Ovarian Hormones and Transdermal Nicotine Administration Independently and Synergistically Suppress Tobacco Withdrawal Symptoms and Smoking Reinstatement in the Human Laboratory

Pang, Raina D.; Liautaud, Madalyn M.; Kirkpatrick, Matthew G.; Huh, Jimi; Monterosso, John; Leventhal, Adam M.

doi:10.1038/npp.2017.216

Cited by 14 publications

(8 citation statements)

References 43 publications

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“…However, when data collected during the luteal phase were grouped based on progesterone levels, researchers found that women with high levels of progesterone reported significantly lower subjective effects. Similar findings show the effects of progesterone on reducing cravings 181,188,189,215 …”

Section: Resultssupporting

confidence: 84%

Psychiatric Symptoms Across the Menstrual Cycle in Adult Women: A Comprehensive Review

Handy

Greenfield

Yonkers

et al. 2022

Harv Rev Psychiatry

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Learning objective After participating in this activity, learners should be better able to: • Discuss and outline the general and overlapping effects of the menstrual cycle on women’s mental health Abstract A growing body of research demonstrates menstrual cycle–dependent fluctuations in psychiatric symptoms; these fluctuations can therefore be considered as prevalent phenomena. Possible mechanisms underlying these fluctuations posit behavioral, psychological, and neuroendocrine influences. Recent reviews document cyclic exacerbation of symptoms and explore these mechanisms in the context of specific and often single disorders. The question remains, however, as to whether there are general and overlapping effects of the menstrual cycle on women’s mental health. To address this gap, we synthesized the literature examining the exacerbation of a variety of psychiatric symptoms across the menstrual cycle in adult women. Results show that the premenstrual and menstrual phases are most consistently implicated in transdiagnostic symptom exacerbation. Specifically, strong evidence indicates increases in psychosis, mania, depression, suicide/suicide attempts, and alcohol use during these phases. Anxiety, stress, and binge eating appear to be elevated more generally throughout the luteal phase. The subjective effects of smoking and cocaine use are reduced during the luteal phase, but fewer data are available for other substances. Less consistent patterns are demonstrated for panic disorder, symptoms of posttraumatic stress disorder, and borderline personality disorder, and it is difficult to draw conclusions for symptoms of generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, and trichotillomania because of the limited data. Future research should focus on developing standardized approaches to identifying menstrual cycle phases and adapting pharmacological and behavioral interventions for managing fluctuations in psychiatric symptoms across the menstrual cycle.

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Section: Resultssupporting

confidence: 84%

Psychiatric Symptoms Across the Menstrual Cycle in Adult Women: A Comprehensive Review

Handy

Greenfield

Yonkers

et al. 2022

Harv Rev Psychiatry

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“…This indicates a possible inflection point in the progesterone curve when the rate of hormone increase begins to slow down, likely during increases in the luteal phase. These findings converge with our previous work showing that progesterone levels in combination with the magnitude and direction of change of progesterone may play an important role in smoking behavior 23 . Specifically, more rapid early luteal increases in progesterone appear to yield the greatest dampening effect on smoking and that this dampening effect diminishes as progesterone reaches asymptotic levels later in the luteal phase.…”

Section: Discussionsupporting

confidence: 90%

“…Hormone levels were centered at each participant's mean 33 (Person Mean Centered; PMC, where higher levels indicate that hormones are greater than the participant's average). Prior research suggests that the relationship between PMC hormone levels and smoking behavior may vary during the menstrual cycle leading to a nonlinear relationship and variation in the correlation between the two 21,23 …”

Section: Methodsmentioning

confidence: 99%

“…In a recent smoking cessation study, our research team demonstrated that women with increasing in progesterone levels (i.e., early luteal phase) had a significantly greater likelihood to report 7‐day abstinence from cigarettes as compared to women with either no change or decreasing progesterone levels 22 . Pang et al 23 collected repeated salivary progesterone and estradiol at three laboratory sessions occurring during distinct ovarian cycle phases in abstinent women. Within‐participant increases in progesterone were associated with decreased negative affect and urges to smoke.…”

Section: Introductionmentioning

confidence: 99%

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Increases in endogenous progesterone attenuate smoking in a cohort of nontreatment seeking women: An exploratory prospective study

et al. 2020

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Despite advances in prevention and treatment, cigarette smoking remains a leading cause of preventable death in the United States. Although men and women are equally likely to attempt to quit smoking cigarettes, women are far less likely to achieve abstinence both during and following cessation treatment. Recent evidence suggests that ovarian hormone levels may play a role in successful abstinence attempts in women smokers. The primary goal of this exploratory prospective observational study was to estimate the association between within‐participant levels of progesterone and estradiol with associated cigarettes smoked per day in adult women smokers (n = 104). The primary study outcome was self‐reported cigarettes smoked per day (CPD) during a 2‐week observational period collected using a daily smoking diary. Additionally, participants collected saliva daily, from which hormone levels (progesterone and estradiol) were derived. Higher within‐participant progesterone levels were associated with a significant decrease in CPD (p = .008) whereas within‐participant estradiol levels were unrelated to CPD (p = .25). Regression models indicated a single change in the trajectory of smoking behavior for both within‐participant progesterone and estradiol. When progesterone values were below the change point, there was a significant inverse relationship between within‐participant progesterone levels and smoking behavior (p = .025) whereas the relationship was attenuated for higher within‐participant progesterone levels (p = .59). The effect of estradiol on smoking behavior was not significant when it was either below (p = .92) or above (p = .16) the change point. Higher within‐participant levels of progesterone but not estradiol are associated with reduced CPD in nontreatment seeking women smokers.

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“…Indeed, a clinical report revealed that women have an easier time quitting smoking during the luteal phase, when E2 levels are decreasing and progesterone levels are relatively higher than E2 (Allen et al, 2008). During acute smoking abstinence, high levels of progesterone were associated with reduced negative affective states in nicotine-dependent women (Pang et al, 2018). Lastly, Nakajima et al (2019) found reduced cortisol responses to stressful stimuli in the luteal versus the follicular phase in a sample of nicotine-dependent women.…”

Section: Discussionmentioning

confidence: 99%

Estradiol promotes and progesterone reduces anxiety-like behavior produced by nicotine withdrawal in rats

Flores

Cruz

Uribe

et al. 2019

Preprint

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The present study assessed sex differences and the role of ovarian hormones in the behavioral effects of nicotine withdrawal. Study 1 compared physical signs, anxiety-like behavior, and corticosterone levels in male, intact female, and ovariectomized (OVX) female rats during nicotine withdrawal. Estradiol (E2) and progesterone levels were also assessed in intact females that were tested during different phases of the 4-day estrous cycle. Study 2 assessed the role of ovarian hormones in withdrawal by comparing the same measures in OVX rats that received vehicle, E2, or E2+progesterone prior to testing. Briefly, rats received a sham surgery or an ovariectomy procedure. Fifteen days later, rats were prepared with a pump that delivered nicotine for 14 days. On the test day, rats received saline or the nicotinic receptor antagonist, mecamylamine to precipitate withdrawal. Physical signs and anxiety-like behavior were assessed on the elevated plus maze (EPM) and light-dark transfer (LDT) tests. During withdrawal, intact females displayed greater anxiety-like behavior and corticosterone levels as compared to male and OVX rats. Females tested in estrus (when E2 is relatively low) displayed less anxiety-like behavior and corticosterone versus all other phases. Anxiety-like behavior and corticosterone were positively correlated with E2 and negatively correlated with progesterone. Intact females displaying high E2/low progesterone displayed greater anxiety-like behavior and corticosterone as compared to females displaying low E2/high progesterone. Lastly, OVX-E2 rats displayed greater anxiety-like behavior than OVX-E2+progesterone rat. These data suggest that E2 promotes and progesterone reduces anxiety-like behavior produced by withdrawal.

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Ovarian Hormones and Transdermal Nicotine Administration Independently and Synergistically Suppress Tobacco Withdrawal Symptoms and Smoking Reinstatement in the Human Laboratory

Cited by 14 publications

References 43 publications

Psychiatric Symptoms Across the Menstrual Cycle in Adult Women: A Comprehensive Review

Psychiatric Symptoms Across the Menstrual Cycle in Adult Women: A Comprehensive Review

Increases in endogenous progesterone attenuate smoking in a cohort of nontreatment seeking women: An exploratory prospective study

Estradiol promotes and progesterone reduces anxiety-like behavior produced by nicotine withdrawal in rats

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