Morgan asks: "Is there anywhere in all this work you've all done, that might suggest that the 'nursing aversion' some mothers experience during ovulation and menstruation, has anything to do with this response?....  And, of course, many pregnant mothers state the same thing."

In regards to nursing while pregnant, Diane W. did a lactnet post awhile back asking about the feelings people experienced during nursing while pregnant. Lactnetters sent her lists of words describing the varying emotions they experienced while nursing when pregnant. We came to a conclusion based on that, that is actually posted on the FAQ page on the site. I will copy and paste that here: 
...... In regards to nursing while pregnant mothers have been interviewed on this subject and it is true that often mothers who are nursing while pregnant resonate with how D-MER is described. But it's currently the thought that most of these mothers are "annoyed" or "irritated" when they first sit down to nurse, probably because of nipple contact, and it dissipates with milk release. Unlike D-MER, in which mothers feel fine with latch on and when the milk release process is triggered their feelings emerge. It is thought that pregnant mothers handle the dopamine drop normally, and that its nipple sensitivity that prompts them to feel irritated.

I expect when Diane gets back to her email next week she will have thoughts to add, but I'll give you mine, which will be the same as hers, just not as eloquently stated!

Regarding menstrual cycles and the responses to them in general....well, face it, we have some good evidence for some stuff, but other stuff is just what has been observed with our collected sample of 200, and not all of them have taken the formal survey and most of them do not have their first postpartum period back and very few of them nursed while pregnant! D-MER often seems to self correct before the first pp period returns....or when the period returns D-MER self corrects (which comes first the chicken or the egg?!) Though a handful of mothers report that their D-MER remains with return of menses but they experience a worsening of symptoms during the week of their menses. ALSO many mothers describe the emotional response of D-MER to what they experienced during PMS or PMDD (though at a much lower intensity then they experience D-MER.) So all that being said, I think that something about the menstrual cycle is significant due to a change in symptoms one way or other (we keep working on tying estrogen in some how.) 

I am strongly apt to say that these women, that you are asking about, are experiencing a *different* hormonal/biological response at these times (ovulation, menstruation, pregnancy, PMS) I think this response has something to do with about nipple sensitivity, and *not about the MER.* D-MER seems to be triggered upon the start of lactogenesis III. Women do not start experiencing these emotions with the MER until the 1-2 weeks postpartum in about 75% of the cases observed. Which means it has nothing to do with mouth to nipple contact, nothing to do with nipple sensitivity and *everything* to do with the MER. D-MER mothers often feel fine when they start to nurse (unless their MER has been triggered before mouth/nipple contact by baby crying, undoing bra clasp etc.)  *AND they experience D-MER with spontaneous letdowns.*

Not your direct question but in regards to a mother starting to have *actual* D-MER with return of menses or when she nurses while pregnant, all in all I feel like there would have to be a serious hormonal shake up for dopamine to start behaving inappropriately after being fine for X many months, but maybe not outside the realm of possibility. 

Now to your direct question about a mother resonating with the D-MER description *only* during these times of hormonal flux? No, it's not likely to be D-MER. And it'd be interesting, if the mother still experiences spontaneous letdowns, to see if during these time of hormonal shifts, does she have the same irritation during a spontaneous letdown as she does when she nurses? My guess is she wouldn't.

I hope my rambling answers your questions!

Genuinely,
Alia

Alia Macrina Heise, CLC, PCD(DONA)
www.d-mer.org
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