--- title: Is dysphoric milk ejection reflex similar to PMDD? | Niyora description: Dysphoric milk ejection reflex is a condition where women feel sad, anxious, or agitated when breastfeeding for up to 5 minutes at a time. It affects 6-27% of url: https://niyora.com/research/papers/defining-dysphoric-milk-ejection-reflex-using-premenstrual-dysphoric-disorder-as-2025/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Is dysphoric milk ejection reflex similar to PMDD? Survey study, 2025 # Is dysphoric milk ejection reflex similar to PMDD? Dysphoric milk ejection reflex is a condition where women feel sad, anxious, or agitated when breastfeeding for up to 5 minutes at a time. It affects 6-27% of breastfeeding women and may be caused by hormonal changes, similar to PMDD. Early or limited evidence Women with dysphoric milk ejection reflex during breastfeeding. ## What they did Reviewed existing research on dysphoric milk ejection reflex and PMDD to propose using PMDD's diagnostic framework to better classify and study dysphoric milk ejection reflex. ## What they found Dysphoric milk ejection reflex and PMDD share key features - both are linked to hormonal changes, both have variable symptoms, and both happen on a predictable schedule. Dysphoric milk ejection reflex causes brief mood changes during milk letdown, lasting up to 5 minutes. Currently, dysphoric milk ejection reflex is not formally classified in diagnostic manuals like PMDD now is. ## What it means for you Dysphoric milk ejection reflex is a real condition that could benefit from formal recognition and study, like PMDD. This could help researchers understand the cause and find treatments. The main limitation is that this is a proposal for how to classify the condition, not a definitive answer - actual studies testing this are still needed. 6-27% Prevalence among breastfeeding women 5 minutes Typical symptom duration ## About the study Original title Defining Dysphoric Milk Ejection Reflex: using Premenstrual Dysphoric Disorder as a framework for proposing preliminary diagnostic criteria Authors Howard M, Davoudian T, Cirino NH Journal Frontiers in psychiatry Year 2025 Study design Survey study Open access Yes Read the paper [doi.org/10.3389/fpsyt.2025.1694844](https://doi.org/10.3389/fpsyt.2025.1694844) Original abstract Dysphoric Milk Ejection Reflex (D-MER) is a distinct neurobiological condition characterized by negative alterations in mental state in response to milk letdown during lactation. Symptoms vary by patient and can include feelings of sadness, anxiety or agitation. Importantly, the symptoms are brief, typically lasting no more than 5 minutes. Prevalence has been found between 6 and 27% of lactating women, but studies show heterogeneity, due in part to inconsistent definition. D-MER is not currently classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD), which presents a challenge for researchers of the condition. The pathophysiology of D-MER is not well understood, but may be mediated by hormonal changes. In an attempt to begin to formalize classification of this condition, the authors explore the association with another recently classified, hormonally mediated and time sensitive condition: premenstrual dysphoric disorder or PMDD. Like D-MER, PMDD is characterized by heterogeneous symptoms that occur on a predictable timeline. The recent addition of a formal diagnostic category into the DSM helped facilitate an expansion of research into etiology and treatment of the condition. This paper will explore a pathway to classification of D-MER based on the current research using the framework of the DSM-5 diagnostic criteria for PMDD. We will conclude by outlining future research priorities that will help to better define this condition and differentiate it from other causes of emotional distress during lactation. Reproduced under CC-BY. ## Topics [Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[Pregnancy and postpartum](https://niyora.com/research/topics/comorbidity-postpartum/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Systematic review, 2026 Why do some women experience mood changes linked to their menstrual cycle? Cohort study, 2025 Do women with a history of PMS or PMDD have more depression during pregnancy and after birth? Case-control study, 2024 Do steroid hormone levels change differently across the menstrual cycle in women with PMDD? Review, 2023 What treatments help mental and physical health problems linked to the menstrual cycle? Cohort study, 2023 Is PMDD a valid medical diagnosis? Survey study, 2022 What causes PMS and PMDD and what new treatments are being studied? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗