A Paradoxical Reaction to Oxytocin?

A new blog from Alia Macrina Heise identifies a syndrome she calls depressive milk ejection reflex, or D-MER. She defines it thus:

"Depressive Milk Ejection Reflex is a condition that causes a prodromal effect of negative emotions that emerge only before the milk ejection reflex, or letdown, in a lactating mother."

According to her blog, she's the mother of three -- and a lactation counselor. Although breastfeeding is supposed to be a peak experience -- deeply rewarding, sensual and soothing, thanks to oxytocin -- she experienced something quite different.

Go to her blog, D-MER.org, to read more about her experiences and those of other women.

One theory Alicia has for the cause of this syndrome, which involves discomfort and depression during breastfeeding, is a paradoxical reaction to oxytocin. A paradoxical reaction is when someone has not the expected reaction to a drug, but a different one, often the opposite.

I would guess that, rather than a paradoxical reaction to oxytocin, D-MER might be caused by an excess of prolactin. Prolactin is involved in milk letdown, but it's also involved in sexual satiety. It's the hormone, released at orgasm, that tells our bodies we've had enough sex, so give it a rest.

People sometimes talk about a feeling of letdown following sex, a sense of depression and even of distaste for one's partner. I think this, too, is the result of a bit too much of prolactin's satiating ability. It makes sense to me that an excess of prolactin, or too intense a response to its effects, could be the cause of D-MER.

Here are studies indicating prolactin's effect on sexual satiety:

Krueger, Tilmann H.C.; Haake, Philip; Hartmann, Uwe; Schedlowski, Manfred; and Exton, Michael S., Orgasm-induced prolactin secretion: feedback control of sexual drive? (Neuroscience and Biobehavioral Reviews 26 2002) 31-44)

Krueger, Tilmann H.C.; Haake, Philip; Haverkamp, J.; Krämer, M .; Exton, Michael S.; Saller, B; Leygraf, N.; Hartmann, Uwe; and Schedlowski, Manfred, Effects of acute prolactin manipulation on sexual drive and function in males (Journal of Endocrinology (2003) 179, 357–365)

Comments

[Alia Macrina Heise]

Hi Susan, Alia here from D-MER.org. I came across your post about D-MER and I wanted to say hello and introduce myself.
I wanted to address your prolactin theory quickly. As far as prolactin goes, in short: The D-MER coincides roughly with OT release and not at all with prolactin release. It's just way too out of synch for prolactin to be considered as a player in D-MER, at least at this point. And it's too much *in* synch with OT release for OT *not* to be considered a player. Prolactin spikes 45 minutes after breastfeeding, OT spikes with breastfeeding.

Thank you for your thoughts and I hope you'll add more!

[Alia Macrina Heise]

I wanted to update you on our investigation of D-MER and let you know that oxytocin isn't involved in the mechanism of D-MER (after all!) Turns out to be an inappropriate drop in dopamine. Dopamine has to drop so prolactin can start it's slow rise, but in D-MER mothers the drop of dopamine is not as is should be, causing the negative emotional reaction. The website has been updated with the details. Thought you'd like to know that oxytocin is innocent still after all! Cheers, Alia

[Susan Kuchinskas]

Thanks for the update, Alia. I'm glad that my fave neurochemical is not at fault. And I love it that real women have not only identified this syndrome, but figured it out.

You can read more (although Alia doesn't give up her refs in advance of writing a paper) here: http://www.d-mer.org/