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October 2007
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Oxytocin Could Relieve Persistent Genital Arousal Disorder

A study released last week found that persistent genital arousal disorder can cause a variety of other psychological symptoms, including depression, anxiety and panic attacks.

Persistent genital arousal disorder (PGAD) is also known as persistent sexual arousal syndrome (PSAS). The PGAD moniker is newer and preferred, because it reflects the latest thinking that this is a problem of genital functioning, rather than of sexual desire. The study's lead author is Sandra Leiblum, Ph.D., former President of the International Society for the Study of Women's Sexual Health. (I'll write more about her research in the future.)

You wouldn't think they'd need to do a research study to figure out that symptoms such as intense sexual desire that intrudes at inappropriate times, lasts for days and can't be relieved would cause distress.

In our  sexist and hyper-sexual society, this malady isn't taken seriously by  many in the medical establishment, according to Jennifer Berman, an MD and director of the Berman Women’s Wellness Center.  According to this article

She argues that the medical establishment—particularly, the Food and Drug Administration—has traditionally not taken female sexual complaints very seriously. Says Dr. Berman, “Their attitude is, ‘Women can’t have orgasms? Who cares? It’s not important!’ But it’s going to be important; it’s a quality of life issue.”

Randall Craig, an endocrinologist in Phoenix, says he's successfully treated two patients with PGAD-like symptoms. He hypothesizes that there are four different types of this disorder, one being "endocrine associated PSAS." According to an undated letter he posted on the PSAS Support Group, it's

characterized by minimal or absent refractory phase after orgasm or by chronically elevated sexual arousal due to a hormone related disorder.  Women in this category would have PSAS beginning at the time of menopause, or would have increased PSAS symptoms during a specific phase of the menstrual cycle (usually for a few days before the onset of the menstrual period).  The three hormones which may play a role in PSAS are progesterone, prolactin, and oxytocin.

He suggests that an insufficient oxytocin release after orgasm could be responsible for the lack of relief and the persistent arousal.

According to Dr. Craig's paper,

It is conceivable that an absent or diminished surge of oxytocin would minimize or prevent resolution of pelvic congestion, or the subjective feeling of relief.  Women with oxytocin deficiency may experience very short refractory periods after each orgasm followed by a rapid return of intense sexual arousal requiring another orgasm for relief.  Hundreds of orgasms may be needed to eventually release enough oxytocin to diminish the state of prolonged sexual arousal.

In such cases, Craig says, inhaling oxytocin could alleviate the symptoms of persistent genital arousal. I've sent Dr. Craig an email requesting more information; hopefully, he'll respond.

See also The Amazing Vagus Nerve

Neglected Kids More Likely to Be Obese

A study at Temple University found that kids who are neglected are more likely to be obese. Abuse or maltreatment, on the other hand, didn't seem to affect their weight.

Temple's Robert Whitaker looked at data from the Fragile Families and Child Wellbeing Study of nearly 5,000 children. At age three, children'sheight and weight were measured, while mothers answered a questionnaire about three types of child maltreatment in the prior year: neglect (such as not providing proper supervision for the child), corporal punishment (such as spanking the child on the bottom with a bare hand) and psychological aggression (such as threatening to spank the child but not actually doing it).

According to the article,

Eighteen percent of the children were obese, and the prevalence of any episode of neglect, corporal punishment or psychological aggression was 11 percent, 84 percent and 93 percent, respectively.

The odds of obesity were 50 percent greater in children who had experienced neglect, after controlling for the income and number of children in the household, the mothers' race/ethnicity, education, marital status, body mass index, prenatal smoking and age, and the children's sex and birth weight.

On the other hand, there was no correlation between corporal punishment or psychological aggression and overweight.

This makes sense if you look at overeating as a way to compensate for oxytocin deprivation. We tend to see overeating as a reaction to stress, which it is. But the stress of isolation is the lack of the ability to connect in an oxytocin-producing interaction with another person. (Although in prairie voles, isolated animals actually produce more oxytocin;  researchers at University of Illinois who did these experiments think this oxytocin production drives the animal to try harder to connect.  See The Amazing Vagus Nerve and The Sex/Food/Love Connection.

Eating -- or rather digesting food, especially fatty food -- sends signals from the gut to the brain via the vagus nerve. Those signals cause the hypothalamus to release oxytocin, which travels to the gut and creates the sensation of satiety.

It seems very likely that this oxytocin release also tweaks the neurons in the brain that create the pleasure in social interactions. So, it makes perfect sense that kids who are lonely for their mothers -- or for anyone to pay attention to them -- could use eating to take the place of social relationship.

The God Relationship and Oxytocin

In the blog In His Works, Eric Chua  wrote about how easily drugs can take the place of relationships with other people.  In Dr. David Eckman - What’s Good About Alcohol and Heroin, he quotes (I think) Eckman,  author of Sex, Food and God:

As an example, on the Internet there is a Web site that talks about oxytocin; it is called the love drug. We no longer need God because all we have to do is inject oxytocin. The author of the article is dead serious. He maintains that belief in God produces oxytocin, the chemical of secure and caring relationships. So forget God – just get the chemical.

(He's not talking about Hug the Monkey, by the way. I always advocate getting your oxytocin the natural, organic way: hugs, sex, puppies, hanging out with friends.)

This post doesn't make it explicit, but it sounds like Eckman sees relationship with god as equivalent to relationship with another human. I'm pretty sure that those people who have a personal relationship with god -- or a higher power as they know it -- activate the same brain circuits when they pray, meditate, think about or otherwise connect with the higher power as they do when they connect with people they're intimate with -- and obtain the same oxytocin release.

I think the key is, for this to happen, you have to really feel and believe that this other being exists.

Mirror Neurons, Oxytocin and Autism

What's the relationship between mirror neurons and oxytocin? Science isn't even clear yet on what mirror neurons do, but news from the annual meeting of the Society for Neuroscience sparks some intriguing ideas.

Mirror neurons seem to fire when we perform an action and also when we watch someone else perform it. Most studies have been done with monkeys: They map which neurons fire when the monkey grasped an apple, and saw the same neurons become active when the monkey watched someone else hold the apple.

According to the press release from the conference, several researchers presented brain imaging studies comparing mirror neuron activity between children with autism and those with normal functioning.

Jaime Pineda, PhD, at the University of California, San Diego, did studies showing that the mirror neuron system is well-developed by the time a child is seven years old. His UCSD colleague, Lindsay Oberman, used EEG to monitor mirror neuron activity in ASD kids. She found that the system did work to some extent, and she saw normal activation of the mirror neurons when the children watched videos of family members, but not of strangers.

She suggests that people with normal brain function are able to generalize that all people are "like me," and therefore to understand them and have empathy for them, while kids on the spectrum are not able to make that leap. From the press release:

This evidence for normal mirror neuron activity in autistic children may indicate that mirror system dysfunction in these cases reflects an impairment in identifying with and assigning personal significance to unfamiliar people and things, Oberman suggests. Whether deficits in relating to unfamiliar people that are characteristic of autism are the cause or the result of a dysfunctional mirror neuron system is unclear.

This leads back to the oxytocin system. Many researchers think that ASD is due to dysfunction in the oxytocin system -- something is wrong with the brain's ability to produce or respond to oxytocin in social situations. Oxytocin influences generosity, increases empathy, and alleviates some of the symptoms of autism.   

Maybe oxytocin is necessary for the mirror neurons to fire; maybe it causes them to fire in response to social cues. Or perhaps, because oxytocin and dopamine are involved in social memory -- keeping track of who my family and friends are -- it's possible that the problem is in the oxytocin system, and the lack of appropriate social memory is what's keeping the mirror neurons to trigger.

This is all speculation; none of the scientists is working on this. Because human studies are so slow, costly and laborious, it seems that it's very difficult for scientists across disciplines to connect their work.

For a more detailed discussion of the research on mirror neurons, Ed Yong of Not Exactly Rocket Science has an excellent post. See Broken chains and faulty mirrors cause problems for autistic children.

Hug Police

Alan kindly sent me a link to another story about banning hugs in school.

According to the Associated Press story, a 13-year-old girl got two days' detention for hugging one of her friends at school. Her middle school, in Mascoutah, Ill. has banned public displays of affection.

Yes, that means all displays and all kinds of affection.

This ban may be state-wide, because this incident follows another one in Oak Park, Ill.

Reading the comments to the news story bring out all the points of view and nuances of this issue. In a society which seems to have lost a common understanding of what's appropriate and what's not, we tend to default to forbidding wide swaths of behavior.

In this case, the ban on PDAs probably was  a response to kids engaging in serious make-out sessions (or whatever the kids call them these days). Leaving it to teachers' discretion on what goes too far would open the school to complaints about discrimination -- and possibly open the kids to discrimination from the teachers.

It's a sad state, but I don't blame this all on the school district.

Oxytocin Influences Generosity, Too

Paul Zak, the "neuroeconomist," is publishing a new paper showing that oxytocin influences generosity.

According to the press release,

In the research, Zak and his colleagues gave doses of oxytocin and a placebo to participants, who were then offered a blinded, one-time decision on how to split a sum of money with a stranger who could accept or reject the split. The results were overwhelming: Those given oxytocin offered 80% more money than those given a placebo.

Zak thinks this effect is due to the increased empathy people feel after they've whiffed oxytocin:

"Oxytocin specifically and powerfully affected generosity using real money when participants had to think about another's feelings," Zak explains. "This result confirms our earlier work showing that oxytocin affects trust, but with a dramatically larger effect for generosity."

Zak is head of the neuroeconomics program at Claremont Graduate University -- and he's taken the lead in human studies of oxytocin. He's actually an economist, not a neuroscientist, but his work is truly breaking new ground in our understanding of how we relate to others.

Here's the study on PLoS. You can listen to a podcast interview with him here:

A Birth Story from Singapore

Rani shares the story of the birth of Kei, her second child, in this pretty amazing post, Kei's Birth 2 - The Day.

Rani had a hospital birth in Singapore, and it sounds like her doctor and hospital were very enlightened. They were able to book a suite with a jacuzzi, and her doctor was supportive of her desire to have a drug-free delivery.

Her account is really vivid and full of nice little details, from her decision to stay home until the contractions were stronger because the hospital didn't have wifi to the sensations as Kei moved through the birth canal. Rani was obviously very well-prepared, knew what to expect and did everything she could to ensure the bonding process with her new baby would begin right away.

I wish young girls all over could read stories like hers, so they'd know what birth could be like.