Women have lower quit rates in smoking cessation than men. There are several factors suggested which are relevant to women's difficulties in smoking programs. One factor cited is the problem that women experience during withdrawal. Similar physiological and psychological symptoms are reported after smoking cessation and during menstrual cycle changes. In this study we evaluated the association between withdrawal and reports of menstrual distress. Results showed that a significant correlation existed between menstrual distress symptoms and initial smoking withdrawal symptoms. Women who quit smoking in the last phase (Phase 2) of their menstrual cycle experienced greater withdrawal than those who quit in the early phase (Phase 1) of the cycle. When these results were compared with male quitters, the Phase 2 women experienced significantly greater withdrawal than males. These results suggest that women may have specific biological needs that should be addressed in smoking treatment programs.