrual cycle.
An estimated 80% experience premenstrual symptoms, which may include: irritability, tension, anxiety, depression, restlessness, headaches, fatigue and cramping. The severity of symptoms can range from mild to disabling.
So how does a woman experiencing significant menstrual symptoms successfully navigate nicotine dependency recovery?
The menstrual cycle can be broken down into two primary segments, the follicular and luteal phases. The follicular or pre-ovulation phase is when significant hormonal changes occur. It announces the first day of a woman's cycle, includes the period of menstrual bleeding and normally lasts in the neighborhood of two weeks.
The luteal phase commences at ovulation, normally lasts two weeks and ends the day before her next period.
A 2008 study tried to determine if the menstrual phase during which a woman attempts to stop smoking affects the risk of smoking relapse.
A total of 202 women were assigned to either commence recovery during the luteal phase or the follicular phase. After 30 days, 34% of women who started during the luteal phase were still not smoking, versus only 14% who started during the follicular phase.
While normal to focus on the 34%, what I find encouraging is the 14%. As they demonstrate, success is achievable even if commencing recovery during the follicular phase, during significant premenstrual symptoms.
Hormone related stress and tension might actually accelerate nicotine elimination by turning urine more acidic, thus causing the kidneys to draw the alkaloid nicotine from the bloodstream quicker (see Chapter 4).
The question now being asked is, is addiction to smoking nicotine a cause of premenstrual syndrome (PMS)? A ten year study published in 2008 followed 1,057 women who developed PMS and 1,968 reporting no diagnosis of PMS, with only minimal menstrual symptoms.
After adjustment for oral contraceptives and other factors, the authors found that "current smokers were 2.1 times as likely as never-smokers to develop PMS over the next 2-4 years." The study concludes, "Smoking, especially in adolescence and young adulthood, may increase risk of moderate to severe PMS."
When is it best to face challenge? Early on or delay it? As Joel often states, commencing recovery during a period of significant anxiety increases the odds that anxiety will never again serve as an excuse for relapse.
Can hormonal related symptoms be so profound that it is best to navigate the most challenging portion of recovery -- the first 72 hours -- during the luteal phase? If concerned, discuss it with your physician.
Keep in mind that the smoking woman's unconscious mind has likely been conditioned to reach for a cigarette during specific menstrual cycle hormonal or symptom related events. The more nicotine use cues encountered and extinguished during the luteal phase, the fewer that will remain to trigger crave episodes during the follicular phase.
The beauty of recovery is that next month's cycle will not be affected by the heightened stresses associated with rapidly declining reserves of the alkaloid nicotine. Also, next month's cycle may very well stand on its own, unaffected by either early withdrawal or cue related crave triggers.
Joel encourages doubters to stroll through the hundreds of thousands of indexed and archived member posts at Freedom, the free message board support group, where each day he supports members in navigating recovery.
"Go back one month and see how many of the woman at our site seem to have panicking posts complaining of intense smoking thoughts month after month after month on any kind of regular pattern."
"The fact is, there are no such posts on the board because after the first few months, not smoking becomes a habit even during times of menstruation."
Joel closes by reminding women concerned about menstrual symptoms, that to keep their recovery on course and getting easier and easier over time, it's still simply a matter of staying totally committed, even during tough times, to their original commitment to Never Take Another Puff!